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Clin Med Exam 1 (Shelby) > Valvular Disease > Flashcards

Valvular Disease Flashcards

1
Q

What is the first line treatment for the management of ACUTE mitral regurgitation

A

IV nitroprusside

Prep for surgery

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2
Q

What would cause supravalvular aortic stenosis

A

Congenital or post-operative

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3
Q

When do you hear a murmur associated with pulmonic stenosis

A

Mid systolic

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4
Q

What is the treatment for chronic aoritc regurgitation

A

Vasodilators (reduce regurgitant volume + increase ejection fraction)

Specifically ACE inhibitors are most helpful

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5
Q

What is the management for mitral steonisis if they also have A FIB or a history of emboli or significant left atrial enlargement

A

Warfarin (INR 2-3)

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6
Q

What is a “water hammer” or “corrigan pulse”

A

Wide pulse pressue asscoated with aortic regurgitation

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7
Q

What is the character of the murmur associated with aortic stenosis

A

Crescendo-decrescendo

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8
Q

Papillary muscle dysfunction post-MI can lead to what valve disorder

A

Mitral regurgitation

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9
Q

What position can you put the patient in to better hear tricuspid regurgitation

A

Inspiration

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11
Q

When do you hear a murmur assocated with tricuspid regurgitation

A

Pan-systolic

Allll of the systole

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12
Q

Which is more common, acute or chronic aortic regurgitation

A

Chronic

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13
Q

What is the management for mitral valve prolapse

A

Life style changes

**if arrhythmia = beta blockers

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15
Q

What are triggers for symptoms for mitral stenosis

A
  1. Sudden exertion
  2. Excitement
  3. Fever
  4. Severe anemia
  5. Tachycardia
  6. Sexy time
  7. Preggo
  8. Thyrotoxicosis
  9. A fib

***bolded on the slides

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16
Q

Low pitch “rumble”, S1 accentuated, opening snap after S2 diastolic murmur heard at the apex

A

Mitral Stenosis

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17
Q

Where do you hear tricuspid regurgitation best

A

LLSB

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18
Q

When is a hypertrophic cardiomyopathy murmur louder, with valsalva or squatting

A

Valsalva

Which is opposite of valvular aortic stenosis

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19
Q

When do you hear a murmur associated with mitral stenosis

A

Mid-late diastole

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20
Q

What would cause subvalvular aortic stenosis

A

Congenital or

Hypertrophic cardiomyopathy

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21
Q

When do you hear a murmur associated with aortic regurgitation

A

Diastole

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23
Q

Where do you hear pulmonic regurgitation best

A

2 LICS

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24
Q

If someone has mild, asymptomatic aortic stenosis, what is the treatment?

A

Educate about symptoms

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25
Q

What is the treatment for chronic mitral regurgitation

A
  1. ACE inhibitors
  2. Vasodilators
  3. Diuretics
  4. Digitalis
  5. Warfarin (INR = 2-3)
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26
Q

What is the treatment for acute aortic regurgitation

A

Urgent cardiology consult

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27
Q

Which murmur is the MOST associated with rheumatic disease

A

Mitral stenosis

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29
Q

Which murmur can often radiate to the neck

A

Aortic stenosis

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30
Q

When do you hear a murmur associated with aortic stenosis

A

Mid systolic

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31
Q

Medium pitch, blowing, radiates to right sternum and xiphoid pansystolic murmur heard best at LLSB

A

Tricuspid regurgitation

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32
Q

What are the benefits and downsides to tissue valves for aortic stenosis

A

Benefit: no warfarin
Downside: does not last as long

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33
Q

With chronic aortic regurg, patients will eveltually develop signs of:

A

Heart failure

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34
Q

If someone has a prosthetic valve to treat aortic stenosis, what are the benefits and downsides?

A

Benefit: lasts longer
Downside: life long warfarn

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35
Q

Where do you hear pulmonic stenosis best

A

2-3 LICS

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36
Q

Where do you hear aortic regurgitation best

A

2-4 LICS

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37
Q

When do you hear a murmur associated with mitral regurgitation

A

Pansystolic

Alllll of systole

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38
Q

Where do you hear aortic stenosis best

A

2 RICS

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39
Q

Medium pitch, harsh, radiates to left should and neck mid-systolic murmur heard best at 2nd-3rd LICS

A

Pulmonic Stenosis

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40
Q

Which murmurs are associated with being pan-systolic

A

Mitral and tricsupid REGURGITATION

41
Q

S4 gallop makes you think:

A

Pulmonary hypertension

41
Q

What position can you put the patient in to better hear pulmonic regurgitaiton

A

Inspiration

43
Q

If someone has moderate, asymptomatic aortic stenosis, what is the treatment?

A

Annual check up

44
Q

“Opening snap followed by mid-diastolic rumbling murmur”

A

Mitral stenosis

45
Q

High pitch, blowing, secrescendo, radiates to apex diastolic murmur heard and the 2nd-4th LICS

A

Aortic regurgitation

46
Q

What abnormality could you potentially see on a CXR of someone with aortic stenosis

A

Post-stenotic dilation of aorta

47
Q

What is the most common cause of mitral stenosis

A

Rhematic heart disease BY FAR

48
Q

What is an Austin-Flint murmur?

