karahm
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Intro, diagnostic approach, history and physical exam

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karahm
Created by karahm about 10 years ago
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Cardio Exam 1 set 1

Cardio Exam 1 set 1

Question 1 of 27

1

Which of the following is NOT a determinant of cardiac output?

Select one of the following:

  • Preload

  • Afterload

  • Contractility

  • Heart Rate

  • Stroke Volume

Explanation

Question 2 of 27

1

Which of the following terms and definitions is INCORRECTLY paired?

Select one of the following:

  • Heart failure- a syndrome of clinical signs and associated neuroendicrine abnormalities that results from impaired emptying or filling of the heart

  • Heart disease- a structural or functional abnormality of the heart

  • Left-sided heart failure- characterized by elevations in central venous pressure that result in ascites, pleural effusion, or peripheral edema

  • All of these are correctly paired

Explanation

Question 3 of 27

1

Heart disease can be classified on an anatomical-pathologic basis or on the basis of pathophysiology.

Select one of the following:

  • True
  • False

Explanation

Question 4 of 27

1

Which of the following is CORRECTLY paired?

Select one of the following:

  • Volume overloads- diseases that decrease the diastolic volume of the heart

  • Pressure overloads- diseases that increase systolic load often because of a decreased resistance to ventricular emptying

  • Contractile dysfunction- any functional or structural disorder of the sarcomeres can result in contractile dysfunction and the syndrome known as dilated cardiomyopathy

  • Diastolic dysfunction- diseases that impair atrial filling

Explanation

Question 5 of 27

1

In the most general sense, the cardiovascular exam is intended to answer which of the following questions? Check all that apply.

Select one or more of the following:

  • What is the cardiac rate?

  • What is the cardiac rhythm?

  • Is the heart enlarged?

  • Is heart failure present?

  • What is the disease that has caused heart failure?

Explanation

Question 6 of 27

1

A diagnosis of left-sided heart failure is made when there is radiographic pulmonary edema and evidence of cardiac dysfunction which is usually demonstrated by radiographic heart enlargement and/or jugular distension.

Select one of the following:

  • True
  • False

Explanation

Question 7 of 27

1

What information can we get from thoracic radiographs? Check all that apply. (Hint: it isn't all of them, I promise.)

Select one or more of the following:

  • Cardiac dimensions using the vertebral heart score

  • Pulmonary vasculature

  • Concomitant diseases

  • Distinguishes between cardiomegaly and pericardial effusion

  • Chambers are easy to distinguish from each other

Explanation

Question 8 of 27

1

Which of the following is NOT part of the clinical utility of the ECG?

Select one of the following:

  • Arrhythmias (diagnosis and follow-up)

  • Conduction abnormalities

  • Monitoring anesthesia

  • Chamber enlargements

  • Electrolyte abnormalities

  • Severity of heart failure

  • All of the above

Explanation

Question 9 of 27

1

An ECHO can confirm the suspected diagnosis, assess cardiac dimensions better than rads, provides non-invasive evaluation of systolic and diastolic function, and evaluation of severity of stenosis or shunts.

Select one of the following:

  • True
  • False

Explanation

Question 10 of 27

1

Which of the following tests and indications are CORRECTLY paired?

Select one of the following:

  • Thoracic radiographs: clinical signs such as cough or dyspnea are present

  • ECHO: the cause of and enlarged radiographic cardiac silhouette is unclear and/or when a definitive etiologic diagnosis of heart disease is important

  • ECG/EKG: when the heart rate is inappropriately high, inappropriately low, or inappropriately irregular

  • ECHO and ECG only

  • Rads and ECHO only

  • All of the above

Explanation

Question 11 of 27

1

Congenital malformations are only found in young patients.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 27

1

Which of the following statements is FALSE?

Select one of the following:

  • Relatively mild heart disease can compromise exercise performance/tolerance in athletes. Sedentary animals don't usually have signs of exercise intolerance until cardiac disease is advanced.

  • Cough that persists for months or years without treatment is most often due to cardiac disease.

  • Tachypnea/hyperpnea/respiratory distress is a relatively consistent finding in patients with cardiogenic pulmonary edema.

  • When cardiac disease explains syncope, an arrhythmia often is responsible.

  • Patients with congenital malformations sometimes develop clinical signs including poor growth (failure to thrive).

Explanation

Question 13 of 27

1

What is the normal heart rate for dogs?

Select one of the following:

  • 60-110

  • 24-50

  • 70-160

  • 160-240

Explanation

Question 14 of 27

1

Which of the following is FALSE regarding arterial pulse?

