Integration of Cardiovascular Learning

Integration of Cardiovascular Learning

These questions were set by my medical school based on clinical skills surrounding the cardiovascular system, and the answers are those I believe to be correct.

1. What are the murmurs of mitral stenosis, mitral regurgitation, aortic stenosis, and aortic regurgitation?
Mitral stenosis – mid-diastolic murmur
Mitral regurgitation – pansystolic murmur
Aortic stenosis – ejection systolic murmur
Aortic regurgitation – early diastolic murmur

2. Give two causes of clubbing
Cyanotic congenital heart disease, infective endocarditis

3. What are splinter haemorrhages?
Small haemorrhages within the nailbed under the nail

4. Give two causes of splinter haemorrhages. Are they embolic or vasculitic?
Infective endocarditis – vasculitic, caused by trauma

5. Describe three reasons for an irregularly irregular pulse.
Atrial fibrillation
Multiple ventricular actopic beats
Atrial flutter with variable block

6. Give two causes of asymmetrical radial pulses
Acute aortic dissection
Proximal arterial disease eg atherosclerosis

7. What is a collapsing pulse? In which condition does it occur?
The pulse vibrates down your fingers when holding the patient’s wrist, raised.
Occurs in aortic regurgitation.

8. What is radiofemoral delay? Name the condition in which it features.
Femoral and radial pulses not in time with each other, the femoral pulse is felt slightly after the radial. Sign of coarctation of the aorta.

9. What are Korotkoff sounds?
Sounds heard over an artery when pressure over it is reduced below systolic arterial pressure.

10. What is the significance of phase I, IV, V Korotkoff sounds?
I – height of systole
IV – the sounds quieten suddenly when the cuff pressure is less than diastolic pressure
V – the sounds stop completely (not always present)

11. What is malar flush and when does it occur?
Rosy cheeks with something of a bluish tinge – Occurs in mitral stenosis

12. Give two signs of hyperlipidaemia.
Xanthalesmata, corneal arcus