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79 Cards in this Set
- Front
- Back
WHY DO WE USE THE TERM HEART FAILURE NOW INSTEAD OF CONGESTIVE HEART FAILURE?
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BECAUSE NOT ALL PATIENTS WITH HEART FAILURE HAVE VOLUME OVERLOAD ON INITIAL PRESENTATION
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CLASSIC EXERTIONAL PAIN, PRESSURE, OR DISCOMFORT IN THE CHEST, SHOULDER, BACK, NECK, OR ARM IS SEEN IN 50% OF PATIENTS WITH THIS CONDITION
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ANGINA PECTORIS
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WHAT IS THE ANNIAL INCIDENCE OF EXERTIONAL ANGINA IN THE POPULATION 30 AND OVER?
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1 PER 1000
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ACUTE CORONARY SYNDROME
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USED TO REFER TO ANY OF THE CLINICAL SYNDROMES CAUSED BY ACUTE MYOCARDIAL ISCHEMIA INCLUDING UNSTABLE ANGINA, NON ST ELEVATION MI, AND ST ELEVATION INFARCTION
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TERM USED TO REFER TO ANY OF THE CLINICAL SYNDROMES CAUSED BY ACUTE MYOCARDIAL ISCHEMIA, INCLUDING UNSTABLE ANGINA, NON ST ELEVATION MI, AND ST ELEVATION INFARCTION
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ACUTE CORONARY SYNDROME
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ANTERIOR CHEST PAIN, OFTEN TEARING OR RIPPING, OFTEN RADIATING INTO THE BACK OR NECK IN WHAT CONDITION?
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ACUTE AORTIC DISSECTION
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SYMPTOMS OR SIGNS OF IRREGULAR HEART ACTION WARRANT WHAT?
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AN EKG
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WHAT IS THE ONLY IRREGULAR HEART ACTION THAT CAN BE DETECTED BEDSIDE?
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ATRIAL FIBRILLATION- IRREGULARLY IRREGULAR
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YOU MAY SEE SUDDEN DYSPNEA IN WHAT CONDITIONS?
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PULMONARY EMBOLUS, SPONTANEOUS PNEUMOTHORAX, ANXIETY
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WHAT CONDITIONS MAY CAUSE ORTHOPNEA?
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LEFT VENTRICULAR HEART FAILURE OR MITRAL STENOSIS; ALSO SEEN IN OBSTRUCTIVE LUNG DISEASE
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WHAT CONDITIONS MIGHT YOU SEE PND (PAROXYSMAL NOCTURNAL DYSPNEA) IN?
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IN LEFT VENTRICULAR HEART FALURE OR MITRAL STENOSIS; MAY BE MIMICKED BY NOCTURNAL ASTHMA ATTACKS
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WHERE DOES DEPENDENT EDEMA APPEAR?
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APPEARS IN THE LOWEST BODY PARTS--THE FEET AND LOWER LEGS WHEN SITTING; OR THE SACRUM WHEN BEDRIDDEN
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CAUSES OF DEPENDENT EDEMA
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CAUSES MAY BE CARDIAC (CHF0, NUTRITIONAL (HYPOALBUMINEMIA), OR POSITIONAL
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YOU MAY SEE PERIORBITAL PUFFINESS AND TIGHT RINGS ON FINGERS IN WHAT CONDITION
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NEPHROTIC SYNDROME
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AN ENLARGED WAISTLINE COULD BE FROM WHAT?
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ASCITES OR LIVER FAILURE
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EDEMA
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ACCUMULATION OF EXCESSIVE FLUID IN THE EXTRAVASCULAR INTERSTITIAL SPACE
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IF A PATIENT REPORTS TRANSIENT SKIPS AND FLIP FLOPS WHAT MIGHT THAT INDICATE?
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PREMATURE CONTRACTIONS
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RAPID REGULAR BEATING OF SUDDEN ONSET AND OFFSET MAY INDICATE WHAT?
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PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA
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A RAPID REGULAR RATE OF LESS THAN 120 BEATS PER MINUTE, ESPECIALLY IF STARTING AND STOPPING MORE GRADUALLY, WHAT IS THE POSSIBLE CAUSE?
