PANCE PREP PEARLS 2026 EXAMINERS SET
QUESTIONS AND ANSWERS SURE A+
✔✔what is tx for rheumatic fever - ✔✔*penicillin G is drug of choice, against group A
strep
erythromycin if PNC allergic
aspirin
✔✔S1 sounds correlate w/ ___
S2 sounds correlate w/ _________ - ✔✔when AV valves close
aortic and pulmonic valves close (physiologic split)
✔✔when is a fixed split present - ✔✔ASD, VSD, pulmonary HTN, mitral regurg
✔✔when is a paradoxical split present - ✔✔maximally on expiration during LBBB and
aortic stenosis
✔✔compare S3 versus S4 - ✔✔S3
-rapid passive ventricular filling
->30y/o pathologic
-lf ventricular systolic failure
, S4
-atrial contraction on stiffened ventricle
-HTN, LVH, aortic stenosis
✔✔opening snap - ✔✔opening of stenotic mitral valve
✔✔harsh murmur - ✔✔abnormal fwd flow through stenotic valve
✔✔blowing murmur - ✔✔abnormal backward flow through incompletely closed valvve
✔✔cardiac areas of auscultation - ✔✔murmur chart page 50!!!
✔✔blowing murmur that radiates to L upper sternal border is ____________ - ✔✔aortic
regurgitation
✔✔increasing venous return (squatting, leg raise, laying down) _______ all murmurs
except in hypertrophic cardiomyopathy - ✔✔increases
✔✔decreasing venous return (valsalva, standing) _______ all murmurs except in
hypertrophic cardiomyopathy - ✔✔decreases
✔✔inspiration better helps to hear _____-sided murmurs - ✔✔right-sided
✔✔expiration better helps to hear _____-sided mumurs - ✔✔left-sided
✔✔what does hand grip do to murmurs? - ✔✔increases afterload/increased backward
flow
increases murmurs in AR/MR/MS
decreases murmurs in AS/MVP/HCM
✔✔which murmurs radiate and to where - ✔✔AS: carotid
AR: lf upper sternal border
MR: axilla
✔✔sitting up and leaning forward will accentuate which murmurs
lying on left accentuates which murmurs - ✔✔AS, AR
MS, MR
✔✔most common type of congential heart disorder? - ✔✔ventricular septal defect
QUESTIONS AND ANSWERS SURE A+
✔✔what is tx for rheumatic fever - ✔✔*penicillin G is drug of choice, against group A
strep
erythromycin if PNC allergic
aspirin
✔✔S1 sounds correlate w/ ___
S2 sounds correlate w/ _________ - ✔✔when AV valves close
aortic and pulmonic valves close (physiologic split)
✔✔when is a fixed split present - ✔✔ASD, VSD, pulmonary HTN, mitral regurg
✔✔when is a paradoxical split present - ✔✔maximally on expiration during LBBB and
aortic stenosis
✔✔compare S3 versus S4 - ✔✔S3
-rapid passive ventricular filling
->30y/o pathologic
-lf ventricular systolic failure
, S4
-atrial contraction on stiffened ventricle
-HTN, LVH, aortic stenosis
✔✔opening snap - ✔✔opening of stenotic mitral valve
✔✔harsh murmur - ✔✔abnormal fwd flow through stenotic valve
✔✔blowing murmur - ✔✔abnormal backward flow through incompletely closed valvve
✔✔cardiac areas of auscultation - ✔✔murmur chart page 50!!!
✔✔blowing murmur that radiates to L upper sternal border is ____________ - ✔✔aortic
regurgitation
✔✔increasing venous return (squatting, leg raise, laying down) _______ all murmurs
except in hypertrophic cardiomyopathy - ✔✔increases
✔✔decreasing venous return (valsalva, standing) _______ all murmurs except in
hypertrophic cardiomyopathy - ✔✔decreases
✔✔inspiration better helps to hear _____-sided murmurs - ✔✔right-sided
✔✔expiration better helps to hear _____-sided mumurs - ✔✔left-sided
✔✔what does hand grip do to murmurs? - ✔✔increases afterload/increased backward
flow
increases murmurs in AR/MR/MS
decreases murmurs in AS/MVP/HCM
✔✔which murmurs radiate and to where - ✔✔AS: carotid
AR: lf upper sternal border
MR: axilla
✔✔sitting up and leaning forward will accentuate which murmurs
lying on left accentuates which murmurs - ✔✔AS, AR
MS, MR
✔✔most common type of congential heart disorder? - ✔✔ventricular septal defect
