Cardiovascular System : Physical Examination -III

Physical Examination -III

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Dicrotic pulse with peaks in systole and diastole. Seen in patients with sepsis or during IABP with inflation just after the dicrotic notch.

Positive abdominojugular reflux maneuver correlates with the pulmonary artery pressure and thus is a marker for

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ANSWER -A
A positive AJR test correlates with the pulmonary artery pressure and thus is a marker for right heart dysfunction, specifically right ventricular failure.

Left ventricular failure produces positive abdominojugular reflux when –

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ANSWER -C
Left ventricular failure produces positive abdominojugular reflux sign when the PCWP is more than 15 mmHg.

Which of the following doesn’t produce POSITIVE ABDOMINOJUGULAR REFLUX-

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ANSWER -D
• Left ventricular failure also produces POSITIVE ABDOMINOJUGULAR REFLUX , usually when the PCWP is more than 15 mmHg.
• Cardiac tamponade does not lead to a positive hepatojugular reflux.
• Constrictive pericarditis, right ventricular failure (commonly due to infarction), and restrictive cardiomyopathy are conditions that frequently produce a positive hepatojugular reflux.

Presence of a right atrial pressure >10 mmHg suggests a pulmonary artery wedge pressure of –

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ANSWER -C
Presence of a right atrial pressure >10 mmHg (as predicted on bedside examination) had a positive value of 88% for the prediction of a pulmonary artery wedge pressure of >22 mmHg.

Very low diastolic blood pressures may be recorded in patients with –

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ANSWER -C
Very low (even 0 mmHg) diastolic blood pressures may be recorded in patients with chronic, severe AR or a large arteriovenous fistula because of enhanced diastolic “run-off.”

Bobbing motion of the patient's head with each heart beat seen in -

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ANSWER -D
de Musset sign - Bobbing motion of the patient's head with each heartbeat - Aortic Regurgitation

“White coat hypertension” is defined by at least ………………..separate clinic-based measurements >140/90 mmHg and at least ……………… non-clinic-based measurements <140/90 mmHg.

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ANSWER -B
“White coat hypertension” is defined by at least three separate clinic-based measurements >140/90 mmHg and at least two non-clinic-based measurements <140/90 mmHg.

Orthostatic hypotension is defined by a fall in systolic pressure >……………..mmHg or in diastolic pressure >……………….. mmHg in response to assumption of the upright posture from a supine position within ………….. min.

Correct! Wrong!

ANSWER -C
Orthostatic hypotension is defined by a fall in systolic pressure >20 mmHg or in diastolic pressure >10 mmHg in response to assumption of the upright posture from a supine position within 3 min.

Pulsus parvus et tardus is seen in –

Correct! Wrong!

ANSWER -A
weak and delayed pulse - pulsus parvus et tardus - defines severe aortic stenosis.

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