1. A mid-systolic click is a feature of which valvular lesion?

2. What finding is demonstrated in this video?

3. This was recorded with the bell of the stethoscope. In what location is this extra sound typically heard best?

4. This murmur was recorded over the mid left sternal border in a young man who passed out during a basketball game. In the second half of the recording, the patient was asked to Valsalva. What other maneuver would be expected to result in an increase in murmur intensity?

5. Which heart sound corresponds to the timing of the x descent of the normal jugular venous pulse?

6. Loss of the a wave can result from which of the following processes? 

7. Which part of the jugular venous waveform in this video is most striking?

 

8. What condition might be expected in this patient?

9. What finding is present?

10. This recording was taken over the femoral pulse in a patient with aortic regurgitation. What finding is present?

 

11. This was recorded over the apex of the heart with the bell of the stethoscope. What finding is present?

12. What condition might be expected in this patient?

13. How many peaks and troughs are visible in the waveform in this video?

 

14. What finding is present?

15. Which of the following is the best description of Carvallo’s sign?

16. The JVP meniscus is visualized 5 cm above the Angle of Louis with the patient lying at 20 degrees. Which of the following is the best estimate of RA pressure?

17. In what part of the cardiac cycle do the extra transient sounds occur?

 

18. What finding is demonstrated in this video?

19. The presence of Lancisi’s sign (CV fusion wave) indicates which of the following valvulopathies?

20. What is the best position to listen for an S3?

21. What condition does this patient have?

 

22. Which image was taken with the patient in a more reclined position?

23. Is the dominant murmur in this recording systolic or diastolic?

24. This murmur was recorded over the mid left sternal border in a young man who passed out during a basketball game. In the second half of the recording, the patient was asked to Valsalva. What medication should be generally be avoided in this patient?

25. Which valve has been replaced in this patient?

26. In what location is this extra sound typically heard best?

27. This was recorded over the base of the heart. Where is the extra transient sound?

28. What is the shape of the murmur in this recording?

29. What finding is demonstrated in this recording?

30. This was recorded over the apex of the heart with the diaphragm of the stethoscope. What additional finding might you expect this patient to have?

31. What is the mechanism of the abnormality in this jugular venous waveform?

32. An S4 gallop cannot occur when which of the following conditions is present?

33. What condition does this patient have?

 

34. This was recorded over the base of the heart. What finding is present?

 

35. True or false: Most of the time, JVP is a measure of volume status.

36. Assuming this patient is in a supine position, and the top of the pulse is 6 cm above the Angle of Louis, what is the jugular venous pressure?

37. Kussmaul’s sign can occur in which of the following settings?

38. What condition does this patient have?

39.  Which of the following is the best description of Kussmaul’s sign?

40. What finding is demonstrated in this video?

41. What condition might be expected in this patient?

42. What cardiac event causes the x descent in the normal jugular venous waveform?

43. Which heart sound corresponds to the timing of the a wave of the normal jugular venous pulse?

44. What finding is present?

45. What is the underlying lesion responsible for this murmur recorded over the apex?

46. What condition might be expected in this patient?

 

47. What can an examiner do at the bedside to increase the intensity of the murmur associated with hypertrophic obstructive cardiomyopathy (HOCM)?

48. What condition does this patient have?

49. This was recorded over the apex of the heart with the bell of the stethoscope. During what part of the cardiac cycle does this transient sound occur?

50. What extra transient sound is heard just after S2 in this recording?

 

51. What finding is demonstrated in this video?

52. What transient sound is typically associated with a stiff ventricle?

53. Which part of the normal jugular venous waveform occurs during ventricular systole?

54. How many troughs are found within the normal jugular venous waveform?

55. Which time interval is longer?

56. What condition might be expected in this patient?

57. During what part of the cardiac cycle does this murmur occur?

58. Which heart sound corresponds to the timing of the ascent of the v wave in the normal jugular venous pulse?

59. Pulsus paradoxus can occur in which of the following settings?

60. What finding is present?

61. What finding might be expected in this patient?

62. The differential diagnosis for an extra sound heard shortly before S1 includes which of the following?

63. What cardiac event causes the y descent in the normal jugular venous waveform?

64. What can cause a widely split S2?

65. What is the conversion of mm Hg to cm H2O?

66. Which descent of the normal jugular venous waveform is dominant?

67. Which of the following describes the pulse in this video?

68. What finding is demonstrated in this video?

69. This recording was taken over the femoral pulse in a patient with aortic regurgitation. What finding is present?

 

70. What additional finding might this patient have?

71. You hear a diastolic murmur at the LLSB. As the patient inhales, the sound increases. What is the most likely cause?

72. What is the name of the murmur in this recording?

73. This was recorded over the apex of the heart with the bell of the stethoscope. What finding is present?

74. How many peaks are visible in the waveform in this video?

75. What cardiac event causes the a wave in the normal jugular venous waveform?

76. What finding might be expected in a patient with this jugular venous waveform (top)?

77. What condition might be expected in this patient?

78. The anatomical location of the JVP meniscus in the neck does what when the patient is reclined (e.g. moves from an upright position to lying at 45 degrees)?