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POSSIBLY SINUS TACHYCARDIA
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HOW MIGHT YOU HAVE TO POSITION A HYPOVOLEMIC PATIENT BEFORE YOU CAN SEE THE NECK VEINS?
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MAY HAVE TO LIE FLAT BEFORE YOU CAN SEE THEM
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WHEN JUGULAR VENOUS PRESSURE IS INCREASED, WHAT ELEVATION MAY BE REQUIRED TO SEE THE NECK VEINS?
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AN ELEVATION UP TO 60 OR EVEN 90 DEGREES MAY BE REQUIRED
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INCREASED JUGULAR VENOUS PRESSURE SUGGESTS WHAT?
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RIGHT SIDED CONGESTIVE HEART FAILURE AND LESS COMMONLY, CONSTRICTIVE PERICARDITIS, TRICUSPID STENOSIS, OR SUPERIOR VENA CAVA OBSTRUCTION
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IN PATIENTS WITH THIS CONDITION, VENOUS PRESSURE MAY APPEAR ELEVATED ON EXPIRATION ONLY?
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OBSTRUCTIVE LUNG DISEASE (THE VEINS WILL COLLAPSE ON INSPIRATION)
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A ELEVATED JVP IS 98% SPECIFIC FOR WHAT?
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AN INCREASED LEFT VENTRICULAR END DIASTOLIC PRESSURE AND LOW LEFT VENTRICULAR EJECTION FRACTION, AND IT INCREASED THE RISK OF DEATH FROM HEART FAILURE
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WHAT IS THE USUAL CAUSE OF UNILATERAL DISTENTION OF THE EXTERNAL JUGULAR VEIN?
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LOCAL KINKING OR OBSTRUCTION
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PROMINENT A WAVES MAY BE SEEN WHEN?
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IN INCREASED RESISTANCE TO RIGHT ATRIAL CONTRACTION, AS IN TRICUSPID STENOSIS; ALSO IN FIRST DEGREE AV BLOCK, SUPRAVENTRICULAR TACHYCARDIA, JUNCTIONAL RHYTHMS, PULMONARY HYPERTENSION, AND PULMONIC STENOSIS
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ABSENT A WAVES IN WHAT CONDITION?
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ATRIAL FIBRILLATION
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LARGE V WAVES IN WHAT CONDITIONS?
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TRICUSPID REGURGITATION, CONSTRICTIVE PERICARDITIS
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A TORTUOUS AND KINKED CAROTID ARTERY MAY PRODUCE WHAT?
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A UNILATERAL PULSATILE BULGE
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CAUSES OF DECREASED CAROTID PULSATION INCLUDE WHAT?
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DECREASED STROKE VOLUME AND LOCAL FACTORS IN THER ARTERY SUCH AS ATHEROSCLEROTIC NARROWING OR OCCLUSION
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WHAT CAN PRESSURE ON THE CAROTID SINUS CAUSE?
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A REFLEX DROP IN PULSE RATE OR BLOOD PRESSURE
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WHAT WILL THE PULSE BE LIKE IN CARDIOGENIC SHOCK?
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SMALL, THREADY, OR WEAK
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THERE WILL BE DELAYED CAROTID UPSTROKE IN WHAT CONDITION?
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AORTIC STENOSIS
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AN AORTIC VALVE MURMUR MAY RADIATE WHERE?
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TO THE NECK AND SOUND LIKE A CAROTID BRUIT
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S1 IS DECREASED IN WHAT CONDITION?
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FIRST DEGREE HEART BLOCK
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S2 IS DECREASED IN WHAT?
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AORTIC STENOSIS
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THRILLS MAY ACCOMPANY LOUD, HARSH, OR RUMBLING MURMURS SUCH AS (4)
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AORTIC STENOSIS, PATENT DUCTUS ARTERIOSUS, VENTRICULAR SEPTAL DEFECT, AND LESS COMMONLY MITRAL STENOSIS
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DEXTROCARDIA
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WHEN THE PATIENT'S HEART IS ON THE RIGHT SIDE
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SITUS INVERSUS
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THE LIVER, HEART, AND STOMACH ARE ALL ON OPPOSITE SIDES FROM NORMAL
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WHAT IS A RIGHT SIDED HEART WITH A NORMALLY PLACE LIVER AND STOMACH NORMALLY ASSOCIATED WITH?
