2313 Exam 4

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Nelikya
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182547
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2313 Exam 4
Updated:
2012-11-08 16:33:39
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5A
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5A-D
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  1. 1. Case One: 48 y/o male. Several hours chest discomfort. 25 years smoking and father CAD—The Diagnosis is:
    c: coronary artery disease
  2. 2. Case Two: 69 y/o female substernal chest pain. BP 133/75. 99 BPM. Treated Acute MI. Respiratory difficulty day3. No pulsus paradoxus or jugular venous distention. No EKG findings. The Diagnosis is:
    c: ventricular septal defect
  3. 3. Case Three: 10 y/o girl with fever and joint swelling 8days. Thin. 122/68 BP. 86 bpm HR. 3/6 Harsh systolic murmur at apex. 2/6 Early diastolic decresendo murmur at left sternal border. S3 present. EKG says 1st deg. AV block. CXR normal. The Diagnosis is:
    c: acute rheumatic fever
  4. 4. Case Four: 44 y/o male. 12 day fever w/ shortness of breath. BP 146/55. Pulse 122 bpm. 4/6 early diastolic decrescendo murmur at left upper and mid sternal border. 2/6 systolic ejection murmur at right upper sternal border. The Diagnosis is:
    b: aortic valve endocarditis
  5. 5. Case Five: 68 y/o male with heart murmur present. Complaint of fatigue and dyspnea. Leaky heart valve and click. BP 133/80. HR 92 bpm. No jugular distention 3/6 holosystolic murmur at apex to axilla. Left atrial enlargement. CXR is mild pectus excavatum and cardiomegaly. The Diagnosis is:
    d: mitral valve prolapse
  6. 6. Case Six: 21 y/o male. Fatigue and dyspnea with exertion.Palpitations and abnormal heart sounds. BP is 150/50 with 78 bpm. Grade II/VI systolic ejection murmur. Grade IV/Vi diastolic decrescendo murmur at left sternal border. The Diagnosis is:
    c: congenital aortic stenosis/regurgitation
  7. 7. Case Seven: 78 y/o retired steel worker with exertional fatigue and dyspnea. Chest pain and palpitations while working on house. Murmur 15 years ago and CXR w/ mild cardiomeglay. BP 120/80. Pulse 122 and irregular. 3/6 harsh holosystolic murmur at apex and decreases with Valsava. Mild Pedal edema. The Diagnosis is:
    a: dilated cardiomyopathy
  8. 8. Case Eight: 62 y/o male with syncope. Exertional chest pain for months. BP 112/83. HR 66 bpm. S1 normal. S2 soft. 4/6 late-peaking systolic ejection murmur at right upper sternal border. 2/6 holosystolic murmur and early diastolic murmur. EKG is LVH. CXR normal. —The Diagnosis is:
    d: valvular aortic stenosis
  9. 9. Case Nine: 57 y/o female with fatigue, extertional dyspnea, and hemoptysis. BP is 103/68. Irregular pulse 133 bpm. S1 & 2 normal. Weak LV impulse and RV lift. Opening snap after S2. EKG is atrial fibrillation. CXR is cephalization of flow in lungs.—The Diagnosis is:
    a: rheumatic mitral stenosis
  10. 10. Case Ten: 26 y/o female with sharp chest pain close to apex. Heart skips beats during stress. 130/80 BP with 88 BPM. II/VI apical end-systolic murmur. EKG after is multiple PVC's.—The Diagnosis is:
    d: mitral valve prolapse.
  11. 1. S1 is caused by:
    A: mitral and tricuspid valve closure
  12. 2. For cardiac auscultation, the mitral area is considered to be the:
    B: cardiac apex
  13. 3. For Cardiac auscultation, the tricuspid area is considered to be the:
    A: lower left sternal border
  14. 4. S2 is caused by:
    C: aortic and pulmonic valve closure
  15. 5. For cardiac auscultation, the aortic are is the:
    C: right upper sternal border
  16. 6. For cardiac auscultation the pulmonic area is the:
    D: left upper sternal border
  17. 7. With inspiration, the interval between the two componenets of S2, aortic and pulmonic valve closure is:
    A: increased
  18. 8. S3 occurs in:
    B: early ventricular diastole
  19. 9. Another term used to describe the S3 is:
    C: protodiastolic gallup
  20. 10. All of the following pathologies are associated with an S3 except:
    B: mitral stenosis
  21. 11. The S4 occurs in response to:
    B: atrial systole
  22. 12. S4 indicates:
    C: decreased ventricular compliance
  23. 13. A loud S1 may indicate the presence of:
    B: mitral stenosis
  24. 14. Ano opening snap is associated with:
    A: atrioventricular valve stenosis
  25. 15. An ejection sound or click is associated with:
    C: semilunar valve stenosis
  26. 16. The midsystolic click may indicate the presence of mitral valve:
    B: prolapse
  27. 17. Fixed split S2 is associated with:
    A: atrial septal defect.
