BLOCK 5 - QUIZ 5 CONTENT| TOP SCORES MADE SIMPLE
| TRUSTED TEST SOLUTIONS!
A diasolic murmur is always [benign/pathologic] Answer: pathologic
Causes of Mitral Stenosis Answer: Rheumatic fever is most common cause
- others include congenital, CTD, LA tumors, surgical complication of M.R. repair
- Women > men
Rheumatic fever is most common cause of what valvular disease?
- others include congenital, CTD, LA tumors, surgical complication of M.R. repair
- Women > men Answer: Mitral Stenosis
What valvular disease impairs LV filling resulting in decreased stroke volume (SV) and
cardiac output (CO) Answer: Mitral Stenosis
Mitral Stenosis symptoms Answer: - Usually symptomatic at 20-40 yo
- Dyspnea and orthopnea
- Hemoptysis (pulmonary apoplexy)
- Blood-tinged sputum (pulmonary
edema)
High-pitched opening snap is heard in what valvular disease? Answer: Mitral stenosis
Low-pitched rumbling diastolic murmur heard best at apex is heard in what vlavular
disease? Answer: Mitral stenosis
What position should a patient with mitral stenosis be placed in? Answer: Left lateral
decubitus position
Mitral stenosis EKG findings Answer: Atrial fibrillation
Atrial fibrillation is EKG finding of what valvular disease? Answer: Mitral stenosis
Best diagnostic tool for mitral stenosis Answer: ECHO
- doming of anterior leaflet
ECHO shows doming of anterior leaflet. What valvular disease? Answer: Mitral
stenosis
1
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,What is often used to assess severity of mitral stenosis Answer: Cardiac cath.
Mitral stenosis treatment if there is A. fib Answer: Anticoagulation
Mitral stenosis treatment Answer: - Anticoagulation if A. fib.
- Diuretics
- Endocarditis prophylaxis
- Moderate-severe dz.: balloon valvuloplasty,
open commissurotomy, valve replacement
What valvular disease is caused by abnormal leaflets, annulus, chordae or papillary
muscles Answer: Mitral regurgitation
Most common is myxomatous valve degeneration Answer: Mitral regurgitation
LA dilates to compensate for increased blood volume in what valvular disease?
Answer: Mitral regurgitation
Mitral regurgitation symptoms Answer: DOE, fatigue, orthopnea, PND (L sided CHF
with pulmonary edema) and eventually R sided CHF symptoms
Mitral stenosis heart sounds Answer: - High-pitched opening snap
- Low-pitched rumbling diastolic murmur heard best at apex
- High-pitched opening snap
- Low-pitched rumbling diastolic murmur heard best at apex Answer: Mitral stenosis
Harsh, holosystolic murmur heard best at apex and radiates to L axilla and back
Answer: Mitral regurgitation
Mitral regurgitation heart sounds Answer: Harsh, holosystolic murmur heard best at
apex and radiates to L axilla and back
Best diagnostic tool for mitral regurgitation Answer: ECHO
Mitral regurgitation treatment Answer: - reduce afterload with vasodilators (ACE-inh.,
hydralazine etc.)
- MV repair w/ annuloplasty (prosthetic ring)-not indicated with heavy calcification,
papillary muscle dysfxn. or endocarditis
- Valve replacemnt
MV repair w/ annuloplasty Answer: Treatment for mitral regurgitation
2
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,- not indicated with heavy calcification, papillary muscle dysfxn. or endocardit
Acute Mitral regurgitation Answer: Papillary muscle, chordae or leaflet dysfxn
-life-threatening since LA cannot dilate
What valvular disease is a papillary muscle, chordae or leaflet dysfxn
-life-threatening since LA cannot dilate Answer: Acute Mitral regurgitation
Mitral Valve Prolapse Answer: Improper closure of the valve between the heart's upper
and lower left chambers
- MV leaflets cross midline plane into LA during systole ("bend but don't break")
Improper closure of the valve between the heart's upper and lower left chambers
- MV leaflets cross midline plane into LA during systole ("bend but don't break")
Answer: Mitral Valve Prolapse
Myxomatous degeneration is classic finding of what valvular disease? Answer: Mitral
Valve Prolapse
Mitral Valve Prolapse symptoms Answer: "MVP syndrome": CP, palpitations, dizziness,
anxiety
- Most are asymptomatic
Mid-systolic click w/ late systolic murmur Answer: Mitral Valve Prolapse
Mitral Valve Prolapse heart sound Answer: Mid-systolic click w/ late systolic murmur
Best diagnostic tool for mitral valve prolapse Answer: ECHO
Mitral Valve Prolapse treatment Answer: - Most pts. with mild dz. require no treatment
