Term
| Other than myocardial ischemia (angina pectoris) what other causes of chest pain may be relieved by nitroglycerin? |
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Definition
spasm of the esophagus
hiatal hernia
mild biliary colic |
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Term
| What is a classic sign of costochondritis? |
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Definition
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Term
| What is a classic sign of Pulmonary Embolism on auscultation? |
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Definition
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Term
| What is a classic sign of Pericarditis on auscultation? |
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Definition
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Term
| What is a classic sign of aortic dissection on peripheral exam (pulse)? |
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Definition
| Unequal or Asymmetric Peripheral pulses |
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Term
| A 60 y/o man presents with recurring intermittent anterior chest pain brought on by physical exertion and relieved by rest. At the time you are seeing him he is asymptomatic. Physical examination (including chest and CV exam), chest x-ray and resting EKG are all normal. What is the most likely diagnosis? What causes this condition? What is the treatment? |
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Definition
| Angina Pectoris (Angina of Effort), Caused usually by CAD. Tx is to address pain (Nitroglycerin) and address CAD (Statin for hyperlipidemia, Nuclear Stress Test and Cardiac Catheterization are good f/u tests) |
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Term
| What condition usually accompanies CAD? |
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Definition
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Term
| Which of the following valvular heart diseases is most likely to be associated with chest pain resembling angina pectoris (myocardial ischemia)? |
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Definition
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Term
| What is the Non-specific enzyme that is released after any skeletal damage including AMI? |
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Definition
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Term
| What is the most important and most sensitive enzyme used to detect AMI? How long do the levels stay elevated after MI? |
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Definition
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Term
| What enzyme marker is very sensitive for myocardial muscle damage after AMI, but only remains in the body for 2 - 3 days after AMI? |
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Definition
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Term
| Which condition has a classic pain description of pain radiating to the left arm, jaw, and neck? |
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Definition
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Term
| In which condition is pain exacerbated by taking a deep breath? |
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Definition
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Term
| When does functional chest pain occur? |
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Definition
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Term
| Which condition has pain described classically as A burning pain that may radiate to the throat or back of the neck? |
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Definition
| Esophageal Reflux (It said Spasms on the Study guide, but I disagree) |
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Term
| Which condition's pain is classically described as Pain radiates to the mid-back and btw shoulder blades, abdomen or legs? |
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Definition
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Term
| What does Taking a patient’s blood pressure and noting asymmetrical readings between the arms suggests what condition? |
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Definition
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Term
| What condition does irregular BP readings between the upper and lower extremity suggest? |
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Definition
| Coarctation of Aorta or Aortic Aneurysm |
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Term
| Which type of angina is precipitated by exercise, cold weather, large meals, and stress? |
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Definition
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Term
| Which type of angina has pain at rest and is precipitated with less activity? |
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Definition
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Term
| Which type of angina has the greatest risk for MI? |
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Definition
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Term
| Which type of angina occurs at rest and is due to coronary vasospasms? |
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Definition
| Variant (Prinzmetal's) Angina |
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Term
| Which 3 populations have ATYPICAL chest pain presentation? |
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Definition
Think Grandma Casey!!
Elderly, Diabetics, Women (Especially Postmenopausal) |
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Term
| Pectus excavatum (funnel chest) is associated with what heart deformity? |
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Definition
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Term
| Which type of rash is associated with Rheumatic fever? What does it look like? |
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Definition
| Erythema marginatum rash - wavy margins! |
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Term
| What are subcutaneous nodules especially at joints a sign of? |
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Definition
| chronic rheumatic heart dx |
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Term
| Which types of lesions are described as small (painless) nodules on the sole of a patient's foot? What condition are they associated with? |
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Definition
Janeway (Jane is sweet) lesions
Bacterial Endocarditis |
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Term
| With what condition are splinter hemorrhages seen? Where on the body are they found? |
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Definition
| Bacterial Endocarditis; feet and hands |
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Term
| Which condition can have sx including painful, erythematous nodular lesions on the finger that is especially common in medical personnel? What are these nodules called? |
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Definition
Bacterial Endocarditis
Osler (big, bad Os) Nodes |
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Term
| What is the medical term for funnel chest? (A chest that caves in) |
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Definition
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Term
| What is the medical term for bird chest? (Chest that protrudes out) |
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Definition
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Term
| In respect to the jugular venous pulse wave, what will happen to a person's A-wave if they are in A-Fib? |
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Definition
| It will disappear (A wave represents atrial contraction - A fib is not really contraction) |
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Term
| Why are pts placed in L Lateral decubitus position? |
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Definition
| Apex of heart is brought closer to the chest wall in that position |