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CONGENITAL HEART DISEASE
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PREGNANCY OR A HGH LEFT DIAPHRAGM MAY DISPLACE THE APICAL IMPULSE WHERE?
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UPWARD AND TO THE LEFT
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THE APICAL IMPULSE CAN BE DISPLACED LATERALLY FROM WHAT CONDITIONS?
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CARDIAC ENLARGEMENT IN CHF, CARDIOMYOPATHY, ISCHEMIC HEART DISEASE
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WHAT DOES LATERAL DISPLACEMENT OUTSIDE THE MIDCLAVICULAR LINE INCREASE THE LIKELIHOOD OF?
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CARDIAC ENLARGEMENT AND A LOW LEFT VENTRICULAR EJECTION FRACTION BY 3-4 AND 10, RESPECTIVELY
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IN THE LEFT LATERAL DECUBITUS POSITION, A DIFFUSE PMI WITH A DIAMETER GREATER THAN 3 CM INDICATES WHAT?
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LEFT VENTRICULAR ENLARGEMENT
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INCREASED AMPLITUDE OF IMPULSES MAY ALSO REFLECT WHAT?
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HYPERTHYROIDISM, SEVERE ANEMIA, PRESSURE OVERLOAD OF THE LEFT VENTRICLE (AS IN AORTIC STENOSIS0, OR VOLUME OVERLOAD OF THE LEFT VENTRICLE (AS IN MITRAL REGURGITATION)
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A SUSTAINED, HIGH AMPLITUDE IMPULSE THAT IS NORMALLY LOCATED SUGGESTS WHAT?
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LEFT VENTRICULAR HYPERTROPHY FROM PRESSURE OVERLOAD (AS IN HYPERTENSION)
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IS A SUSTAINED HIGH AMPLITUDE IMPULSE IS DISPLACED LATERALLY, CONSIDER WHAT?
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VOLUME OVERLOAD
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A SUSTAINED LOW AMPLITUDE (HYPOKINETIC) IMPULSE MAY RESULT FROM WHAT?
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DILATED CARDIOMYOPATHY
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BRIEF MIDDIASTOLIC IMPULSE INDICATES WHAT?
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AN S3
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AN IMPULSE JUST BEFORE THE SYSTOLIC APICAL BEAT ITSELF INDICATES WHAT?
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AN S4
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A MARKED INCREASE IN AMPLITUDE WITH LITTLE OR NO CHANGE IN DURATION OCCURS IN WHAT SITUATIONS?
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IN CHRONIC VOLUME OVERLOAD OF THE RIGHT VENTRICLE, AS FROM ATRIAL SEPTAL DEFECT
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AN IMPULSE WITH INCREASED AMPLITUDE AND DURATION OCCURS WITH PRESSURE OVERLOAD OF THE RIGHT VENTRICLE DUE POSSIBLY TO WHAT CONDITIONS?
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PULMONIC STENOSIS OR PULMONARY HYPERTENSION
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WHERE IS THE IMPULSE FELT EASILY IN PATIENTS WITH OBSTRUCTIVE PULMONARY DISEASE?
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HIGH IN THE EPIGASTRIUM WHERE HEART HEART SOUNDS ARE OFTEN HEARD BEST; THE HYPERINFLATED LUNGS, WILL HOWEVER, PREVENT PALPATION OF AN ENLARGED RIGHT VENTRICLE IN THE LEFT PARASTERNAL AREA
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WHAT CONDITION MIGHT MAKE THE APICAL IMPULSE UNDETECTABLE?
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LARGE PERICARDIAL EFFUSION
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WHAT TYPE OF APICAL PULSE MIGHT BE FOUND IN A MARKEDLY DILATED FAILING HEART?
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A HYPOKINETIC APICAL IMPULSE THAT IS DISPLACED FAR TO THE LEFT
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WHAT DOES A PALPABLE S2 IN THE RIGHT 2ND INTERSPACE SUGGEST?
