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PANCE Prep Cumulative Review Questions And Correct Answers Latest Version
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PANCE Prep Cumulative Review QuestionsAnd Correct Answers Latest Version
Normal in children & athletes with high output. Pathologic when due to CHF,
dilated cardiomyopathy ANS✔✔ S3
Always pathologic, due to non-compliant ventricles such as during
myocardial ischemia, severe HTN; or due to atrial kick (absent in atrial
fibrillation) ANS✔✔ S4
Abnormally large decrease in systolic blood pressure more than 10mmHg on
inspiration; associated with pericardial effusion, tamponade, pericarditis,
asthma attack, tension pneumo, SVC obstruction ANS✔✔ Pulsus Paradoxus
JVD, hypotension, muffled heart sounds. Signifies pericardial
effusion/tamponade ANS✔✔ Beck's Triad
High pitched, early S3 due to constrictive pericarditis related to Sjogrens,
scleroderma, RA, or viral pericarditis ANS✔✔ Pericardial Knock
Secondary pericarditis after an MI or pericardotomy. Treat with ASA (can use
indomethacin or other NSAIDS) ANS✔✔ Dressler's Syndrome
appropriate warfarin anticoagulation therapy *for atrial fibrillation or
hypercoagulable states* ANS✔✔ INR 2-3
appropriate warfarin anticoagulation therapy *for aortic valve replacement*
ANS✔✔ INR 2.5-3.5
,Common cause of *heart failure after a URI* ANS✔✔ Myocarditis
flank pain, hypotension, *pulsatile abdominal mass* ANS✔✔ Triad of
Ruptured AAA
EKG changes, nausea/vomiting, yellow-green visual disturbances ANS✔✔
Digoxin Toxicity
systolic ejection murmur heard at base with *radiation to left clavicle*
ANS✔✔ Pulmonary Stenosis
female or post-MI: systolic murmur heard best at apex *preceded by click*
without radiation of murmur ANS✔✔ Mitral Valve Prolapse
Systolic murmur heard best at apex with radiation to left axilla ANS✔✔ Mitral
Regurgitation
*Continuous, harsh, machinery murmur.* Treat with indomethacin ANS✔✔
Patent Ductus Arteriosus
Cyanotic neonate: pulmonary artery stenosis, ventricular septal defect,
overriding aorta, right ventricular hypertrophy ANS✔✔ Tetrology of Fallot
Diastolic murmur heard best at apex without radiation with history of
rheumatic heart disease ANS✔✔ Mitral Stenosis
,Peds with leg pain after physical activity, diminshed femoral pulses, unequal
R & L arm BP, rib notching on CXR ANS✔✔ Coarctation of the aorta
Holosystolic murmur heard best at LSB, may have ventricular hypertrophy
ANS✔✔ Ventricular Septal Defect
Systolic, diamond shaped murmur with radiation to carotids. May have
syncope, angina, or CHF ANS✔✔ Aortic Stenosis
Diastolic murmur with laterally displaced PMI and physical exam findings
including waterhammer pulses, Quincke's Pulse, Corrigan's Pulse, Austin flint
murmur ANS✔✔ Aortic Regurgitation
Subungual capillary pulsation, PE finding of aortic regurgitation ANS✔✔
Quincke's Pulse
Rapid rise and fall of pulse pressures, PE finding of aortic regurgitation
ANS✔✔ Corrigan's Pulse
Painful red raised lesions on hands and feet associated with infective
endocarditis ANS✔✔ Osler Nodes
Nontender, macular (flat) erythematous lesions on palms of hands & soles of
feet, associated with infective endocarditis ANS✔✔ Janeway Lesions
Tiny blood clots under the fingernails or toenails that run vertically and are
associated with infective endocarditis ANS✔✔ Splinter Hemorrhage
, Rapid, deep, labored breathing associated with metabolic acidosis (DKA)
ANS✔✔ Kussmaul Breathing
Deep breathing patterns alternating with episodes of apnea, occurs with
heart failure & brain damage ANS✔✔ Cheyne-Stokes Breathing
Radiographic finding on CXR that clinically indicates silicosis (sandblasters)
ANS✔✔ Eggshell Pattern
Radiographic finding on CXR that clinically indicates asbestosis (shipbuilders,
building demolition). Also, hyaline membrane disease (respiratory distress
syndrome) in premature neonates due to surfactant deficiency ANS✔✔
Ground glass
Venous stasis, vessel wall injury, hypercoagulability ANS✔✔ Virchow's Triad
pediatric with barking cough & stridor; treat with racemic epinephrine &
glucocorticoids if stridor at rest ANS✔✔ Viral Croup
Pediatric in tripod position, drooling, appears toxic. Get to OR to intubate &
maintain patent airway. Due to haemophilis most commonly ANS✔✔
Epiglottitis
Radiographic appearance on lateral x-ray that signifies epiglottitis ANS✔✔
Thumbprint Sign
AP radiographic finding of trachea, signifies laryngotracheobronchitis (viral
croup) ANS✔✔ Steeple Sign
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