Cardiovascular System : Physical Examination -VI

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Which of the following always signify structural heart disease –

Correct! Wrong!

ANSWER -B
Diastolic heart murmurs always signify structural heart disease.

Valsalva manoeuvre [strain phase] decreases the intensity or duration of all left-sided murmurs EXCEPT -

Correct! Wrong!

ANSWER -C
Valsalva manoeuvre strain phase decreases the intensity or duration of all left-sided murmurs except mitral valve prolapse (MVP) and hypertrophic cardiomyopathy (HOCM)

All of the following are TRUE for Strain phase of Valsalva manoeuvre EXCEPT -

Correct! Wrong!

ANSWER -C
Strain phase of Valsalva manoeuvre - ↑ ventricular volume,


Strain phase of Valsalva manoeuvre MURMURS -
↑ MVP, ↑ HOCM
↓ AS, ↓ PS, ↓ MS, ↓ AR, ↓ MR, ↓VSD, ↓ PDA

During the initial hypotension after amyl nitrite inhalation all of the following murmurs decrease in intensity EXCEPT –

Correct! Wrong!

ANSWER -D
During the initial hypotension after amyl nitrite inhalation, murmurs of MR, VSD, and AR decrease in intensity, because of decrease in BP and systemic vascular resistance, whereas the murmur of AS increases.

All of the following murmurs increase after hand grip exercise EXCEPT –

Correct! Wrong!

ANSWER -D
Murmurs of MR, VSD, and AR - increase with hand grip exercise. HOCM – murmur decreases with hand grip exercise

Most common cardiac cause of clubbing –

Correct! Wrong!

ANSWER -A
Cyanotic heart disease.
Infective endocarditis usually causes a milder form of clubbing, whereas in congenital cyanotic heart disease, gross, drumstick appearance may be seen.

What is the normal Lovibond angle –

Correct! Wrong!

ANSWER -B
Lovibond angle - normal <165° angle – This is the angle between the nailbed and the fold (cuticula).

Clubbing usually develops first in the –

Correct! Wrong!

ANSWER -A
Clubbing usually develops first in the thumb and forefinger, and occurs in the other fingers later.

All of the following are TRUE regarding Unilateral clubbing in the upper extremity EXCEPT –

Correct! Wrong!

ANSWER -D
Unilateral clubbing in the upper extremity may be due to anomalies of the aortic arch, aortic or subclavian artery aneurysm, pulmonary hypertension with patent ductus arteriosus, and brachial arteriovenous aneurysm or fistula.

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