6. Why is it said that upon inspiration, s2 sounds are 'split' (also known as the physiological splitting of S2)?
The split refers to a murmur in the atrioventricular valves, indicative of a defect, as normally the valves close simultaneously during inspiration
Pulmonary valve closure heard after valve tricuspid closure, as the left ventricle takes longer to squeeze the extra blood out
Pulmonary valve closure heard after aortic valve closure, as the right ventricle takes longer to squeeze the extra blood out
S2 sounds do not split. This happens in S1 heart sounds due to diaphragm negative pressure during inspiration
7. What are the names of the atrioventricular values?
Mitral, Tricuspid
Pulmonary, Aortic
Mitral, Aortic
Tricuspid, Pulmonary
8. What is a pulse deficit?
When there is a difference of 10 bpm or more between the radial pulse and carotid pulse
When there is a difference of 2 bpm or more between the radial pulse and carotid pulse
When there is a difference of 2 bpm or more between the radial pulse and apical pulse
When there is a difference of 10 bpm or more between the radial pulse and apical pulse
9. Where can the apical pulse be heard?
6th intercoastal space mid-clavicular line
Axilla line, 4th intercostal space
5th intercostal space mid-clavicular line
At the sternal notch
10. Where would you hear aortic value sounds?
5th left intercostal space midclavicular line
4th left intercostal space
2nd right intercostal space
2nd left intercostal space
11. When/why do you measure BP on the popliteal artery?
When the blood pressure on the arm is too high
When the blood pressure is too low on the brachial artery
Should be done all the time, as it is more accurate but less convenient
BP is not taken on the popliteal artery. The femoral artery is used instead
12. Which of the following is not a cause of Halitosis?
Ketones
Atrophic rhinitis
Gingivitis
Bronchiectasis
None of the above
Poor dental hygiene
Stomatitis
Lung abscess
Tumours of the nasal passage
13. Which of the following is not true about Jaundice?
Reduction of circulating oxyhaemoglobin in the dermal and subconjunctival capillaries, or from the vasoconstriction due to cold exposure or sympathetic activation
Bilirubin serum concentration rises above 50 micromoles per litre
Bilirubin serum concentration rises above 3 milligrams per decilitre
Abnormal yellow discoloration of the skin, sclera and mucous membranes
14. What is the major differentiation between Hypercarotenaemia and Jaundice?
There are not particular differences between the two, and can be used as interchangeable terms
The conjunctiva of the eyes are yellow in hypercarotenaemia, whilst the conjunctiva in jaundice is pale or "white"
Hypercarotenaemia is seen as a yellowish discoloration in the face, palms and soles, but not the sclera and conjunctiva as observed in Jaundice
The two are identical, but jaundice is accompanied with abdominal pain and sometimes abdominal distention
15. Which of the following are untrue regarding the causes of cyanosis?
Low cardiac output, arterial disease, venous stasis or obstruction
Cold exposure
Polycythaemia
Gastrointestinal and nervous system diseases
Respiratory and cardiovascular diseases
16. Reduction of circulating oxyhaemoglobin in the dermal and subconjunctival capillaries, or from the vasoconstriction due to cold exposure or sympathetic activation. What sign is associated with this description?
Haemosiderin
Pallor
Haemochromatosis
Jaundice
17. A pulse deficit may be indicative of atrial fibrillation. What is your opinion about this statement?
True
False
18. Why is it potentially dangerous to apply too much pressure on carotid artery palpation?
Decrease in circulating oxyhaemoglobin in the dermal and subconjunctival capillaries, or from the vasoconstriction due to cold exposure or sympathetic activation
Vasovagal syncope due to sudden drop in cardiac output, causing cerebral hypoperfusion
Supra vena cava regurgitation
Arterial rupture
19. Which statement is false regarding BP in pregnancy?
In the third trimester, BP readings would be normal
Increased blood pressure measures may be an indication of preeclampsia
The BP readings that show 20% drop on repeat is normal
The first and second trimester, BP may be 5-10 mmHg lower
20. What is the indication of a 'weak' carotid artery pulse?
