PANCE - PREP PEARLS Questions and
Answers A+ Guide
systolic "ejection" crescendo-decrescendo harsh murmur at RUSB that
radiates to carotids - correct answers✅✅aortic stenosis
harsh diastolic rumble murmur at apex (low) in LLD that may be preceded by
OPENING SNAP and is MCC by ________ - correct answers✅✅mitral
Stenosis
rheumatic heart disease
what is a diastolic decrescendo blowing murmur @ LUSB and is associated
with hammer rumble - correct answers✅✅aortic regurgitation
note:
wide pulse pressure
increases with handgrip
decreases with amyl nitrate
+/- austin flint murmur = mid-late diastolic rumble at apex
aortic regurgitation + head bobbing - correct answers✅✅DeMussets
aortic regurgitation + nailbed pulsations - correct answers✅✅Quincke
pulses
blowing holosystolic murmur @ apex that radiates to axilla - correct
answers✅✅mitral regurgitation
note:
,PANCE - PREP PEARLS Questions and
Answers A+ Guide
increases with handgrip
decreases with amyl nitrate
midsystolic ejection click at apex is caused by what - correct
answers✅✅mitral valve prolapse
note: reassurance and good prognosis in asymptomatic pts or with mild sx
systolic ejection crescendo-decrescendo flow murmur at PULMONIC AREA -
correct answers✅✅atrial septal defect
note:
ostium secundum most common
left to right shunt (noncyanotic)
continuous machinery murmur that is loudest at pulmonic area - correct
answers✅✅patent ductus arteriosus
note: left to right shunt (noncyanotic), continued PGE2 production promotes
patency, IV indomethacin if preterm to close PDA
systolic murmur that radiates to the back/scapula/chest
increase BP upper > lower extermities
delayed/weak femoral pulses - correct answers✅✅coarctation of aorta
along with coarctation of aorta, 70% also have ____ - correct
answers✅✅bicuspid aortic valves
,PANCE - PREP PEARLS Questions and
Answers A+ Guide
coarctation of aorta
CXR - correct answers✅✅rib notching
note:
"3 sign" on barium swallow
angiogram gold standard
Tx balloon angioplasty, PGE1
tetralogy of fallot is what type of shunt?
What are the defects
1.
2.
3.
4. - correct answers✅✅right to left
1. VSD
2. R ventricular hypertrophy
3. overriding aorta
4. pulmonic stenosis (RV outflow obstruction)
(photo: boot-shaped heart)
, PANCE - PREP PEARLS Questions and
Answers A+ Guide
anti-arrhythmic classes
I
II
III
IV
V - correct answers✅✅I- Na+ channel blockers (slow conduction velocity)
Ia- procainamide, prolongs repolarization
Ib- lidocaine, shortens repolarization
II- beta blockers (propranolol, metoprolol, esmolol)
III- K+ channel blockers (K+ prevents efflux)
IV- CCB (verapamil, diltiazem)
V- others, adenosine
atropine is first line treatment in _________________ - correct
answers✅✅bradycardia
adenosine is used for treatment in ________ - correct
answers✅✅tachycardia
causes transient heart block in AV node
class V
Answers A+ Guide
systolic "ejection" crescendo-decrescendo harsh murmur at RUSB that
radiates to carotids - correct answers✅✅aortic stenosis
harsh diastolic rumble murmur at apex (low) in LLD that may be preceded by
OPENING SNAP and is MCC by ________ - correct answers✅✅mitral
Stenosis
rheumatic heart disease
what is a diastolic decrescendo blowing murmur @ LUSB and is associated
with hammer rumble - correct answers✅✅aortic regurgitation
note:
wide pulse pressure
increases with handgrip
decreases with amyl nitrate
+/- austin flint murmur = mid-late diastolic rumble at apex
aortic regurgitation + head bobbing - correct answers✅✅DeMussets
aortic regurgitation + nailbed pulsations - correct answers✅✅Quincke
pulses
blowing holosystolic murmur @ apex that radiates to axilla - correct
answers✅✅mitral regurgitation
note:
,PANCE - PREP PEARLS Questions and
Answers A+ Guide
increases with handgrip
decreases with amyl nitrate
midsystolic ejection click at apex is caused by what - correct
answers✅✅mitral valve prolapse
note: reassurance and good prognosis in asymptomatic pts or with mild sx
systolic ejection crescendo-decrescendo flow murmur at PULMONIC AREA -
correct answers✅✅atrial septal defect
note:
ostium secundum most common
left to right shunt (noncyanotic)
continuous machinery murmur that is loudest at pulmonic area - correct
answers✅✅patent ductus arteriosus
note: left to right shunt (noncyanotic), continued PGE2 production promotes
patency, IV indomethacin if preterm to close PDA
systolic murmur that radiates to the back/scapula/chest
increase BP upper > lower extermities
delayed/weak femoral pulses - correct answers✅✅coarctation of aorta
along with coarctation of aorta, 70% also have ____ - correct
answers✅✅bicuspid aortic valves
,PANCE - PREP PEARLS Questions and
Answers A+ Guide
coarctation of aorta
CXR - correct answers✅✅rib notching
note:
"3 sign" on barium swallow
angiogram gold standard
Tx balloon angioplasty, PGE1
tetralogy of fallot is what type of shunt?
What are the defects
1.
2.
3.
4. - correct answers✅✅right to left
1. VSD
2. R ventricular hypertrophy
3. overriding aorta
4. pulmonic stenosis (RV outflow obstruction)
(photo: boot-shaped heart)
, PANCE - PREP PEARLS Questions and
Answers A+ Guide
anti-arrhythmic classes
I
II
III
IV
V - correct answers✅✅I- Na+ channel blockers (slow conduction velocity)
Ia- procainamide, prolongs repolarization
Ib- lidocaine, shortens repolarization
II- beta blockers (propranolol, metoprolol, esmolol)
III- K+ channel blockers (K+ prevents efflux)
IV- CCB (verapamil, diltiazem)
V- others, adenosine
atropine is first line treatment in _________________ - correct
answers✅✅bradycardia
adenosine is used for treatment in ________ - correct
answers✅✅tachycardia
causes transient heart block in AV node
class V