- Endocarditis prophylaxis if M.R. is present
- Watch closely for worsening M.R. and decline in LV functio
Causes of tricuspid stenosis Answer: rheumatic, carcinoid, congenital, tumor,
vegetations
Tricuspid Stenosis symptoms Answer: Fatigue, abd. distention, leg swelling
- PE suggestive of RV failure: JVD, hepatojugular reflux, LE edema
Opening snap w/ a soft, high-pitched diastolic murmur Answer: Tricuspid stenosis
Fatigue, abd. distention, leg swelling
- PE suggestive of RV failure: JVD, hepatojugular reflux, LE edema
3
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, Symptoms of what valvular disease? Answer: Tricuspid stenosis
Tricuspid stenosis heart sounds Answer: Opening snap w/ a soft, high-pitched diastolic
murmur
Best diagnostic tool for tricuspid stenosis? Answer: ECHO
Causes of tricuspid Regurgitation Answer: Usually due to RV dilation and failure-other
causes: endocarditis, carcinoid, congenital, traum
What valvular disease is well-tolerated unless RV failure then get associated
symptoms/signs Answer: tricuspid regurgitation
High-pitched holosystolic murmur heard best at L sternal border Answer: Tricuspid
Regurgitation
Tricuspid Regurgitation treatment Answer: Usually improves w/ tx. of underlying cause-
if not then surgical repair or replacement
Tricuspid Regurgitation heart sound Answer: High-pitched holosystolic murmur heard
best at L sternal border
Pulmonic Stenosis is usually [congenital/acquired] Answer: congenital
What valvular disease is usually secondary to pulm. HTN and RV failure Answer:
Pulmonic Regurgitation
Pulmonic Regurgitation is usually secondary to? Answer: pulm. HTN and RV failure
Graham Steell murmur Answer: high-pitched, blowing diastolic murmur heard best at
second L intercostal space
- Heard in pulmonary regurgitation
high-pitched, blowing diastolic murmur heard best at second L intercostal space
Answer: Graham Steell murmur
- Heard in pulmonary regurgitation
Pulmonary regurgitation heart sounds Answer: Graham Steell murmur
- high-pitched, blowing diastolic murmur heard best at second L intercostal space
Pulmonic Regurgitation treatment Answer: Treat underlying cause of pulm. HTN
- Rarely valve repair or replacement
Multivalvular Disease is seen in what patients Answer: rheumatic heart dz. and older
pts
4
APPHIA - Crafted with Care and Precision for Academic Excellence.
| TRUSTED TEST SOLUTIONS!
A diasolic murmur is always [benign/pathologic] Answer: pathologic
Causes of Mitral Stenosis Answer: Rheumatic fever is most common cause
- others include congenital, CTD, LA tumors, surgical complication of M.R. repair
- Women > men
Rheumatic fever is most common cause of what valvular disease?
- others include congenital, CTD, LA tumors, surgical complication of M.R. repair
- Women > men Answer: Mitral Stenosis
What valvular disease impairs LV filling resulting in decreased stroke volume (SV) and
cardiac output (CO) Answer: Mitral Stenosis
Mitral Stenosis symptoms Answer: - Usually symptomatic at 20-40 yo
- Dyspnea and orthopnea
- Hemoptysis (pulmonary apoplexy)
- Blood-tinged sputum (pulmonary
edema)
High-pitched opening snap is heard in what valvular disease? Answer: Mitral stenosis
Low-pitched rumbling diastolic murmur heard best at apex is heard in what vlavular
disease? Answer: Mitral stenosis
What position should a patient with mitral stenosis be placed in? Answer: Left lateral
decubitus position
Mitral stenosis EKG findings Answer: Atrial fibrillation
Atrial fibrillation is EKG finding of what valvular disease? Answer: Mitral stenosis
Best diagnostic tool for mitral stenosis Answer: ECHO
- doming of anterior leaflet
ECHO shows doming of anterior leaflet. What valvular disease? Answer: Mitral
stenosis
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
,What is often used to assess severity of mitral stenosis Answer: Cardiac cath.
Mitral stenosis treatment if there is A. fib Answer: Anticoagulation
Mitral stenosis treatment Answer: - Anticoagulation if A. fib.
- Diuretics
- Endocarditis prophylaxis
- Moderate-severe dz.: balloon valvuloplasty,
open commissurotomy, valve replacement
What valvular disease is caused by abnormal leaflets, annulus, chordae or papillary
muscles Answer: Mitral regurgitation
Most common is myxomatous valve degeneration Answer: Mitral regurgitation
LA dilates to compensate for increased blood volume in what valvular disease?
