Cardiovascular

Front 1

Which sound is closer to S2, mid-diastolic, low-pitched, described as a gallop, S3 or S4?

Back 1

S3

Front 2

S3 or S4: Which is closer to S1, late diastolic, higher pitch, described as a triple gallop?

Back 2

S4

Front 3

S3 or S4? Caused by decreased ventricular compliance, like in aortic stenosis, mitral regurgitation, HTN, angina, MI, and old age

Back 3

S4

Front 4

S3 or S4? Can be caused physiologically by rapid filling during diastole such as what happens in increased cardiac output (thyrotoxicosis, pregnancy, pediatric)

Back 4

S3

Front 5

What are some causes of a pathological S3? (causes of decreased compliance of the ventricle)

Back 5

Ventricular failure or dilation, aortic regurgitation, mitral regurg, patent ductus arteriosus, ventricular septal defect, constrictive pericarditis

Front 6

T/F a physiological murmur is heard when there is an increased turbulence of blood flow across an abnormal valve.

Back 6

False: A physiological murmur is heard when there is an increased turbulence of blood flow across an normal valve.

A pathologic murmur occurs when there is turbulence across an abnormal valve due to stenosis or regurgitation.

Front 7

Which group of murmurs have their highest intensity in the middle of systole, have a crescendo-decrescendo quality?

Back 7

midsystolic ejection murmurs

Front 8

Which group of murmurs occur when there is a gap between S1 and the murmur and can be caused by MR as in the case of papillary muscle dysfunction or MVP?

Back 8

Late systolic murmurs

Front 9

These murmurs extend from S1 to S2, pitch and loudness stay the same, caused by leakage from a high-pressure chamger to low, causes include MR, TR and ventricular septal defect

Back 9

Pansystolic murmurs

Front 10

These murmurs are always pathological, are softer and more difficult to hear than their counterpart

Back 10

Diastolic murmurs

Front 11

These murmurs start with S2 and are a decrescendo murmur, loudest at its commencement, producing a high-pitched sound. Causes include AR or PR.

Back 11

Early diastolic murmurs

Front 12

These murmurs occur in the later phase of diastole, they are lower in pitch, can be caused by MS or TS or atrial myoma (rare).

Back 12

mid-diastolic murmur

Front 13

These murmurs occur during both systole and diastole without pause. Causes include patent ductus arteriosus, atrteriovenous fistula, and venous hum.

Back 13

Continuous murmurs

Front 14

Which murmur grade is the quietest accompanied by a thrill? Pathological or not?

Back 14

4, pathological

Front 15

Which murmur grade is so loud that it is audible even without direct placement of the stethoscope to the chest?

Back 15

6

Front 16

T/F A mid-systolic murmur in an asymptomatic individual is most likely physiological.

Back 16

True

Front 17

T/F the intensity of the murmur doesn't always correlate to the severity of the lesion

Back 17

True (small lesions can be loud)

Front 18

T/F Murmurs of grade 2 and above are usually pathological

Back 18

False (grade 3 and above)

Front 19

Palpation of the pulse while listening to the heart can help discern S1 from S2:

T/F The pulse indicates diastole, therefore corresponding to the 2nd heart sound

Back 19

False: The pulse indicates systole, therefore corresponding to the 1st heart sound

Front 20

Which area do you want to listen to with both the bell and diaphragm of the stethoscope and why?

Back 20

Mitral area because low-pitched sounds like MS and S3 can be heard better with the bell while
S4 and MR can be heard better with the diaphragm (higher-pitched)

Front 21

Inspiration cause right or left sided murmurs to accentuate

Back 21

right-sided

Front 22

Expiration cause right or left sided murmurs to accentuate

Back 22

Left-sided

Front 23

Auscultating during deep expiration with the patient leaning forward will accentuate what murmur

Back 23

aortic regurgitation

Front 24

The valsalva maneuver will accentuate these murmurs

Back 24

hypertrophic cardiomyopathy and MVP when listening over the left sternal edge

Front 25

Squatting increases venous return which will make which murmurs louder

Back 25

those associated with AS and MR

Front 26

Squatting makes these murmurs softer

Back 26

hypertrophic cardiomyopathy and MVP

Front 27

MR PASS MVP means

Back 27

mitral regurgitation

physiologic

aortic stenosis

systolic

Mitral valve prolapse

Front 28

MS ARD means

Back 28

Mitral stenosis

Aortic regurgitation

Diastolic

Front 29

A person with clinical significant aortic stenosis can be SAD (symptoms of AS are...)

Back 29

syncope, angina, dyspnea

Front 30

When assessing JVD, the IJV and carotid both pulsate. If you note the pulsation of the radial pulse matches one of these vessel's pulsation, then you have found which?

Back 30

the carotid artery