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 EMQ 2

 

   

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EMQ: 2

Radial Pulse

a)      Anacrotic

b)      Collapsing

c)      Pulsus paradoxus

d)      Bisferiens

e)      Bounding

f)        Radio-femoral delay

g)      Radio-radial delay

h)      Small volume, irregular in rhythm and volume

i)        Jerky upstroke

j)        Pulsus alternans

Select the most likely pulse that will be felt in the clinical scenarios given below:

1)      A young man with hypertension. He has visible pulsations in the suprasternal notch, a heaving apex beat and there are prominent periscapular blood vessels. There is a continuous bruit best heard over the back.

2)      An elderly female with a tapping apex beat, a loud first heart sound, an opening snap and a rumbling mid-diastolic murmur best heard just medial to the apex beat. There is no pre-systolic accentuation of the murmur.

3)      An elderly man with a heaving apex beat, soft single second heart sound and a harsh ejection systolic murmur radiating to the neck

4) A teenager with severe breathlessness, showing signs of respiratory distress. On auscultation of his chest there are bilateral sibilant rhonchi.

5)      An elderly patient who is breathless and oedematous and has an elevated JVP , displaced apex beat , a 3rd heart sound and bilateral basal crepitations

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