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SYSTEMIC HYPERTENSION
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A PULSATION IN THE RIGHT 2ND INTERSPACE SUGGESTS WHAT?
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A DILATED OR ANEURYSMAL AORTA
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A PROMINENT PULSATION IN THE LEFT 2ND INTERSPACE OFTEN MEANS WHAT?
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DILATION OR INCREASED FLOW IN THE PULMONARY ARTERY
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WHAT DOES A PALPABLE S2 IN THE LEFT 2ND INTERSPACE SUGGEST?
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PULMONARY HYPERTENSION
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WHAT SHOULD BE USED TO DESCRIBE WHERE MURMURS ARE BEST HEARD?
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ANATOMICAL LOCATION WHERE THEAN VLAVE AREA
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WHAT POSITION ACCENTUATES OR BRINGS OUT A LEFT SIDED S3 OR S4 AND MITRAL MURMUR, ESPECIALLY MITRAL STENOSIS?
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THE LEFT LATERAL DECUBITUS POSITION
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SITTING UP, EXHALING COMPLETELY, AND STOPPING BREATHING ON EXHALATION WILL WILL BRING OUT WHAT MURMURS?
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AORTIC MURMURS, ESP. AORTIC REGURGUTATION (SOFT DIASTOLIC MURMUR IN THIS POSITION)
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WHAT DO DIASTOLIC MURMURS NORMALLY INDICATE?
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VALVULAR HEART DISEASE
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SYSTOLIC MURMURS MAY INDICATE WHAT?
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VALVULAR DISEASE BUT OFTEN OCCUR WHEN THE HEART VALVES ARE NORMAL
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WHAT NORMALLY IS TEH CAUSE OF MIDSYSTOLIC MURMURS>
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BLOOD FLOW ACROSS THE SEMILUNAR (AORTIC AND PULMONIC) VALVES
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WHAT IS NORMALLY THE CAUSE OF PANSYSTOLIC MURMURS?
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REGURGITANT FLOW ACROSS THE ATRIOVENTRICULAR VALVES
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EARLY DIASTOLIC MURMURS NORMALLY ARE CAUSED BY WHAT?
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REGURGITANT FLOW ACROSS INCOMPETENT SEMILUNAR VALVES
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A CRESCENDO MURMUR
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ONE THAT GROWS LOUDER
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A DECRESCENDO MURMUR
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ONE THAT GROWS SOFTER
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A CRESCENDO-DECRESCENDO MURMUR
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FIRST RISES IN INTENSITY AND THEN FALLS
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A PLATEAU MURMUR
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SAME INTENSITY THROUGHOUT
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WHERE DOES THE LOUD MURMUR OF AORTIC STENOSIS RADIATE?
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INTO THE NECK (IN THE DIRECTION OF ARTERIAL FLOW)
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A MURMUR BEST HEARD IN THE 2ND INTERSPACE OFTEN ORIGINATES WHERE
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AT OR NEAR THE AORTIC VALVE
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EMPHYSEMATOUS LUNGS DO WHAT TO THE INTENSITY OF MURMURS?
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DIMINISH THE INTENSITY
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AN IDENTICAL DEGREE OF TURBULENCE WOULD CAUSE A _______ MURMUR IN A THIN PERSON THAN A VERY MUSCULAR OR OBESE PERSON.
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LOUDER
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MURMURS IN THE RIGHT SIDE OF THE HEART TEND TO VARY WITH ______________ MOTE THAN LEFT SIDED MURMURS.
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RESPIRATION
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WHAT IS THE ONLY SYSTOLIC MURMUR THAT INCREASES IN INTENSITY DURING THE VALSALVA MANEUVER?
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MURMUR OF HYPERTROPHIC CARDIOMYOPATHY
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WHAT INDICATES A PULSUS ALTERNANS?
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ALTERNATELY LOUD AND SOFT KOROTKOFF SOUNDS OR A SUDDEN DOUBLING OF THE APPARENT HEART RATE AS THE CUFF PRESSURE DECLINES
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WHAT DOES PULSUS ALTERNANS INDICATE?
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SEVERE LEFT SIDED HEART FAILURE
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