Cardiovascular -- Barron's CCRN Exam
2025 Questions and Answers
S3 occurs where and when? - ANSWER-heard best at the apex of the heart right
after S2
what is S3 associated with? - ANSWER-Heart failure, Pulmonary hypertension, cor
pulmonale, and mitral/aortic/tricuspid insufficiency
what is S3? - ANSWER-rapid rush of blood into a dilated ventricle
what is S4? - ANSWER-atrial constriction of blood into a non-compliant ventricle
Where and when does S4 occur? - ANSWER-Best heard over the apex with the
bell right before S1
what is s4 associated with? - ANSWER-myocardial ischemia, infarction,
hypertension, ventricular hypertrophy, aortic stenosis
Pericardial friction rub is associated with what? - ANSWER-Pain during deep
inspiration and positional pain
Pulse pressure equation - ANSWER-systolic - diastolic = pulse pressure
normal pulse pressure values - ANSWER-40-60
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,systolic BP represents what? - ANSWER-Cardiac output and stroke volume
what does a decrease in systolic pressure mean if diastolic doesn't change? -
ANSWER-This = narrowing pulse pressure. Seen often with severe hypovolemia
or a severe drop in Cardiac output.
diastolic BP represents what? - ANSWER-Systemic vascular resistance (SVR)
what does a decrease in diastolic BP mean? - ANSWER-this = widening pulse
pressure. May indicate vasodilation, severe sepsis, septic shock.
time ratio for systolic vs. diastolic - ANSWER-1.0/1.33
what is perfused during diastole? - ANSWER-Coronary arteries
causes of valvular heart disease - ANSWER-- coronary heart disease
- dilated cardiomyopathy
- Degeneration
- Bicuspid aortic valve
- Rheumatic fever
- Infection
- Connective tissue diseases
murmurs of insufficiency are? - ANSWER-regurgitation when the valve is close
murmurs of stenosis are? - ANSWER-regurgitation when the valve is open
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, are these murmurs acute or chronic? - ANSWER-Stenosis = chronic
Insufficiency = acute or chronic
systolic murmurs sound like what? - ANSWER-lub...shhhhh...dub
what are the valves doing during a systolic murmur? - ANSWER-aortic and
pulmonic valve stenosis (they are open)
Mitral and tricuspid insufficiency (they are closed)
how does a mitral valve insufficiency show up on a pulmonary artery catheter? -
ANSWER-giant v waves
what other defect can cause systolic murmurs? - ANSWER-ventricular septal
defect (heard on the left sternal border)
what do diastolic murmurs sound like? - ANSWER-lub...dub...shhhhh
what are the valves doing during diastolic murmurs? - ANSWER-aortic/pulmonic
insufficiency (closed)
Mitral/Tricuspid stenosis (open)
mitral valve stenosis is particularly associated with what? - ANSWER-atrial
fibrillation due to atrial enlargement
grades of acute MI - ANSWER-grade 1/2 -- papillary muscle dysfunction
grade 5/6 -- papillary muscle rupture (emergency)
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
2025 Questions and Answers
S3 occurs where and when? - ANSWER-heard best at the apex of the heart right
after S2
what is S3 associated with? - ANSWER-Heart failure, Pulmonary hypertension, cor
pulmonale, and mitral/aortic/tricuspid insufficiency
what is S3? - ANSWER-rapid rush of blood into a dilated ventricle
what is S4? - ANSWER-atrial constriction of blood into a non-compliant ventricle
Where and when does S4 occur? - ANSWER-Best heard over the apex with the
bell right before S1
what is s4 associated with? - ANSWER-myocardial ischemia, infarction,
hypertension, ventricular hypertrophy, aortic stenosis
Pericardial friction rub is associated with what? - ANSWER-Pain during deep
inspiration and positional pain
Pulse pressure equation - ANSWER-systolic - diastolic = pulse pressure
normal pulse pressure values - ANSWER-40-60
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,systolic BP represents what? - ANSWER-Cardiac output and stroke volume
what does a decrease in systolic pressure mean if diastolic doesn't change? -
ANSWER-This = narrowing pulse pressure. Seen often with severe hypovolemia
or a severe drop in Cardiac output.
diastolic BP represents what? - ANSWER-Systemic vascular resistance (SVR)
what does a decrease in diastolic BP mean? - ANSWER-this = widening pulse
pressure. May indicate vasodilation, severe sepsis, septic shock.
time ratio for systolic vs. diastolic - ANSWER-1.0/1.33
what is perfused during diastole? - ANSWER-Coronary arteries
causes of valvular heart disease - ANSWER-- coronary heart disease
- dilated cardiomyopathy
- Degeneration
- Bicuspid aortic valve
- Rheumatic fever
- Infection
- Connective tissue diseases
murmurs of insufficiency are? - ANSWER-regurgitation when the valve is close
murmurs of stenosis are? - ANSWER-regurgitation when the valve is open
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
, are these murmurs acute or chronic? - ANSWER-Stenosis = chronic
Insufficiency = acute or chronic
systolic murmurs sound like what? - ANSWER-lub...shhhhh...dub
what are the valves doing during a systolic murmur? - ANSWER-aortic and
pulmonic valve stenosis (they are open)
Mitral and tricuspid insufficiency (they are closed)
how does a mitral valve insufficiency show up on a pulmonary artery catheter? -
ANSWER-giant v waves
what other defect can cause systolic murmurs? - ANSWER-ventricular septal
defect (heard on the left sternal border)
what do diastolic murmurs sound like? - ANSWER-lub...dub...shhhhh
what are the valves doing during diastolic murmurs? - ANSWER-aortic/pulmonic
insufficiency (closed)
Mitral/Tricuspid stenosis (open)
mitral valve stenosis is particularly associated with what? - ANSWER-atrial
fibrillation due to atrial enlargement
grades of acute MI - ANSWER-grade 1/2 -- papillary muscle dysfunction
grade 5/6 -- papillary muscle rupture (emergency)
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
