OSCE Cardiovascular Assessment 2

Question 1

Pulsus paradoxus is defined as a fall in systolic BP greater than 10 mmHg during inspiration. Which condition most commonly causes this finding?

Accepted Answer

Cardiac tamponade

Answer

Cardiac tamponade causes pulsus paradoxus because pericardial fluid restricts ventricular filling, exaggerating the normal inspiratory drop in left ventricular stroke volume.

Question 2

During cardiovascular examination you note Kussmaul's sign — the JVP rises paradoxically on inspiration. This is most pathognomonic of which condition?

Accepted Answer

Constrictive pericarditis

Answer

Kussmaul's sign is pathognomonic for constrictive pericarditis, where a rigid, fibrotic pericardium prevents right heart expansion on inspiration, causing JVP to rise rather than fall.

Question 3

A pansystolic murmur heard best at the cardiac apex that radiates to the left axilla is most consistent with which diagnosis?

Accepted Answer

Mitral regurgitation

Answer

Mitral regurgitation produces a pansystolic murmur loudest at the apex that classically radiates to the axilla, reflecting the direction of the regurgitant jet from the mitral valve.

Question 4

With the patient at 45 degrees, you measure JVP pulsation 5 cm above the sternal angle. How do you interpret this finding?

Accepted Answer

Mildly elevated JVP

Answer

Normal JVP is ≤3–4 cm above the sternal angle at 45°; a measurement of 5 cm represents a mildly elevated JVP, suggesting impaired right heart filling or increased central venous pressure.

Question 5

During the peripheral cardiovascular inspection, you observe yellow plaques at the medial canthi of both eyes. These are called xanthelasma and are associated with which risk factor?

Accepted Answer

Hyperlipidemia

Answer

Xanthelasma are cholesterol deposits in the periorbital skin, most strongly associated with hyperlipidemia and elevated cardiovascular risk.

OSCE Practice Test

OSCE Practice Test

OSCE Cardiovascular Assessment 2