Cardiac Physical Exam Quiz

1. Which of the following clinical signs is LEAST specific for cardiovascular disease in dogs and cats?
A. Jugular venous distension
B. Grade I/VI systolic murmur
C. Cardiac enlargement on thoracic radiographs with pulmonary vein distention
D. A diastolic murmur
E. Marked elevation of NT-proBNP

2. Which of the following pairings of pulse characterization and disease process are INCORRECTLY matched?
A. Pulsus paradoxus : Pericardial effusion
B. Bigeminal pulses : Premature beats
C. Bounding pulses : Aortic insufficiency
D. Weak pulses : Patent Ductus Arteriosus

3. An S4 gallop is usually suggestive of cardiac disease in small animals. When examining a cat with an S4 gallop, which of the following clinical entities is LEAST likely?
A. Hypertrophic cardiomyopathy with infrequent ventricular premature depolarizations
B. Lone atrial fibrillation
C. Hyperthyroidism and sinus rhythm
D. Restrictive cardiomyopathy and congestive heart failure

4. In some disease processes, heart murmur intensity is roughly associated with the severity of disease. In which of the following diseases is murmur intensity MOST LIKELY TO CORRELATE with severity of disease?
A. Hypertrophic cardiomyopathy (HCM) in a cat
B. Degenerative mitral valve disease (DMVD) and mitral regurgitation in a dog
C. Dilated cardiomyopathy (DCM) in a dog
D. Tricuspid valve dysplasia in a dog

5. A holosystolic murmur is most typical for which of these cardiovascular diseases?
A. Aortic stenosis and insufficiency
B. Patent ductus arteriosus (PDA)
C. Mitral or tricuspid regurgitation
D. Subaortic or pulmonic stenosis
E. Aortic or pulmonic insufficiency

6. Which of the following cardiovascular diseases is associated with differential cyanosis?
A. Patent ductus arteriosus with left-to-right shunting (PDA)
B. Systemic hypertension
C. Patent ductus arteriosus with pulmonary hypertension and right-to-left shunting (reverse PDA)
D. Pulmonary hypertension

7. Which of the following statements is MOST CORRECT relative to palpation of the thorax during a cardiac examination?
A. The apex beat in a normal animal is usually strongest on the right side of the thorax
B. The apex beat may be displaced in animals with an intrathoracic mass that is in contact with the heart
C. The apex beat is often displaced into the abdomen in animals with diaphragmatic hernia
D. The apex beat is often displaced into the abdomen in animals with peritoneopericardial diaphragmatic hernia (PPDH)

8. Which of the following clinical entities would be MOST LIKELY to be associated with pulse deficits during simultaneous auscultation of the heart and palpation of arterial pulses?
A. Atrial fibrillation
B. An S3 gallop
C. An S4 gallop
D. A III/VI systolic regurgitant quality murmur over the left cardiac apex

9. An increase in pulse strength (strong or bounding pulses) can be commonly associated with all of the following conditions EXCEPT:
A. Increased contractility due to high sympathetic tone
B. Diastolic run off as in aortic regurgitation
C. Bradycardia due to third degree AV block
D. Hypovolemia with evidence of hypoperfusion