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Test 6

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kafopaci2016's version from 2016-06-17 15:48

Section 1

Question Answer
hallmark of VSD as post MI complicationoxygen saturation is not the same between RT atrium & RT ventricle.
VSD as complication of MI (anterior).when ? charchtarestics?dx with what?3-5 days post MI.(hypotension,tachycardia), holosystolic murmur at lt sternal border, dx with pulmonary artery catheterization or echo.
whats the normal cardiac output? how is it affected in VSD?normal CO=5 L/min. in acute VSD (post MI)it will be low.
post MI (VSD VS mitral regurgitation )?increased oxygen saturation of RT ventricle in VSD not in MR.
in pt with PE why there will be holosystolic murmur at LT sternal border?tricuspid regurge due to increase RT sided heart pressures.
what would increase PCWP?MR
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Section 2

Question Answer
FEVER + MONOARTICULER SYMPTOMS.think of?Septic arthritis
when you suspect septic arthritis. Gm +ve VS Gm-ve ?Gm-ve(E.Coli, Psudomonus)->in pt with immunecomrimized or IV drug use, (N.gonnorhea)young sexually active.. Gm+ve(if none of the previous scenarios)in a preexisting joint damage like a pt with RA
in pt with culture negative persistent oligo or mono arthritis you suspect?mycobacterial joint infection
pt with malignancy induced DIC , anemia is due to ?microangiopathic hemolysis
discontinue cervical cancer screening at ?>65 yrs
frequency of mammography in >50 yrs F?every 2 yrs
pap smear recommended age?freq?30-65 every 3 yrs
colon ca screening age?freq?50-75 colonoscopy every 10 yrs, FOBT annually
absence seizures progress to myoclonic to generalized tonic clonic in teenager is called?juvenile myoclonic epilepsy
when dose juvenile myoclonic seizures occurs?worsened by?occurs upon awakening worsened by sleep deprivation.
lennox-gastaut syndrome is?<7yrs with wide array of seizure types +MR
you suspect meningitis in pt >60yrs immuncomprimised?what to give?what to add? why?empiric antibiotic( ceftriaxone+vancomycin) . add ampicillin to cover listeria cuz its common in this category.
cause of parkinson disease?loss of dopaminergic neurons in substantia nigra pars compacta
CSF findings in GBS ?high protein normal WBCs called ( albuminocytologic dissociation)
IV drug user with fever and tenderness over L1,L2. coming with sever leg weakness?you suspect?ttt?epidural access. vancomycin to cover staph including (MRSA)
pt >65 yrs with anemia,thrombocytopenia, leukopenea. blood smear shows (ovalocyte+ neutrophils with decreased segmentation).dx?next step?myelodysplastic syndrome. you do bone marrow biopsy.
atrophic gastritis VS myelodysplastic syndrome?amount of neutrophil segmentation.
pt with DKA ,whats responsible for his symptoms?fatty acid breakdown in the liver.
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