Things to know for the OSCE Cardiovascular Flashcards Preview

Year 3 - Clinical Communication Skills > Things to know for the OSCE Cardiovascular > Flashcards

Flashcards in Things to know for the OSCE Cardiovascular Deck (24)
Loading flashcards...
1

What are the cardiovascular causes of Clubbing

- Congenital cyanotic heart disease
- infective endocarditis

2

What are Osler's node

- red, tender nodules on fingers pulps or thenar eminence (immune complex deposition)
- seen in infective endocarditis as rare and late sing

3

What are Janeway lesions

- non tender macular papular lesions seen on palms or finger pulps (embolic phenomenon) - infective endocarditis - rare

4

What can cause radio-radial delay

- aortic correction
- aortic dissection
- subclavian artery stenosis

5

What can cause a collapsing pulse

- Aortic regurgitation
- PDA
- pregnancy
- fever
- thyrotoxicosis

6

What can cause pulses paradoxus

- cardiac tamponade (late)
- severe acute/COPD

7

What is pulses paradoxus

- pulse wave volume decreases significantly during inspiration

8

What are the signs of hypercholestrolaemia in eyes

- Corneal arcus - significant only if <50 years old
- xanthelasma

9

What is mitral faces suggestive of

mitral stenosis

10

what can cause central cyanosis

- hypoxaemia - e.g. right to left cardiac shunt

11

What is Kussmaul's sign

- JVP will rise with inspiration in pericardial constriction, right ventricular infarction or cardiac tamponade

12

What can cause a raised JVP

- right sided heart failure - e.g. due to left sided heart failure or pulmonary hypertension
- tricuspid regurgitation
- constrictive pericarditis

13

What is a thrill

a palpable vibration caused by turbulent blood flow through the heart valve (palpable murmur)

14

What is a heave

- right ventricular hypertrophy

15

What can cause displacement of the apex beat

- cardiomegaly (e.g. cardiomyopathy, CCF) mediastinal shift (e.g. Pleural effusion, tension pneumothorax)

16

What can cause a forceful and sustained apex beat

- pressure-loaded
- e.g. left ventricular hypertrophy

17

What is the cause of a forceful and non sustained apex beat

- volume loaded
- e.g. hyper metabolic states, aortic/mitral regurgitation

18

What causes a double impulse apex beat

Hypertrophic cardiomyopathy

19

Where are the valves

- aortic 2nd intercostal space right sternal edge
- pulmonary 2nd intercostal space in left sternal edge
- tricuspid 4th/5th intercostal space lower left sternal edge
- mitral 5th intercostal space midclavicular line

20

How do you find the mitral stenosis

- mid diastolic rumble
- ask patient to roll onto their left side and ausculate the mitral area using the bell

21

How do you find mitral regurgitation

- pan systolic murmur
- in the same position, ausculate in the mitral area again this time using the diaphragm
- ausculate into the axilla to identify radiation of this murmur

22

How do you find aortic stenosis

- Ejection systolic
- with the patient back in normal seated position, auscultate int he carotid arteries using the diaphragm m

23

How do you find aortic regurgitation

- early diastolic murmur
- sit the patient forwards and auscultate over the aortic areas with the diaphragm

24

What investigations would you perform

- full set of abs
- peripheral vascular and respiratory exam
- ECG
- bloods
- CXR
- Echo