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AHN 568 Module 1- Questions & Answers
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AHN 568 Module 1- Questions & Answers
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AHN 568 Module 1- Questions &Answers
What does paradoxical pulse/pulsus paradoxus indicate? Correct Ans--pericardial
tamponade, asthma, copd, PE, pericarditis
-it's a difference in SBP 10-12mmHG in inspiration (respiratory variation)
what position to place patient to listen for extra heart sounds and feel PMI? Correct Ans-
s3/s4 and PMI, opening snap, mitral stenosis= LEFT lateral decubitus listen w BELL
pg 514
position to detect aortic regurgitation? Correct Ans-sit up, lean forward, exhale
diaphragm to detect higher pitch diastolic murmur of aortic regurg.
what side of stethescope to listen to heart?: Correct Ans-both diaphragm and bell
bell in left lateral=MStenosis, s3/s4, opening snap s2
diaphragm when lean forward and exhale=ARegurg
Where is the epigastric region? Correct Ans-above the stomach
subxiphoid pg 515
-where you can palpate the RV impulse pg 519
Bell Correct Ans-low pitch sounds of S3/S4 and mitral stenosis at apex
Diaphragm Correct Ans-high pitch, S1 S2
aortic and mitral regurgitation and pericardial friction rubs
,most common extra heart sound? Correct Ans-systolic click of mitral valve prolapse
two grading scales of murmurs Correct Ans-systolic 1-6
diastolic 1-4
explain midsystolic murmurs Correct Ans--midsystolic murmurs are often functional murmurs
from anything that reduces left vent volume like stand, squat, or valsalva.
-what causes them is blood flow across the semilunar valves (aortic and pulmonic) during
systole.
explain pansystolic murmurs Correct Ans-pan-systolic (holosystolic) murmurs are from
regurgitant backward blood flow across AV values (mitral/ tricuspid).
What is a late systolic murmur? Correct Ans-mitral valve prolapse or mitral regurgitation.
often proceeded by systolic click.
explain early diastolic murmurs Correct Ans-regurg across incompetent semilunar (aortic
pulmonic) valves
explain mid-diastolic murmurs Correct Ans-turbulent flow across AV values in diastole (mitral
& tricuspid)
what causes a continuous murmur Correct Ans-congenital PDA, AV fistula, pericardial friction
rub
they're non valvular.
when to begin screening for CV risk factors? Correct Ans-20 yr old if has 1 st degree relative
with premature heart disease (<55yr male or <65 female).
, risk factors on CV screening Correct Ans--family hx of premature heart disease
-cigarette smoking
-unhealthy diet
-inactive ( reccomend 30 min mod intensity 5/days)
-obesity BMI >25, men waist >40 in and >35 women
-hypertension
-dislipidemia
-diabetes- check a1c q 3yrs at age 45
-a fib
what things cause a diminished S1 sound? Correct Ans-1st degree heart block
left BBB
MI
aortic regurgitation
what accentuates physiologic splitting of S2? Correct Ans-inspiration
what causes pathologic splitting of s2? Correct Ans-pulmonic stenosis
mitral regurgitation
right BBB
where can split S2 be heard best? Correct Ans-right 2nd ICS (Base)
what causes s4? Correct Ans-hypertension, aortic stenosis, ischemic and hypertrophic
cardiomyopathy
think STIFF ventricle
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