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AGACNP Review - Cardiovascular Exam Questions And Verified Detailed Answers
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AGACNP Review - Cardiovascular Exam Questions AndVerified Detailed Answers
What about a murmur in the 2nd ICS that's systolic in nature. What type is this? -
ANSWER It's in the *5th ICS*, so it's MITRAL. It's in *mid-diastole*, so it's DIASTOLIC. --->
I use "MS ARD". The only mitral heart murmur found in diastole is *MITRAL STENOSIS.*
Its in the *2nd ICS*, so its AORTIC. And its systolic. So I use "MR ASS". The only aortic
heart murmur found in systole is *AORTIC STENOSIS.*
Heart Failure: What mechanism causes it? - ANSWER A syndrome that results when the
*CARDIAC OUTPUT is insufficient* to meet the metabolic needs of the body
Differentiate the 2 types of heart failure and how they result in decreased cardiac
output. - ANSWER SYSTOLIC HEART FAILURE: inability to CONTRACT results in
decreased cardiac output
DIASTOLIC HEART FAILURE: inability to RELAX AND FILL results in decreased cardiac
output
Which valves are open and which valves are closed during S1 and S2? - ANWER S1:
-AV valves CLOSED (mitral and tricuspid)
-Semilunar valves OPEN (aortic and pulmonic)
S2:
-AV Valves OPEN (mitral and tricuspid)
-Semilunar valves CLOSED (aortic and pulmonic)
Systole is the period between what 2 phases?
,Diastole is the period between what 2 phases? - ANSWER Systole is the period between
S1 and S2
Diastole is the period between S2 and S1
S3
1. With what condition is this sound most associated?
2. What does it sound like? (State)
3. In what condition is this sound abnormal?
4. In what condition is this sound normal? - ANSWER 1. Associated with *Increased fluid
states*
2. "Ken-TUCK-y"
3. CHF: abnormal sound.
4. Pregnancy: normal sound
S4
1. What condition is this sound most associated with?
2.What does it sound like? (State)
3. Name the 3 most common diseases that cause this sound - ANSWER - Associated with
*Stiff ventricular wall*
-"Ten-ne-ssee" (rapid)
Causes: Things that cause ventricular wall stiffness
*1) MI*
*2) LEFT VENTRICULAR HYPERTROPHY*
,*3) CHRONIC HTN (which causes LVH)*
Name what sound would be associated with the following conditions:
1. Hypertension
2. MI
3. Heart failure
4. Heart failure 2/2 MI - ANSWER 1.Hypertension = S4
2.MI = S4
3.Heart failure = S3
4.Heart failure 2/2 MI = S3 and/or S4
Difference between mumurs III/IV and IV/VI - ANSWER III: moderately loud; easily heard,
*audible WITHOUT A THRILL*
IV: loud, *associated with a THRILL*
MS. ARD & MR. ASS
- Which murmurs are low? Which murmurs are high-pitched?
- Which murmurs radiate? Differentiate. - ANSWER *M*itral *S*tenosis and *A*ortic
*R*egurgitation occur in *DIASTOLE*
*M*itral *S*tenosis = loud S1, LOW-pitched apical "crescendo" rumble
*A*ortic *R*egurgitation = "blowing" murmur
-----------------
, *M*itral *R*egurgitation and *A*ortic *S*tenosis occur in *SYSTOLE*
*M*itral *R*regurgitation = musical, blowing, or HIGH-pitched;
*RADIATES TO BASE OR LEFT AXILLA*
*A*ortic *S*tenosis = "blowing", rough harsh murmur,
usually *RADIATES TO THE NECK*
-----------------
- MS is low-pitched and MR is high-pitched
- Systolic murmurs radiate.
Which murmurs have a blowing quality? - ANSWER The REGURGITATION murmurs and
AORTIC STENOSIS
*A*ortic *R*egurgitation = blowing murmur
*M*itral *R*egurgitation = blowing, musical, or HIGH-pitched
*A*ortic *S*tenosis = blowing, rough harsh murmur
You hear a murmur at the 5th ICS mid-diastole. What type is this?
Compare Acute Heart Failure and Chronic Heart Failure in terms of:
a) What side of the heart are they associated with?
b) Mechanism of failure - ANSWER Acute:
a) Left-sided.
b) Acute presentation usually follows acute MI or valve rupture.
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