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29 Cards in this Set
- Front
- Back
What are some signs that point to right sided congestion
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ascites, jugular venous distention, peripheral edema, cardiac cirrhosis
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whats a sign of left sided congestion
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pulmonary edema
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findings of endocarditis 5 gimme it
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roth spots, splinter hem, janeway lesions, osler nodes, mucocutaneous petechiae
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pulsus paradoxus can be caused by
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tamponade, pericardial dz
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pulsus bisiferens can be caused by
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aortic regurge, hypertrophic cardiomyopathy
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Pulsus alterans can be caused by
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PVC, left ventricular disease
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Pulsus tardus can be caused by
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aortic stenosis
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asymmetrical pulses can be caused by
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aortic dissection, PVD, vasculitis, subclavian steal syndrome
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what sided valves usually close first?
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left becuase of the increased pressure
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You hear an s3 gallop in a pregant lady who's pretty far along, what do you suspect
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nothing, its a normal variant
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when does an S3 worry you
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present after 40 yrs of age or decreased left heart fx
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S4 gallop is usually indicative of...
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stiff ventricle, stemming from HCM or LVH
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Usually, most murmurs increase when you _____ preload, but the exceptions are....
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increase; MVP and HCM
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a sustained 30 second handgrip should be able to help you to differentiate between what, and how
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it doesn't change the murmur of MVP, but does soften the murmur in HCM(increase afterload i.e. widens outflow tract)
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right sided mumurs with ____ and left sided increase with_____
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inspiration; expiration
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what position would you put a patient in to best hear a s3/4 gallop
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left lateral recumbent
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a fixed S2 split is associated with...
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ASD
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whats the most common congenital valve abnormality
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aortic stenosis (bicuspid)
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systolic ejection murmur at RUSB that radiates into carotids is indicative of...
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aortic stenosis
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A pt presents with mid-systolic click and is unaffected by sustained handgrip, what cha thinkin?
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Mitral valve prolapse, common in teenagers, dx with echo
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when should you use antibiotics with mitral valve prolapse?
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if you hear a murmur
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what valves replacements are never seen on x-rays?
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right sided, they are never replaced
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3 things should pop into mind when you dx tricuspid stenosis/regurgitation?
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rheumatic heart disease, staph endocarditis, carcinoid syndrome
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Gimme some sx of trsicuspid stenosis...
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systemic venous congestion (edema, dyspnea) adominal pain secondary to liver congestion, fluttering in neck secondary to increased JV pressure,
Diastolic murmur at LSB, giant a wave, EKG with RAH w/o RVH |
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pt is on fenfluramine for anorexia, what is associated with this, valve
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tricuspid regurgitation
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You see large R in V1, 7 causes of it?
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RVH
RBBB posterior wall mi misplaced leads muscular dystrophy dextrocardia WPW |
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Pulmonic stenosis is always...
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CONGENITAL
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Whats the good thing about Porcine valve and when would you use them
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less durable dont require anticoagulation,
use in pts over 65, contras exist for anticoag, female of child bearing age |
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when do you not wanna give antibiotics prophylaxis (congenital)
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isolated secundum atrial septal defect
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