Karteikarten
CV examination
Karten in diesem Stapel (30)
- 1How do you start?A - Alcohol hand gel
I - Introduce self
O - obtain consent
E - expose trunk
U - sit at 45 degrees
End of bed assessment - 2Three things on the nailsClubbing
Capillary refill
Splinter haemorrhages - 3Three CV causes of clubbinginfective endocarditis
cyanotic congenital heart disease
atrial myxoma - 4Two things to look for in the handsPeripheral cyanosis/ coldness
Janeway lesions and Osler's nodes - 55 things you check for in the pulseRate
Rhythm
Character
Collapsing pulse
Radio-radial and radio-femoral delay - 6Three CV changes to blood pressureLow systolic - AS
Wide pulse pressure - AR
High systolic - hypertension - 76 things you look for in the eyesxanthelasma
corneal arcus
scleral icterus
conjunctival pallor
conjunctival petechial haemorrhage
Roth's spots - 83 things you look for in the mouthcentral cyanosis
dental hygiene
dehydration - 93 things to check for in the neckCarotid endarterectomy scars
Carotid pulse character
Raised JVP - 10Inspection of the praecordiumSternotomy scars
Thoracotomy scars
Pacemaker/ ICD - 11Palpation of praecordiumHeaves and thrills
Apex beat
Hepatomegaly - 12Which heart sounds are loudest on inspiration/expiration?rIght HS loudest on Inspiration
lEft HS loudest on Expiration - 135 things to do after auscultationListen for crackles
Feel for sacral oedema
Feel for pitting oedema on legs
Assess lower limb perfusion
Thank and cover the patient - 14Further investigationsBedside: Urine dipstick, fundoscopy
Bloods: glucose, FBC, CRP
Imaging: CXR, Echo
Special: ECG, stress test - 15Causes of split heart soundsright bundle branch block (split S1)
left bundle branch block (split S2)
wide splitting in ASD due to overload
normal splitting (A slightly earlier) - 16How can Down's syndrome affect the cardiovascular system?more likely to have congenital atrio-septal or ventriculo-septal defects (with mitral regurgitation)
- 17What syndrome is associated with coarctation of the aortaTurner's syndrome
- 18How does thyrotoxicosis affect the cardiovascular system?Can cause AF and cardiac failure
- 19What are the signs of Marfan's syndrome?Being tall with slender limbs
Lens dislocation
Skeletal problems - Pectus excavatum, flat feet, scoliosis
Aortic root dilation and dissection
Mitral valve prolapse - 20Things to look for in the hands in a peripheral vascular examTar staining
Capillary refill
Evidence of ischaemia
Evidence of diabetes - 21Pulses to feel in the armsRadial
Radio-radial delay
Brachial - 22Things to look for in the eyes in e peripheral vascular examcorneal arcus and xanthelasma
- 23Things to look for in the abdomen in a peripheral vascular examScars - including sternotomy scar
Visibe pulsations
Palpate for aortic aneurysm
Auscultate for aortic and ileal bruits - 24Things to look for in the legs in peripheral vascular exam (7)Scars - including groin
Ulceration
Haemosideration
Sores on pressure points
Fungal infection or gangrene between toes
Capillary refill
Temperature - 25Where is the femoral pulse?mid-inguinal point - between ASIS and symphysis pubis
- 26Where is the posterior tibial pulse felt?2 cm inferior and posterior to the medial malleolus
- 27Further testsBedside - BP, Berger's test
Bloods - lipids, glucose
Imaging - Doppler, Angiogram
Special - Ankle-Brachial Pressure Index - 28What would you look for in a venous examination?haemosiderin deposition
ulceration
varicosities
thread veins
lipodermatosclerosis
(attention to medial gaiter region) - 29How could you describe the character of the apex beat? (3)Heaving, diffuse - LV hypertrophy from aortic or mitral incompetence
Forceful - hypertrophy from aortic stenosis or hypertension
Tapping - palpable first heart sound in mitral stenosis - 30How could you describe the character of the carotid pulse? (4)Slow rising - aortic stenosis
Collapsing - aortic regurgitations, arerio-venous fistula
small amplitude - heart failure, shock or mitral stenosis
large amplitude - thyroid overactivity
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- Examinations Karteikarten am CV examination, erstellt von queen_laidley am 29/03/2015.
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