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AHN 568 MODULE 1 QUESTIONS AND ANSWERS 2024
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AHN 568 MODULE 1 QUESTIONS AND ANSWERS 2024
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AHN 568 MODULE 1what things cause a diminished S1 sound? - ANSWERS-1st degree heart block
left BBB
MI
aortic regurgitation
what accentuates physiologic splitting of S2? - ANSWERS-inspiration
what causes pathologic splitting of s2? - ANSWERS-pulmonic stenosis
mitral regurgitation
right BBB
where can split S2 be heard best? - ANSWERS-right 2nd ICS (Base)
what causes s4? - ANSWERS-hypertension, aortic stenosis, ischemic and
hypertrophic cardiomyopathy
think STIFF ventricle
is S4 heard in a fib? - ANSWERS-NO. never hear S4 in afib.
,aortic stenosis (location, radiation, intensity, pitch, quality, maneuvers, causes,
timing) - ANSWERS-location: right 2nd-3rd ICS
radiation: carotids, or to apex
intensity/pitch: medium, harsh, crescendo-decrescendo
quality: harsh and musical
maneuvers: sitting and leaning forward, no hold breath
causes: bicuspid valve, calcification
timing: midsystolic
pulmonic stenosis (location, radiation, intensity, pitch, quality, causes, timing) -
ANSWERS-location: left 2nd-3rd ICS
radiation: if loud it radiates to left shoulder and neck
intensity: soft to loud (with thrill if loud)
pitch: medium, crescendo-decresendo
quality: harsh
causes: congenital, atrial septal defect
timing: midsystolic
Hypertropic Cardiomyopathy positions - ANSWERS-increase intensity: stand &
valsalva
decrease intensity: squat & release of valsalva
, mitral regurgitation: (location, radiation, intensity, pitch, quality, maneuvers,
causes, timing) - ANSWERS-location: apex 5th ICS MCL
radiation: to left axilla
intensity: pansystolic/holosystolic
pitch: medium to high
quality: blowing
no maneuvers change intensity
often associated with S3.
causes: endocarditis, rheumatic heart dx, collagen vascular dx, papillary muscle
dysfunction
*SYSTOLIC
aortic regurgitation (location, radiation, intensity, pitch, quality, maneuvers,
causes, timing) - ANSWERS-location: LEFT* 2-4th ICS
radiation: to apex or sternal border if loud
intensity: grade 1-4
pitch: high, use diaphragm
quality: blowing decrescendo, sounds like breath sounds
maneuvers: sit, lean forward, and HOLD BREATH
timing: diastolic
causes: leaflet abnormalities, aortic pathology like marfan, atrial septal defect
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