1. A 45 year old man comes into your office complaining of heart palpitations. You listen at his heart apex with the diaphragm of the stethoscope and hear a mid systolic click (an extra beat in between the 1st and 2nd heart sound). What is the likely diagnosis? Aortic regurgitation Mitral valve prolapse Mitral regurgitation Mitral stenosis

2. A 50 year old woman comes into your office citing exercise intolerance. You listen to her heart at the lower left sternal border with the bell of the stethoscope and hear an S3 sound (an extra, low frequency heart beat occurring after the 2nd heart sound). What is the likely diagnosis? Aortic stenosis Patent ductus arteriosis Mitral stenosis Congestive heart failure

3. If a patient has atrial fibrillation (the atria no longer respond to heart pace-making cells) an S4 heart sound (an extra, low frequency beat occurring before the first heart sound) will not exist. True False

4. A 10 year old boy comes into your office with no symptoms or complaints. When listening with the bell of the stethoscope at the apex, you hear an S3 heart sound. What is the diagnosis? Pulmonic Stenosis Chronic heart failure Normal heart sound Tricuspid Stenosis

5. A 40 year old man comes into your office complaining of exercise intolerance. You listen to his heart at the 3rd left intercostal space with the diaphragm and hear a murmur that is saw-like in quality that begins after S1 (first heart sound) and ends before S2 (2nd heart sound) during systole (while the heart is contracting). What is a likely diagnosis? Tricuspid stenosis Aortic regurgitation Aortic Stenosis Mitral stenosis

6. The diastolic murmur of tricuspid stenosis (narrowing and hardening of the tricuspid valve cusps) can only be heard with the diaphragm of the stethoscope. True False

7. A 70 year old man comes into your office complaining of heart palpitations. You listen to his heart at the lower left sternal border with the bell of the stethoscope and hear a rumbling murmur that occurs only during diastole (while the ventricles are filling). What is the likely diagnosis? Mitral stenosis Tricuspid regurgitation Aortic stenosis Tricuspid stenosis

8. A 55 year old woman comes into your office complaining of exercise intolerance. You listen to her heart at the 2nd right intercostal space with the diaphragm of the stethoscope and hear a diastolic murmur of blowing quality. What is the likely diagnosis? Aortic stenosis Tricuspid regurgitation Mitral regurgitation Aortic regurgitation

9. A 67 year old man enters your office with no complaints. You listen to his heart at the apex and hear an opening snap when listening with the diaphragm and a rumbling diastolic murmur when listening with the bell. What is the likely diagnosis? Tricuspid stenosis Pulmonic stenosis Aortic stenosis Mitral stenosis

10. Now for a whopper: A 60 year old woman enters your office with no symptoms to complain of. You listen to her heart at the 2nd left intercostal space and hear a mid-systolic murmur accompanied with wide fixed splitting of the S2 heart sound (Usually the 2nd heart sound is split and widens with inspiration at the 2nd left intercostal space). What is the diagnosis? Atrial septal defect Tricuspid regurgitation Pulmonic regurgitation Mitral regurgitation