Select one of the following:

  • Pulse amplitude is an important characteristic of arterial pulse. The pulse amplitude is determined by pulse pressure (the difference between systolic pressure and diastolic pressure). Pulse pressure depends on stroke volume, aortic distensibility, resistance to flow, end-diastolic volume of arteries, and heart rate.

  • Weak (hypokinetic) arterial pulse most often reflects a small stroke volume associated with hypovolemia or sometimes (but not usually) heart disease.

  • Absent arterial pulse may be related to obstruction due to thromboembloism or simply is an "artifact" such as the patient being obese.

  • Bounding (hyperkinetic) arterial pulse occurs only with PDA. The diastolic run-off throught the PDA contributes to the widening of the the pulse width.

Explanation

Question 15 of 27

1

Which of the following is FALSE about central venous pulse?

Select one of the following:

  • The jugular veins function as manometers. The degree of distension and the height of jugular pulsation reflects right atrial (and right ventricular diastolic) pressure.

  • It should be evaluated when the patient is standing.

  • The height of jugular pulsation needs to be >10 cm to suggest right heart failure, volume overload.

  • Edema under the chin is common in horses with right heart failure.

Explanation

Question 16 of 27

1

Which of the following is INCORRECT about mucous membranes?

Select one of the following:

  • CRT is not sensitive to acute decreases in CO

  • Pallor is due to a decrease in oxyhemoglobin. This may be associated with anemia and/or vasoconstriction.

  • Peripheral cyanosis may be due to lung disease or (rarely) heart defects such as Tetrology of Fallot.

Explanation

Question 17 of 27

1

Which of the following pairings of transient heart sounds and action in the heart are CORRECT? Check all that apply.

Select one or more of the following:

  • S1: AV valve closure

  • S1: Atrial contraction

  • S2: AV valve closure

  • S2: semilunar valve closure

  • S3: semilunar valve closure

  • S3: early diastolic filling

  • S4: early diastolic filling

  • S4: atrial contraction

Explanation

Question 18 of 27

1

Splitting sound occurs when the 2 components of S2 or S1 can be discerned with auscultation.

Select one of the following:

  • True
  • False

Explanation

Question 19 of 27

1

Which of the following are about transient systolic clicks? Select all that apply.

Select one or more of the following:

  • High frequency sound associated with mitral valve prolapse

  • Common in older, small breed dogs (a precursor of mitral valve regurgitation)

  • Audibility of S3 and/or S4

  • In cats (and many dogs), high heart rates mean that the 2 sounds are "summated"

  • Heard when atrial pressures are high and ventricle is close to its elastic limit.

Explanation

Question 20 of 27

1

A murmur is a prolonged series of vibrations that originates from the cardiovascular system. In general, murumurs arise when laminar blood flow breaks down resulting in disturbed flow.

Select one of the following:

  • True
  • False

Explanation

Question 21 of 27

1

Which of the following is TRUE of determinants of blood flow character?

Select one of the following:

  • Velocity is the most important. Acceleration explains almost all murmurs.

  • Viscosity is the most important. Anemia may explain murmurs when HCT <~17

  • Diameter is the most important. As blood vessels are dilated or constricted blood flow changes.

Explanation

Question 22 of 27

1

Which of the following is TRUE about murmurs?

Select one of the following:

  • Grade 1: a loud murmur with thrill/audible if stethoscope is lifted from chest

  • Grade 2: loud murmur with an associated thrill

  • Grade 3: murmur of intermediate intensity

  • Grade 4: soft murmur

  • Grade 5: very soft and focal

Explanation

Question 23 of 27

1

Which of the following is the timing for systolic murmur?

Select one of the following:

  • between S1 and S2

  • between S2 and S1

Explanation

Question 24 of 27

1

A continuous murmur begins during systole and persists after S2. It is also pretty much pathopneumonic for PDA.

Select one of the following:

  • True
  • False

Explanation

Question 25 of 27

1

What is/are PMI for murmurs?

Select one of the following:

  • Left heart base (aortic/pulmonic areas) 4th, 5th ICS

  • Left apex (mitral) 6th ICS

  • Most in cats are heard along the sternal borders

  • Left heart base and left apex

  • All of the above

  • None of the above

Explanation

Question 26 of 27

1

Which of the following describe a regurgitant configuration?

Select one or more of the following:

  • Mid-systolic

  • mid-diastolic

  • diamond-shaped

  • associated with outflow tract obstruction

  • plateau-shaped

  • associated with AV valves

Explanation

Question 27 of 27

1

Innocent murmurs are typically heard in puppies, kittens, and adult horses.

Select one of the following:

  • True
  • False

Explanation

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