79. This murmur was recorded over the mid left sternal border in a young man who passed out during a basketball game. In the second half of the recording, the patient was asked to Valsalva. What additional finding might this patient be expected to have?

80. What finding is demonstrated in this recording?

81. You hear a holosystolic soft blowing murmur heard best at the left lower sternal border. What is the most likely cause?

82. Is the normal jugular venous pulse palpable or non-palpable?

83. Jugular venous pressure is a surrogate of what?

84. The angle of Louis sits how high above the right atrium in most patients in the supine position?

85. This was recorded over the base of the heart. What finding is present?

86. What is the shape of the dominant murmur in this recording?

 

87. Which of the following is the best description of Quincke’s pulse?

88. What is the underlying cause of the systolic murmur in this case?

89. What is the single loudest (most intense) sound in the recording?

 

90. What finding is demonstrated in this video?

91. Which feature on auscultation best predicts the severity of aortic stenosis?

92. What condition does this patient have?

93. What feature of the peripheral pulse is most characteristic of aortic stenosis?

94. Is the murmur in this recording systolic or diastolic?

95. Pulsus alternans is an indication of which of the following?

96. What condition does this patient have?

 

97. What causes the increase in murmur intensity just before S1?

 

98. This was recorded over the apex of the heart with the bell of the stethoscope. During what part of the cardiac cycle does this extra sound occur?

99. What valve has been replaced in this patient?

 

100. What additional finding might be expected in this patient?

101. This was recorded over the apex of the heart with the bell of the stethoscope. During what part of the cardiac cycle does this extra sound occur?

102. You hear a late systolic murmur with a mid systolic click over the apex. What is the most likely cause?

103. Which of the following is the best description of Corrigan’s pulse?

104. Which of the following is the best description of Traube’s sign?

105. Which heart sound corresponds to the timing of the y descent in the normal jugular venous pulse?

106. What blood vessel is visible in this video?

107. The differential diagnosis for an extra sound heard shortly after S2 includes which of the following?

108. This was recorded over the base of the heart. Where is the extra transient sound?

109. What can an examiner do at the bedside to move the click associated with mitral valve prolapse closer to S1?

110. Which of the following is the best description of a water hammer pulse?

111. This was recorded over the apex of the heart with the bell of the stethoscope. What condition might you expect this patient to have?

112. What finding is demonstrated in this video?

113. What is demonstrated in this video?

114. What transient sound is typically associated with fluid overload?

115. Which of the following are characteristics of the normal jugular venous pulse?

116. Compared to the diaphragm, the bell is better at picking up high frequency sounds. True or false?

117. This was recorded over the apex of the heart with the bell of the stethoscope. During what part of the cardiac cycle does this extra sound occur?

118. What is the name for this murmur recorded over the apex?

119. You hear a systolic crescendo-decrescendo murmur over a patient’s right upper sternal border. What is the most likely cause?

120. What is the cause of this murmur recorded over the apex?

121. What can an examiner do at bedside to increase the intensity of the murmur associated with aortic stenosis?

122. What condition does this patient have?

123. An opening snap is a feature of which valvular lesion?

124. This was recorded over the apex of the heart with the diaphragm of the stethoscope. What finding is present?

125. What electrocardiographic finding might be expected in this patient?

 

126. What is the cause of the a wave in the jugular venous waveform?

127. Is the dominant murmur in this recording systolic or diastolic?

 

128. What cardiac event causes the v wave in the normal jugular venous waveform?

129. During what part of the cardiac cycle does this murmur occur?

 

130. What can cause a fixed split S2?

131. What additional finding might be expected in a patient with the following?”

132. In what location is this murmur typically heard best?

133. Which pulse is best for orienting to the cardiac cycle?

134. What term is used to describe this murmur recorded over the apex?

135. What electrocardiographic finding might be expected in this patient?

136. Which of the following statements regarding gallops is most accurate?

137. This was recorded over the apex of the heart with the diaphragm of the stethoscope. During what part of the cardiac cycle does this extra sound occur?