Answer: Mitral regurgitation
Mitral regurgitation symptoms Answer: DOE, fatigue, orthopnea, PND (L sided CHF
with pulmonary edema) and eventually R sided CHF symptoms
Mitral stenosis heart sounds Answer: - High-pitched opening snap
- Low-pitched rumbling diastolic murmur heard best at apex
- High-pitched opening snap
- Low-pitched rumbling diastolic murmur heard best at apex Answer: Mitral stenosis
Harsh, holosystolic murmur heard best at apex and radiates to L axilla and back
Answer: Mitral regurgitation
Mitral regurgitation heart sounds Answer: Harsh, holosystolic murmur heard best at
apex and radiates to L axilla and back
Best diagnostic tool for mitral regurgitation Answer: ECHO
Mitral regurgitation treatment Answer: - reduce afterload with vasodilators (ACE-inh.,
hydralazine etc.)
- MV repair w/ annuloplasty (prosthetic ring)-not indicated with heavy calcification,
papillary muscle dysfxn. or endocarditis
- Valve replacemnt
MV repair w/ annuloplasty Answer: Treatment for mitral regurgitation
2
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,- not indicated with heavy calcification, papillary muscle dysfxn. or endocardit
Acute Mitral regurgitation Answer: Papillary muscle, chordae or leaflet dysfxn
-life-threatening since LA cannot dilate
What valvular disease is a papillary muscle, chordae or leaflet dysfxn
-life-threatening since LA cannot dilate Answer: Acute Mitral regurgitation
Mitral Valve Prolapse Answer: Improper closure of the valve between the heart's upper
and lower left chambers
- MV leaflets cross midline plane into LA during systole ("bend but don't break")
Improper closure of the valve between the heart's upper and lower left chambers
- MV leaflets cross midline plane into LA during systole ("bend but don't break")
Answer: Mitral Valve Prolapse
Myxomatous degeneration is classic finding of what valvular disease? Answer: Mitral
Valve Prolapse
Mitral Valve Prolapse symptoms Answer: "MVP syndrome": CP, palpitations, dizziness,
anxiety
- Most are asymptomatic
Mid-systolic click w/ late systolic murmur Answer: Mitral Valve Prolapse
Mitral Valve Prolapse heart sound Answer: Mid-systolic click w/ late systolic murmur
Best diagnostic tool for mitral valve prolapse Answer: ECHO
Mitral Valve Prolapse treatment Answer: - Most pts. with mild dz. require no treatment
- Endocarditis prophylaxis if M.R. is present
- Watch closely for worsening M.R. and decline in LV functio
Causes of tricuspid stenosis Answer: rheumatic, carcinoid, congenital, tumor,
vegetations
Tricuspid Stenosis symptoms Answer: Fatigue, abd. distention, leg swelling
- PE suggestive of RV failure: JVD, hepatojugular reflux, LE edema
Opening snap w/ a soft, high-pitched diastolic murmur Answer: Tricuspid stenosis
Fatigue, abd. distention, leg swelling
- PE suggestive of RV failure: JVD, hepatojugular reflux, LE edema
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
, Symptoms of what valvular disease? Answer: Tricuspid stenosis
Tricuspid stenosis heart sounds Answer: Opening snap w/ a soft, high-pitched diastolic
murmur
Best diagnostic tool for tricuspid stenosis? Answer: ECHO
Causes of tricuspid Regurgitation Answer: Usually due to RV dilation and failure-other
causes: endocarditis, carcinoid, congenital, traum
What valvular disease is well-tolerated unless RV failure then get associated
symptoms/signs Answer: tricuspid regurgitation
High-pitched holosystolic murmur heard best at L sternal border Answer: Tricuspid
Regurgitation
Tricuspid Regurgitation treatment Answer: Usually improves w/ tx. of underlying cause-
if not then surgical repair or replacement
Tricuspid Regurgitation heart sound Answer: High-pitched holosystolic murmur heard
best at L sternal border
Pulmonic Stenosis is usually [congenital/acquired] Answer: congenital
What valvular disease is usually secondary to pulm. HTN and RV failure Answer:
Pulmonic Regurgitation
Pulmonic Regurgitation is usually secondary to? Answer: pulm. HTN and RV failure
Graham Steell murmur Answer: high-pitched, blowing diastolic murmur heard best at
second L intercostal space
- Heard in pulmonary regurgitation
high-pitched, blowing diastolic murmur heard best at second L intercostal space
Answer: Graham Steell murmur
- Heard in pulmonary regurgitation
Pulmonary regurgitation heart sounds Answer: Graham Steell murmur
- high-pitched, blowing diastolic murmur heard best at second L intercostal space
Pulmonic Regurgitation treatment Answer: Treat underlying cause of pulm. HTN
- Rarely valve repair or replacement
Multivalvular Disease is seen in what patients Answer: rheumatic heart dz. and older
pts
4
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