Podcast
Questions and Answers
What is tachypnea defined as?
What is tachypnea defined as?
Dyspnea refers to a normal sensation of breathing.
Dyspnea refers to a normal sensation of breathing.
False
What must be evaluated before starting a physical examination of a child?
What must be evaluated before starting a physical examination of a child?
Mental and motor development
Weight and _____ must be measured and noticed during an examination.
Weight and _____ must be measured and noticed during an examination.
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Which of the following symptoms indicates respiratory distress?
Which of the following symptoms indicates respiratory distress?
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Match the symptoms with their associated condition:
Match the symptoms with their associated condition:
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Pale appearance and anemia can be observed during an examination.
Pale appearance and anemia can be observed during an examination.
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What is the primary cause of dyspnea during exertion?
What is the primary cause of dyspnea during exertion?
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Which of the following is a common cause of peripheral oedema?
Which of the following is a common cause of peripheral oedema?
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A heaving apex beat indicates left ventricular hypertrophy (LVH).
A heaving apex beat indicates left ventricular hypertrophy (LVH).
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What does a lowermost and outermost apex beat suggest?
What does a lowermost and outermost apex beat suggest?
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The arterial pulse contour changes due to _____, viscosity, vessel geometry, and compliance.
The arterial pulse contour changes due to _____, viscosity, vessel geometry, and compliance.
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Which drug class retains sodium and can cause peripheral oedema?
Which drug class retains sodium and can cause peripheral oedema?
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When assessing pulse character, which pulse is generally preferred over the radial pulse?
When assessing pulse character, which pulse is generally preferred over the radial pulse?
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Match the type of pulse with their characteristics:
Match the type of pulse with their characteristics:
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A sharp downward deflection in the arterial pulse contour is known as incisura.
A sharp downward deflection in the arterial pulse contour is known as incisura.
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Which heart sound is primarily caused by the closing of the mitral and tricuspid valves?
Which heart sound is primarily caused by the closing of the mitral and tricuspid valves?
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Children have a more variable heart rate compared to adults.
Children have a more variable heart rate compared to adults.
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What is a primary method for evaluating arterial oxygenation non-invasively?
What is a primary method for evaluating arterial oxygenation non-invasively?
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What does the 'dub' sound in the lub-dub sequence represent?
What does the 'dub' sound in the lub-dub sequence represent?
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Crying usually worsens cyanosis in patients with cyanotic heart defects.
Crying usually worsens cyanosis in patients with cyanotic heart defects.
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Name one of the three common causes of central cyanosis.
Name one of the three common causes of central cyanosis.
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The apical pulse should be listened to for at least _____ minute.
The apical pulse should be listened to for at least _____ minute.
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A hyperoxygenation test requires a child to breathe ________% oxygen for 10 minutes.
A hyperoxygenation test requires a child to breathe ________% oxygen for 10 minutes.
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Match the following auscultation areas with the corresponding valves:
Match the following auscultation areas with the corresponding valves:
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What arterial oxygen saturation level suggests congenital heart disease after a hyperoxygenation test?
What arterial oxygen saturation level suggests congenital heart disease after a hyperoxygenation test?
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What should be palpated in infants to assess heart rate?
What should be palpated in infants to assess heart rate?
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Systole is the period when the heart is relaxed.
Systole is the period when the heart is relaxed.
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In infants, peripheral edema due to heart failure first appears ________.
In infants, peripheral edema due to heart failure first appears ________.
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Match the conditions with their associated causes of cyanosis:
Match the conditions with their associated causes of cyanosis:
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Name one factor that can elevate heart rate.
Name one factor that can elevate heart rate.
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What is a typical initial sign of congestive heart failure in an infant?
What is a typical initial sign of congestive heart failure in an infant?
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Which grade of murmur is described as 'faint, heard only with special effort'?
Which grade of murmur is described as 'faint, heard only with special effort'?
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Diastolic murmurs can be classified as systolic and continuous.
Diastolic murmurs can be classified as systolic and continuous.
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What type of murmur is commonly associated with aortic stenosis?
What type of murmur is commonly associated with aortic stenosis?
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A murmur characterized by a 'crescendo-decrescendo' pattern occurs during __________.
A murmur characterized by a 'crescendo-decrescendo' pattern occurs during __________.
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Match the types of mitral murmurs with their corresponding conditions:
Match the types of mitral murmurs with their corresponding conditions:
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Which type of murmur is characterized by turbulence due to an atrial septal defect?
Which type of murmur is characterized by turbulence due to an atrial septal defect?
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A mid-diastolic murmur is loudest at the beginning of diastole.
A mid-diastolic murmur is loudest at the beginning of diastole.
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Name one condition that can cause increased flow murmurs.
Name one condition that can cause increased flow murmurs.
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Which of the following is NOT a primary indication for transthoracic echocardiography (TTE)?
Which of the following is NOT a primary indication for transthoracic echocardiography (TTE)?
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Transoesophageal echocardiography (TOE) provides clearer images than transthoracic echocardiography (TTE).
Transoesophageal echocardiography (TOE) provides clearer images than transthoracic echocardiography (TTE).
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Name one advantage of cardiac computed tomography (CT) compared to other imaging modalities.
Name one advantage of cardiac computed tomography (CT) compared to other imaging modalities.
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The _____ principle is used in cardiac ultrasonography to assess blood flow.
The _____ principle is used in cardiac ultrasonography to assess blood flow.
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Match the following types of echocardiography with their uses:
Match the following types of echocardiography with their uses:
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Which of the following is a common indication for using transoesophageal echocardiography (TOE)?