138. This murmur was recorded over the mid left sternal border in a young man who passed out during a basketball game. In the second half of the recording, the patient was asked to Valsalva. What condition does this patient have?

139. Which part of the jugular venous waveform in this video is most striking?

 

140. Pulsus alternans is an indication of which of the following?

141. The murmur of aortic regurgitation is usually best heard over the 2^nd intercostal space of the right upper sternal border. True or false?

142. Which of the following is a direct cause of Kussmaul’s sign?

143. In what location is this murmur typically heard best?

144. What condition does this patient have?

145. Which part of the normal jugular venous waveform is not visible at the bedside?

146. What finding is demonstrated in this recording?

 

147. Which of the following describes the pulse in this video?

148. What condition might be expected in this patient?

149. This was recorded over the apex of the heart with the bell of the stethoscope. What finding is present?

150. Is the murmur in this recording systolic or diastolic?

 

151. This was recorded over the apex of the heart with the diaphragm of the stethoscope. What condition might you expect this patient to have?

152. What can cause a paradoxically split S2?

153. Kussmaul’s sign can occur in which of the following settings?

154. Which time interval is longer?

155. What cardiac event causes the y descent in the normal jugular venous waveform?

156. Which of the following describes the pulse in this video?

157. What condition might be expected in this patient?

158. Which part of the jugular venous waveform in this video is most striking?

 

159. Which heart sound corresponds to the timing of the y descent in the normal jugular venous pulse?

160. What is the conversion of mm Hg to cm H2O?

161. What finding is demonstrated in this video?

162. Which part of the jugular venous waveform in this video is most striking?

 

163. What condition might be expected in this patient?

164. How many troughs are found within the normal jugular venous waveform?

165. Which heart sound corresponds to the timing of the a wave of the normal jugular venous pulse?

166. What finding is demonstrated in this video?

167. How many peaks are visible in the waveform in this video?

168. Which heart sound corresponds to the timing of the ascent of the v wave in the normal jugular venous pulse?

169. What cardiac event causes the v wave in the normal jugular venous waveform?

170. Which part of the normal jugular venous waveform occurs during ventricular systole?

171. The JVP meniscus is visualized 5 cm above the Angle of Louis with the patient lying in 60 degrees. Which of the following is the best estimate of RA pressure?

172. The angle of Louis sits how high above the right atrium in most patients in the supine position?

173. Jugular venous pressure is a surrogate of what?

174.  Which of the following is the best description of Kussmaul’s sign?

175. What additional finding might be expected in this patient?

176. Which heart sound corresponds to the timing of the x descent of the normal jugular venous pulse?

177. What is the cause of the a wave in the jugular venous waveform?

178. Which descent of the normal jugular venous waveform is dominant?

179. How many peaks and troughs are visible in the waveform in this video?

 

180. What condition might be expected in this patient?

181. Which of the following are characteristics of the normal jugular venous pulse?

182. Which image was taken with the patient in a more reclined position?

183. What finding is demonstrated in this video?

184. Which part of the normal jugular venous waveform is not visible at the bedside?

185. What is the mechanism of the abnormality in this jugular venous waveform?

186. The presence of Lancisi’s sign (CV fusion wave) indicates which of the following valvulopathies?

187. Is the normal jugular venous pulse palpable or non-palpable?

188. What finding is demonstrated in this video?

189. Assuming this patient is situated at 20 degrees, and the top of the pulse is 6 cm above the Angle of Louis, what is the jugular venous pressure?

190. What cardiac event causes the a wave in the normal jugular venous waveform?

191. True or false: Most of the time, JVP is a measure of volume status.

192. What cardiac event causes the x descent in the normal jugular venous waveform?

193. Which of the following is the best description of Carvallo’s sign?

194. What finding might be expected in a patient with this jugular venous waveform (top)?

195. What condition might be expected in this patient?

196. The anatomical location of the JVP meniscus in the neck does what when the patient is reclined (e.g. moves from an upright position to lying at 45 degrees)?

197. What condition does this patient have?

198. What finding is demonstrated in this video?

199. What finding is demonstrated in this video?

200. What finding is demonstrated in this video?

201. What additional finding might be expected in a patient with the following?

202. Which of the following is a direct cause of Kussmaul’s sign?

203. Which blood vessel is directly visible in this video?

204. Which of the following describes the pulse in this video?

205. What is demonstrated in this video?

206. What condition does this patient have?

207. What condition might be expected in this patient?

208. What condition might be expected in this patient?