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Term
| Why are pts asked to sit up, lean forward and exhale on heart exam? |
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Definition
| Brings base of the heart closer to the chest wall (helps determine if aortic regurgitation murmur is present) |
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Term
| What is a positive Kussmaul sign? What conditions can cause a positive Kussmaul sign? |
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Definition
when JVP rises with inspiration; constrictive pericarditis, R ventricular disease (aka “dry lung”)
R Ventricular Failure, Vena Cava Stenosis, Pericardial Effusion, Pleural dx |
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Term
| If PMI is displaced towards the epigastrum, what condition do you suspect? If it is displaced laterally, what condition do you expect? |
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Definition
Epigastric - COPD (Remember vertical heart in COPD, b/c of hyperinflated lungs)
Laterally - Indicates Hypertrophic Cardiomyopathy, (can be present for lots of reasons, one being CHF) |
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Term
| With what conditions may an S4 gallop be present? |
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Definition
| hypertrophy, atrial malfunction |
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Term
| With what conditions may an S3 gallop be present? In which populations of pts is S3 normal? |
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Definition
Dilatation, ventricular failure
Normal finding in children and athletes |
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Term
| What is a Thrill? With which grade murmurs is a Thrill present? |
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Definition
Superficial vibratory sensations felt on skin
Grade 4, 5 and 6 |
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Term
| With which conditions does an S1 split occur? |
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Definition
| Splitting only with coexisting RBBB and pulmonary HTN |
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Term
| With which conditions does an S2 split occur? |
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Definition
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Term
| In which condition is pulses paradoxus present? |
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Definition
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Term
| What is Levine's sign? With what condition is it present? |
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Definition
| clenched fist held over the chest; AMI |
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Term
| With which valvular condition does the murmur increases with standing and valsalva? |
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Definition
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Term
| With which valvular condition does the murmur increase with squatting? |
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Definition
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Term
| With which valvular condition does the murmur at the PMI when you press on the RUQ? |
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Definition
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Term
| With what condition is Pulsus parvus et tardus present? |
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Definition
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Term
| Which murmur radiates to the neck/carotids and R infraclavicular area? |
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Definition
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Term
| Which murmur radiates to the left axilla or the left scapular/rhomboid? |
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Definition
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Term
| Which murmur radiates into the epigastrum? |
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Definition
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Term
| Which murmurs are High Frequency murmurs? |
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Definition
| Mitral Regurg, Tricuspid Regurg, Aortic Regurg |
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Term
| Which murmurs ar low frequency murmurs? |
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Definition
| Mitral Stenosis, Tricuspid Stenosis |
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Term
| Which murmur is associated with an opening-smap that occurs following S2 and a loud S1? |
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Definition
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Term
| In which two conditions is aortic regurgitation murmur seen? |
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Definition
| rheumatic fever and Marfan's |
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Term
| Which murmurs are holosystolic murmurs? |
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Definition
| Mitral Regurg, Tricuspid Regurg, Ventricular Septal Defect |
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Term
| Which murmur increases with inspiration and occurs between S1 and S2? |
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Definition
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Term
What does valsalva do to the following murmurs?
Mitral Valve prolapse
Aortic Stenosis
Hypertrophic Cardiomyopathy |
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Definition
Mitral Valve prolapse = Increases
Aortic Stenosis - Decreases
Hypertrophic Cardiomyopathy - Increased |
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Term
What does squatting do to the following murmurs?
Mitral Valve prolapse
Aortic Stenosis
Hypertrophic Cardiomyopathy |
|
Definition
Mitral Valve prolapse-decreases
Aortic Stenosis - Increases
Hypertrophic Cardiomyopathy - Decreases |
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Term
Listening at the PMI and pushing on the RUQ does what to the following murmurs?
Tricuspid Regurg
Mitral Regurg
MVP |
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Definition
Tricuspid Regurg - Increases Intensity
Mitral Regurg - remains unchanged
MVP - Remains unchanged |
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Term
Listening at the PMI and inhaling deeply does what to the following murmurs?
Tricuspid Regurg
Mitral Regurg
MVP |
|
Definition
Tricuspid Regurg - Increased
Mitral Regurg - unchanged
MVP - unchanged |
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Term
Listening at the PMI and passively raising the leg does what to the following murmurs?
Tricuspid Regurg
Mitral Regurg
MVP |
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Definition
Tricuspid Regurg - increased
Mitral Regurg - unchanged
MVP - unchanged |
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Term
| Which murmur is described as Harsh late-peaking crescendo-decrescendo mid-systolic murmur? |
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Definition
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Term
| Which murmur is described as Harsh crescendo-decrescendo systolic murmur, Heard best at left sternal border, Occur btw S1 and S2? |
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Definition
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Term
| Which type of murmur is described as Soft holosystolic murmur, Heard best at the Lower Left Sternal Border whose Intensity increases with inspiration, pressure over liver, or passively raising the leg? |
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Definition
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Term
| Which murmur is described as Blowing holosystolic murmur, Heard best at the apex, Radiation to the axilla and inferior edge of left scapula? What possible conditions is this murmur associated with? |
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Definition
Mitral Regurgitation
Associated with a MI |
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