Which of the following is a common indication for using transoesophageal echocardiography (TOE)?
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A calcium score obtained from cardiac computed tomography reflects the amount of calcification present in the coronary arteries.
A calcium score obtained from cardiac computed tomography reflects the amount of calcification present in the coronary arteries.
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What is one common condition that can be assessed using transthoracic echocardiography (TTE)?
What is one common condition that can be assessed using transthoracic echocardiography (TTE)?
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Study Notes
History, Physical Examination, and Diagnostic Methods in Cardiovascular Diseases
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History (Anamnesis): A detailed account of the patient's present and past medical events, including illnesses, operations, accidents, etc. This information is gathered from the patient themselves or a relative. Important considerations include the patient's conscious state and cooperation level.
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Identity Information: Essential data includes name, date of birth (age is vital, especially in pediatrics), gender, birthplace, telephone number, address, and source of the patient's history. Crucial to be certain to whom one is talking.
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Complaints: Subjective experiences of illness or disturbance such as shortness of breath (dyspnea), fatigue, chest pain, palpitations, and fainting (syncope).
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Signs: Objective indicators of disease or disturbance, such as swelling (edema), shortness of breath (dyspnea), rapid breathing (tachypnea), bluish discoloration (cyanosis), and clubbing of the fingers.
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Details of Complaints: Key information about symptoms to be documented includes duration, type, pattern (similar experiences), severity, past treatments, and factors triggering or aggravating symptoms
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Past History (Prenatal, Natal, Postnatal): A detailed medical history focusing on the prenatal, natal, and postnatal phases, outlining any associated conditions, illnesses, or medications impacting the patient.
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Important aspects of Family History: Essential information encompasses the patient's family history, with a particular focus on any occurrences of congenital heart disease, inherited disorders, metabolic issues, sudden cardiac death at a young age, or other relevant conditions.
Diagnostic Methods
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ECG (Electrocardiogram): Measures the electrical activity of the heart to detect abnormalities and cardiac rhythm issues. Includes details like heart rate, atrial rates, ventricular rates
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Telecardiography: An imaging technique producing a visual representation of the cardiovascular structure.
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Hyperoxia Test: Used to assess response of the patient to oxygen administration, determining the possible causes of hypoxia. Measurements of the arterial blood gases are taken.
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Biochemical Investigations: Laboratory tests evaluating blood constituents to identify markers such as BNP, CPK-MB, and troponin; to detect heart failure and other conditions. Can also assess blood electrolytes or kidney function.
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Echocardiography (TTE and TEE): An ultrasound technique visualizing the heart structure and function. TTE (transthoracic) is an application method to the chest, while TEE (transesophageal) is a technique used via the esophagus.
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CT (Computed Tomography): A scan method to assess the anatomy of the cardiovascular vessels.
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MRI (Magnetic Resonance Imaging): A noninvasive, versatile technique with high-quality imaging capabilities useful for imaging the heart's anatomy and function.
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Nuclear Medicine: Techniques using radioactive substances to evaluate heart function and blood flow patterns within the heart.
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Catheter Angiography: A diagnostic procedure inserting a catheter into the blood vessels to visualize the coronary arteries for any blockages. Can also be used therapeutically with procedures like angioplasty or stent placement.
Taking a History - Additional Notes
- Chief Complaint: The primary reason a patient seeks medical assistance.
- Prenatal, perinatal, and postnatal history: Background of the patient's development, crucial for identifying possible congenital heart issues.
- Family history: Essential component for early risk identification or genetic predispositions.
- Feeding patterns: Important considerations in infants and young children.
- Fatigue, Edema, Dyspnea/Tachypnea, Cyanosis: Significant symptoms to evaluate respiratory and cardiovascular status.
- Growth and development: Indicators of possible underlying conditions or disorders.
- Medications: A list of all medications the patient is currently taking.
- Psychosocial history: Important for comprehensive patient assessment. This is crucial in identifying potential psychological factors.
Physical Examination
- Inspection: Visual observation for signs like facial pallor in children, edema (swelling), cyanosis (bluish discoloration), unusual chest shapes, or other abnormalities.
- Palpation: Method to assess for the presence of heaves, and thrills or other abnormal sensations.
- Percussion: Using percussion to assess for the size & shape of the cardiovascular issues and presence of fluid build up. (This is used less frequently).
- Auscultation: Listening to heart tones with a stethoscope.
Important Additional Notes
- Down Syndrome: Cardiac examinations are highly recommended routinely for Down syndrome patients due to frequently present heart defects.
- Fetal Alcohol Syndrome: Characteristics like low nasal bridge, minor ear abnormalities, and indistinct philtrum can be observed. A possible association with conditions like VSD (ventricular septal defect).
- Determining the appropriate timing and manner of examination for children: Consider child's sensitivity, behavior, age- and development-appropriate methods, and use of supportive materials or strategies to encourage cooperation are crucial for examinations.
- Causes of raised JVP (jugular venous pressure): Assess underlying conditions like heart failure, tricuspid valve dysfunction, pericardial effusion, and superior vena cava blockage.
- Important Considerations in Using Diagnostic Tools: Correct use of tools (e.g., obtaining accurate blood pressure readings) is crucial for obtaining valid information. Addressing potential pitfalls and considering patient demographics and circumstances is paramount.
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Description
Test your knowledge on key medical assessment concepts, including respiratory distress, pulse evaluation, and physical examination protocols for children. This quiz will challenge your understanding of various symptoms, conditions, and drug classifications relevant to medical practice.