A

Soft, low-pitched doastolic murmur at the apex which sounds like a mitral stenosis murmur

50
Q

Low pitch, may have opening snap, mid-late diastolic murmur heard best at LLSB

A

Tricuspid stenosis

51
Q

What do you see on an echo of aortic stenosis

A

Immobile, calcifed leaflets

52
Q

What are the two types of prosthetic aortic valves

A

Ball and cage

Tilting valve

53
Q

Which valve disease is assocated with a SMALL pulse pressure

A

Aortic stenosis

54
Q

What happens to the valves with rheumatic heart disease

A

Diffusely thickened due to fibrous tissue/calcium deposits

Leaflets = immobilized and rigid

55
Q

Aortic stenosis patient education 3 major things

A

Avoid STRENUOUS activity
Avoid dehydration
Pay attention to signs of worsening disease aka symptoms

56
Q

In what position is mitral stenosis best heard

A

Left lateral decubitus position

At the apex with the bell

58
Q

Where do you hear tricuspid stenosis best

A

LLSB

59
Q

What are two etiologies for acute aortic regurgitations

A

Aortic dissection

Infective endocarditis

60
Q

What is the best diagnostic study for valvular disorders

A 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO 
ECHO ECHO ECHO ECHO
61
Q

When is someone indicated for surgery with aortic stenosis

A

SYMPTOMATIC OR SEVERE

62
Q

Medium to high pitch, blowing, radiates to left axilla pansystolic murmur heard best at the apex

A

Mitral Regurgitation

63
Q

What position can you put the patient to best hear aortic stenosis

A

Patient sitting, leaning forward

Squatting

64
Q

Which murmur is associated with “RUMBLING”

A

Mitral stenosis

64
Q

MId-late systolic click (left) =

A

Mitral valve prolapse

65
Q

Which valve disease has sxs usually due to pulmonary congestion

A

Mitral stenosis

66
Q

Where do you hear mitral stenosis best

A

Apex

67
Q

What is the management of SYMPTOMATIC aoritc stenosis

A

Cardiac catherization

Valve replacement may be needed

67
Q

What is the treatment for mitral stenosis if they have mild symptoms only

A

Diuretics

Stop eating so much salt

68
Q

Mitral valve prolapse can lead to what other valve disorder

A

Mitral regurgitation

69
Q

What is the treatment for tricuspid and pulmonic valve disorders

A

Sodium restriction
Diuretics
Surgical repair or replacement

70
Q

High pitch, blowing, descrescendo early diastolic murmur heard best at 2nd LICS

A

Pulmonic Regurgitation

71
Q

Medium pitch, harsh, crescendo-decrescendo systolic murmur at the 2nd RICS that radiates to the neck

A

Aortic Stenosis

71
Q

If someone has aortic stenosis and is between the ages of 30-65, what is the most likely cause?

A

Congenital bicuspid valve which becomes calcified and stenotic

Also rhematic valve disease

71
Q

What are the 3 surgiers for mitral stenosis

A

Valvuloplasty
Mitral commisurotomy
Prosthetic valve

72
Q

When do you hear a murmur associated with pulmonic regurgitation

A

Early distaole

72
Q

What is the main etiology for aortic regurgitation

A

Rheumatric valvular disease

Connective tissues diease (RA, Mafran, Ehler-Danlos)

73
Q

“Abnormalities of valve leaflets” make you think of what valve disease

A

Mitral regurgitation

74
Q

What position can you put the patient in to better hear tricuspid stenosis

A

Increases with inspiration

Squatting

75
Q

Rheumatic heart disease makes me think of which valve diseases

A

Aortic regurgitation
Aortic Stenosis
Mitral regurgitation
Mitral Stenosis

76
Q

Where do you hear mitral regurgitation best?

A

Apex

77
Q

When do you hear a murmur associated with tricuspid stenosis

A

Mid-late diastole

79
Q

Huge left atrium with left ventricular hypertrophy is a severe consequence of which valve disease

A

Mitral regurgitation

80
Q

If someone has aortic stenosis and is under the age of 30, what is the most likely cause?

A

Unicuspid valve

81
Q

What is the aortic stenosis triad

A

Angina
Syncope
Heart failure

82
Q

What is the INR range for someone with a prostehtic valve from aortic stenosis

A

2.5-3.5

83
Q

A mitral stenosis murmur can also sound like what other type of murmur

A

Austin-Flint murmur

84
Q

Wide pulse pressure makes you think of what valve disease

A

Aortic regurgitation

84
Q

Which valve disorer is a pretty common condition, up to 2.5% of the general population

A

Mitral valve prolapse

85
Q

Mitral stenosis is commonly associated with what other cardiac abnormality

A

ATRIAL FIBRILLATION

86
Q

What murmurs could produce an “opening snap” sound

A

Mitral or tricuspid STENOSIS

87
Q

“Radiates to the axilla” + “pansystolic murmur” =

A

Mitral regurgitation

88
Q

If a patient has mitral stenosis, what other thing do 40-50% of patients also have?

A

A fib

92
Q

What position can you put the patient in to better hear aortic regurgitation

A

Patient sitting, leading forward, full exhalation

Clin Med Exam 1 (Shelby) (10 decks)

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