study_ing
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most post Mi qs are ok to handle..except for the last 2 options i narrow down to!! and i salways chose the wrong answer!!
lets hope these help.
1. post MI pt ( recent),
develops hypotension, Jugular venous distension, sinus tachycardia
what do u look for to choose btw rt ventricular infarction vs free wall rupture?
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| study_ing
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2. pansystolic murmur
APICAL, if it radiates to axilla, think MR( hence papillary muscle affected)
if left lower sternal border, no radiation to axilla,, systolic thrill present sometimes
THINK VSD
Edited by study_ing on 09/10/06 - 02:08 PM
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| robin082006
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wall rupture is better choice.
But we need more info.
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| study_ing
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it definitely is robins, but thats what im asking..u look for mention of pulsus paradoxus in the picture. if present its definitely wall rupture. pulsus paradoxus duz not occur in rt ventricular infarct, though JV distension may be presentin both
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| study_ing
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actually i feel that qs are too long in this step..hence once u got a vague idea , u gotta focus on looking for certain s/s in the huge list given.
im hoping this approach helps my speed..in thereal exam, in confusing qs id mark the qs with an annotation and look over the case with certain points in mind...
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| study_ing
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3.easy clue to ventricular septal rupture vs free wall rupture?
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| saadtazjam
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Post MI Complications:
Hypotension+JVD+Rales+Tachycardia=CHF
Presence of Murmur=Papillary Muscle rupture
Clear lungs+Pulsus Paradoxus=Cardiac tamponade(Clear lungs(C) in Cardiac and (P) in tamPonade)
Free wall rupture due to cardiac tamponade
Rt ventricular Infarction:No Rales and EKG findings
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| study_ing
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nice, 'mnemonicy' and simple..thanx saadtazjam 
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