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Don't take our word for it
"The stations you provide are strikingly similar to those I came across during my medical school finals (some even verbatim!), and I have tried many other exam platforms. I'm truly grateful for your priceless support throughout my final couple of years at medical school!"
Raza Q
"It has absolutely everything for medical school, so many histories with detailed differential diagnoses, how to approach emergencies, commonly prescribed drugs..every kind go examination youโll ever need in osces"
John R
"Thank you SO MUCH for the amazing educational resource. Iโve tried lots of platforms and books with mock OSCE stations and yours is by far and away the best Iโve tried"
Ed M
"Get this right away. So helpful for OSCEs but also general clinical learning and understanding. Wish I had brought it sooner"
Emma W
"Without a doubt, your platform outshines all other OSCE resources currently available. In all honesty, I can confidently attribute my success in securing a distinction in my finals to OSCEstop."
Harish K
"OSCEstop distinguishes itself from many other platform banks by offering a wealth of questions that mimic the demanding and complex aspects of our finals. This platform played a crucial role in ensuring I was ready for the level of difficulty that awaited me in my final exams."
Aortic stenosis causes increased resistance between the left ventricle and systemic circulation. This results in limited cardiac output and subsequent LV hypertrophy.
Character: ejection systolic
Best heard: upper right sternal edge; loudest on expiration
Radiation: carotids and apex
Symptoms:
Exertional dyspnoea
Syncope
Angina (coronary perfusion impaired)
Signs:
Slow-rising pulse
Narrow pulse pressure
Heaving apex beat (pressure-loaded)
Soft or absent S2 (depending on AS severity)
May be signs of LVF (S3, pulmonary oedema)
Causes ofโฆ Aortic stenosis
Age-related calcification (most)
Bicuspid aortic valve (e.g. Turnerโs syndrome)
Congenital
Rheumatic heart disease
Aortic sclerosis
Aortic sclerosis murmur
Aortic sclerosis is a hard and inflexible aortic valve (thickened, NOT narrowed) due to age-related calcification. This causes turbulence and a local sound only.
Character: ejection systolic
Best heard: upper right sternal edge
Radiation: does not radiate
Symptoms: none
Signs:
No abnormal signs
Differentiate from AS by normal pulse, apex and S2
Mitral regurgitation
Mitral regurgitation causes backflow of blood from left ventricle to left atrium during systole. This causes LV and left atrial dilation, which ultimately results in pulmonary hypertension.
Mitral regurgitation murmur
Character: pansystolic
Best heard: apex; loudest on expiration
Radiation: left axilla
Symptoms:
Dyspnoea
Orthopnoea
Paroxysmal nocturnal dyspnoea
Signs:
AF
Displaced thrusting apex (volume-loaded)
Soft S1
Signs of pulmonary hypertension (RV heave, loud P2)
Mitral valve prolapse is when a mitral valve leaflet prolapses into the left atrium during ventricular systole.
Character: mid-systolic click and/or late systolic murmur
Differentiate from MR by normal S1 then gap before murmur
Best heard: apex; loudest on expiration
Radiation: left axilla and back
Symptoms: atypical chest pain
Signs:
Murmur only
Can develop significant MR
Associations ofโฆ Mitral valve prolapse
Connective tissue diseases
Primary congenital
Polycystic kidney disease
Hypertrophic obstructive cardiomyopathy
SLE
Muscular dystrophy
Ventricular septal defect
A ventricular septal defect results in some blood from the left ventricle leaking into the right ventricle during systole. It is usually congenital (chronic), or due to a myocardial infarction (acute).
Ventricular septal defect murmur
Character: pansystolic loud machinery-like murmur
Best heard: lover left sternal edge
Radiation: whole precordium
Symptoms: often none if small
Signs:
Signs of pulmonary hypertension (RV heave, loud P2)
If acute, may cause cardiogenic shock
Tricuspid regurgitation
Tricuspid regurgitation results in the backflow of blood from the right ventricle to the right atrium during systole. This causes increased right atrial and venous pressure.
Tricuspid regurgitation murmur
Character: pansystolic
Differentiate from MR byโฆ
louder on inspiration because itโs on the right
Giant JVP
Non-displaced apex
Best heard: lower left sternal edge; loudest on inspiration
Radiation: none
Symptoms:
Fatigue
Ascites
Peripheral oedema
Signs:
Giant โvโ waves in JVP (giant JVP waves without RVF = TR)
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