TDP2 – Questions With Appropriate Solutions

TDP2 – Questions With Appropriate Solutions
Where will S1 will be loudest along? Correct Answer - over the
left 4th intercostal space (mitral/tricuspid)

Where will S2 will be loudest along? Correct Answer - the 2nd
R/L intercostal spaces, aortic and pulmonary valve at the beginning
of diastole

S3 (Kentucky)- Correct Answer - commonly associated with
left ventricular failure (blood from left atrium slamming into an
already overfilled ventricle during early diastolic filling. Known as
atrial gallop

S4 (Tennessee)- Correct Answer - sound created by blood
trying to enter a stiff, noncompliant left ventricle during atrial
contraction. Known as ventricular gallop

What is THE BELL: MORE SENSITIVE TO? Correct Answer -
LOW-PITCHED SOUNDS OF S3 AND S4 AND THE MURMUR OF
MITRAL STENOSIS

What is THE DIAPHRAGM: BETTER FOR HEARING? Correct
Answer - HIGH- PITCHED SOUNDS OF S1 AND S2 SUCH AS
AORTIC AND MITRAL REGURGITATION AND PERICARDIAL RUBS

How can auscultation of certain murmurs be improved? Correct
Answer - TURNING ON TO THE LEFT SIDE OR LEANING
FORWARD:

BRINGS THE HEART CLOSER TO THE CHEST WALL

Grade 1/6 auscultation intensity Correct Answer - Softer in
volume than S1 and S2, very faint (very hard to hear)

,Grade 2/6 auscultation intensity Correct Answer - Equal in
volume to S1 and S2, quiet, but heard immediately

Grade 3/6 auscultation intensity Correct Answer - Louder in
volume than S1 and S2, moderately loud

Grade 4/6 auscultation intensity Correct Answer - Louder in
volume than S1 and S2, with palpable thrill

Grade 5/6 auscultation intensity Correct Answer - Louder in
volume than S1 and S2, with thrill; may be heard when the
stethoscope is partly off the chest

Grade 6/6 auscultation intensity Correct Answer - Louder in
volume than S1 and S2, with thrill; may be heard with stethoscope
entirely off the chest

Systolic Murmurs Correct Answer - 1.Aortic Stenosis
2.Pulmonic Stenosis
3.Mitral Regurgitation
4.Tricuspid Regurgitation
5.Hypertrophic Cardiomyopathy
6.Mitral Valve Prolapse
7.Ventricular Septal Defect (VSD)

Diastolic Murmurs Correct Answer - 1.Aortic Regurgitation
2.Pulmonic Regurgitation
3.Mitral Stenosis
4.Tricuspid Stenosis

Aortic Stenosis Correct Answer - right 2nd intercostal space:
Crescendo-decrescendo, harsh sound

, Pulmonic Stenosis Correct Answer - Left 2nd intercostal space:
Crescendo-decrescendo, may have ejection click

Mitral Regurgitation Correct Answer - Apex: Holosystolic,
high-pitched blowing, best in left lateral decubitus position

Tricuspid Regurgitation Correct Answer - Lower Left sternal
border: Holosystolic, high-pitched blowing

Hypertrophic Cardiomyopathy Correct Answer - Left sternal
border: Crescendo-decrescendo, harsh quality

Mitral Valve Prolapse Correct Answer - Apex: Midsystolic click
followed by late systolic murmur, best in left lateral decubitus
position

Ventricular Septal Defect (VSD) Correct Answer - Left lower
sternal border: Holosystolic, loud and harsh

Aortic Regurgitation Correct Answer - Left sternal border:
Decrescendo, blowing quality

Pulmonic Regurgitation Correct Answer - Left upper sternal
border: Decrescendo, high-pitched, increases with inspiration

Mitral Stenosis Correct Answer - Apex: Holodiastolic, Low-
pitched rumbling, opening snap present, heard with BELL

Tricuspid Stenosis Correct Answer - Lower left sternal border:
Low-pitched rumble, opening snap present

extreme axis Correct Answer - QRS axis from -90 to +180

right axis deviation Correct Answer - QRS axis +90 to +180