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AG-ACNP Boards – Cardiology: Questions & Solutions
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AG-ACNP Boards – Cardiology: Questions & Solutions
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AG-ACNP Boards – Cardiology: Questions & SolutionsHeart Murmurs what is heard with each grade? Right Ans - I/VI barely
audible
II/VI audible but faint
III/VI moderately loud easily heard
IV/VI loud and associated with a thrill
V/VI very loud heard with one corner of stethoscope off
VI loudest
L sided valvular disease Right Ans - automatic cardiology referral
MS ARD Right Ans - Mitral
Stenosis
Aortic
Regurgitation
Diastolic murmurs
MR ASS Right Ans - Mitral
Regurgitation
Aortic
Stenosis
Systolic
mitral Right Ans - *5th ICS mid chest - LSB
*Apex
*think about direction of flow through valve-->will be heard at apex, radiating
to axilla because points downward
,aortic Right Ans - 2nd intercostal space, right sternal border
base
MS Right Ans - low pitched
apical crescendo
diastolic
MR Right Ans - radiating to L axilla
blowing, musical, high pitched
systolic
associated w/ papillary mm rupture w/ RCA infarct 4-7 days for STEMI
AS Right Ans - blowing, harsh murmur
usually radiating to carotids - think about direction of aorta - makes sense
anatomically
systolic murmur
AR Right Ans - blowing
diastolic
Heart failure definition Right Ans - cardiac output cannot meet the needs of
the body
Types of heart failure Right Ans - systolic: inability to contract resulting in
decreased cardiac output
Diastolic: inability to relax and fill result in decreased CO
Acute: Abrupt onset follows MI or valve rupture
, Chronic: develops as a result of compensatory mechanisms that have been
employed over time to improve CO
NYHA Class I Right Ans - No s/s
NYHA Class 2 Right Ans - Slight limitation of physical activity
NYHA Class 3 Right Ans - Marked limitations of physical activity
NYHA Class 4 Right Ans - Severe; inability to carry out any physical activity
without discomfort. Symptomatic all the time.
S/S of Left heart Failure (Acute) Right Ans - Dyspnea at rest/Coarse rales
over all lung fields/wheezing frothy cough - pulmonary edema
murmur of mitral regurgitation - systolic murmur loudest at apex, radiating to
L axilla... RCA STEMI sequela
S3
S/S of chronic heart failure (Left) Right Ans - JVD
Hepatomeglay
splenomegaly
abdominal fullness
dependent edema - as a result of increase capillary hydrostatic pressure
paroxysmal nocturnal dyspnea
appears chronically ill
displaced PMI
S3/S4
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