Question

Match List I (Clinical signs) with List II (Cardiac disease) and select the correct answer using the codes given below the lists.

List I (Clinical signs)	List II (Cardiac disease)
A. Hill's sign	1. Pericardial effusion
B. Ewart's sign	2. Hypertrophic cardiomyopathy
C. Double systolic impulse	3. Junctional rhythm
D. Cannon waves	4. Aortic regurgitation

Codes:

• A. A - 4, B - 2, C - 1, D - 3
• B. A - 3, B - 1, C - 2, D - 4
• C. A - 4, B - 1, C - 2, D - 3
• D. A - 3, B - 2, C - 1, D - 4

Hint:

Match each sign to its mechanism: pressure gradient, compression, hypertrophy, or timing mismatch.

Answer 1

The Correct Option is C

Step 1: Start with the pulse pressure clue.
Hill's sign compares leg cuff pressure with arm cuff pressure. A gap of $20$ mm Hg or more points to a wide pulse pressure state, and the classic cause is aortic regurgitation. So Hill's sign links to 4.

Step 2: Move to the chest wall dullness.
Ewart's sign is dullness with bronchial breath sounds just under the tip of the left scapula. A big pericardial effusion pushes on the lung base and creates exactly this finding, so Ewart's sign links to 1.

Step 3: Think about the double impulse.
When the ventricle wall is thick and stiff, as in hypertrophic cardiomyopathy, the atrial kick has to work hard to fill it, and this gives a palpable pre-systolic bump right before the main systolic beat. This double systolic impulse links to 2.

Step 4: Think about cannon waves.
Cannon waves show up in the neck veins when the atrium and ventricle beat out of step, so the atrium squeezes against a shut tricuspid valve. A junctional rhythm is a common cause of this loss of coordination, so cannon waves link to 3.

Step 5: Build the final code.
Combining all four pairs gives A-4, B-1, C-2, D-3, which is option (c).
\[ \boxed{A\text{-}4,\ B\text{-}1,\ C\text{-}2,\ D\text{-}3} \]