  28. 18. Which of the following heart sounds is associated with pericarditis?
    C: pericardia friction rub
  29. 19. Which of the following heart sounds is associated with constrictive pericarditis?
    D:pericardial knock
  30. 1. Which of the following is incorrect when describing the auscultation areas for the cardiac valves?
    C: mitral: lower left sternal border
  31. 2. A grade I murmur is a murmur that is:
    D: barely heard
  32. 3. A grade II murmur is a murmur that is:
    D: faintly heard
  33. 4. A grade III murmur is a murmur that is:
    C: moderately loud
  34. 5. A grade IV murmur is a murmur that is:
    D: loud
  35. 6. A grade V murmur is a murmur that is:
    C: very loud
  36. 7. A grade VI murmur is a murmur that is:
    D: loud with a trill
  37. 8. A ___ murmur is one that begins softly and becomes louder:
    A: crescendo
  38. 9. A ___ murmur is a murmur that begins loud and becomes softer:
    B: decrescendo
  39. 10. A ___ murmur begins softly, becomes louder and then decreases in loudness:
    B: crescendo-decrescendo
  40. 11. A ___ murmur begins loud, becomes softer, and then increases in loudness:
    A: decrescendo-crescendo
  41. 12. A low pitched murmur is best heard with the stethoscope’s:
    A: bell
  42. 13. A medium pitched murmur is bed heard with the stethoscope’s:
    C: both bell and diaphragm
  43. 14. A high pitched murmur is best heard with the stethoscope’s:
    B: diaphragm
  44. 15. Which of the following murmurs begins with the first heart sound and end in mid-systole?
    A: early systolic
  45. 16. All of the following are possible causes of early systolic murmurs except:
    A: valvular aortic stenosis
  46. 17. Which of the following murmurs begins after the semilunar valves open?:
    B: systolic ejection
  47. 18. All of the following are associate with a systolic ejection murmur except:
    D: ventricular septal defect
  48. 19. Which of the following murmurs is present when there is flow between two chambers that have widely different pressure throughout systole?
    C: pansystolic
  49. 20. All of the following are considered to be associate with pansystolic murmur except:
    D: mitral valve prolapse
  50. 21. Which of the following murmurs star well after ejection?
    B: late systolic
  51. 22. All of the following are associated with a late systolic murmur except:
    C: valvular pulmonic stenosis
  52. 23. Which of the following murmurs begins immediately after the second heart sound?
    A: early diastolic
  53. 24. Which of the following is most likely to cause an early diastolic murmur?
    A: aortic valve regurgitation
  54. 25. Which of the following murmurs is caused by forward flow across an atrioventricular valve?
    B: mid-diastolic
  55. 26. All of the following are associated with a mid-diastolic or late diastolic murmur except:
    D: aortic regurgitation
  56. 27. Which of the following murmurs may result from blood flow constantly moving from a high pressure to a low pressure area?
    D: continuous
  57. 28. All of the following are associated with a continuous murmur except:
    C: severe mitral regurgitation
  58. 29. Which effect will the strain phase of the Valsalva maneuver have on venous return?
    B: decrease
  59. 30. All of the following murmurs will decrease in intensity during the strain phase of the Valsava except:
    C: hypertrophic obstructive cardiomyopathy
  60. 31. What effect with isometric handgrip have on mitral regurgitation?
    A: increase
  61. 32. What effect will isometric handgrip have on valvular aortic stenosis?
    B: decrease
  62. 33. What effect will the inhalation of amyl nitrite have on a ventricular septal defect murmur?
    B: decrease
  63. 34. What effect will the inhalation of amyl nitrite have on left heart regurgitant murmurs?
    B: decrease
  64. 35. What effect will the inhalation of amyl nitrite have on the murmur of hypertrophic obstructive cardiomyopathy?
    A: increase
  65. 36. What effect will the inhalation of amyl nitrite have on mitral valve prolapse?
    A: increase
  66. 1. Which of the following is used to evaluate the cardiovascular repsonse to exercise?
    -a: exercise stress test
  67. 2. All of the following are indications for an exercise stress test except:
    -c: valvular aortic stenosis
  68. 3. Which of the following is the most reliable indicator of myocardial ischemia during a exercise stress test examination:
    -a: ST segment depression
  69. 4. Which of the following is a positive inotripe and positive chronotrope?
    -d: dobutamine
  70. 5. All of the following may induce myocardial ischemia via dilation of the coronary arteries except:
    -d: dobutamine
  71. 1. A graphic recording of heart sounds are murmurs is the:
    -b: phonocardiogram
  72. 2. All of the following may be performed during a phonocardiographic examination except:
    -d: atrial pressure tracing

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