dowjunk
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Hi fellows....I have come back from an unscheduled call today...very tired....and unmotivated, lol.
But let start eating each other's brain to get the commandment on the topic!
Rulez: None; anything and everything related to cardiac pathhology.
Lets start.
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| dowjunk
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I'll start my Qs from tomorrow isA. I am drained for tonite.
But just wanted you guys to explain the changes in heart and CVS due to left to right shunt? like RVH, LVH, heart dilatation, if yes then why?
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| dowjunk
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A 27-year-old G2 P1 woman has a screening ultrasound performed at 18 weeks gestation. The fetus is appropriate in size for 18 weeks. The fetal kidneys, liver, head, and extremities appear normal. However, the fetus has a heart with a membranous ventricular septal defect, overriding aorta, and marked pulmonic atresia. If the baby were to be liveborn, which of the following characteristics on physical examination would most likely result from these cardiac defects?
A Systemic hypertension
B Weak lower extremity pulses
C Clubbing of digits
D Telangiectasias
E Cyanosis
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| dowjunk
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A 50-year-old man has the sudden onset of substernal chest pain one afternoon. The pain persists for the next three hours. He then becomes short of breath and diaphoretic. He goes to the emergency department that evening. On physical examination his vital signs include T 37 C, P 95/minute, RR 25/minute, and BP 130/90 mm Hg. A chest radiograph shows a slightly enlarged heart and mild pulmonary edema. An EKG shows ST segment elevation in anterior leads V1 - 6. Which of the following serum laboratory test findings is most likely to be present in this man?
A Urea nitrogen of 110 mg/dL
B Sodium of 115 mmol/L
C ALT of 876 U/L
D Troponin I of 32 ng/mL
E HDL cholesterol of 55 mg/dL
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| dowjunk
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A 24-year-old woman with rheumatic heart disease becomes febrile. On physical examination she has a systolic murmur. An echocardiogram shows vegetations of the aortic valve cusps. A blood culture is positive for Staphylococcus epidermidis. She receives a porcine bioprosthesis because of her desire to have children and not to take anticoagulant medication. After ten years, she must have this prosthetic valve replaced. Which of the following pathologic findings in the bioprosthesis has most likely led to the need for replacement?
A Dehiscence
B Endocarditis
C Strut failure
D Calcification
E Thrombosis
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| dowjunk
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A 25-year-old previously healthy woman dies suddenly and unexpectedly. She had complained only of a slight headache for 3 days before her demise. At autopsy, the medical examiner finds an enlarged, dilated 410 gm heart with only minimal coronary atherosclerosis and normal cardiac valves. Microscopically, the myocardium on both the right and the left ventricles demonstrates infiltration by small lymphocytes, with focal myocyte necrosis. Which of the following infectious agents is most likely to have caused these findings?
A Coxsackie B virus
B Candida albicans
C Aspergillus fumigatus
D Streptococcus, viridans group
E Staphylococcus aureus
F Cytomegalovirus
G Streptococcus, group A
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| dowjunk
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A 72-year-old woman has had no major illnesses throughout her life. She has had 3 syncopal episodes over the past 2 weeks. Over the past 2 days she has developed shortness of breath and a cough with production of frothy white sputum. On physical examination she is afebrile. Her blood pressure is 135/90 mm Hg. She has no peripheral edema. A chest radiograph reveals a prominent left heart border in the region of the left ventricle, but the other chambers do not appear to be prominent. There is marked pulmonary edema. Laboratory studies show a total serum cholesterol of 170 mg/dL. Which of the following is the most likely diagnosis?
A Acute rheumatic fever
B Mitral valve stenosis
C Atherosclerotic aortic aneurysm
D Calcific aortic stenosis
E Infective endocarditis
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| dowjunk
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A 49-year-old woman had atrial fibrillation that was poorly controlled, even with amiodarone therapy. She suffered a "stroke" and died. At autopsy, her 600 gm heart is noted to have a mitral valve with partial fusion of the leaflets along with thickening and shortening of the chordae tendineae. There is an enlarged left atrium filled with mural thrombus. Which of the following underlying causes of death is she most likely to have?
A Systemic lupus erythematosus
B Coronary atherosclerosis
C Marantic endocarditis
D Rheumatic fever
E Amyloidosis
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| dowjunk
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A 45-year-old man was rushed to the hospital following the sudden onset of an episode of crushing substernal chest pain. He receives advanced life support measures. His course was marked by intractable cardiogenic shock and he died 4 days later. At autopsy, a large transmural anterolateral area of coagulative necrosis was found in the anterolateral wall of the left ventricle. Which of the following microscopic findings is most likely to be present?
A Fibroblasts and collagen
B Granulation tissue
C Necrotic muscle and neutrophils
D Granulomatous inflammation
E Diffuse chronic inflammation
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| dowjunk
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A ver good Question:
A 45-year-old woman has had worsening shortness of breath for 3 years. She now has to sleep sitting up on two pillows. She has had difficulty swallowing for the past year. She has no history of chest pain. A month ago, she had a "stroke" with resultant inability to move her left leg and difficulty moving her left arm. She is afebrile. A chest radiograph reveals a near-normal left ventricular size with a prominent left atrial border. Which of the following conditions is most likely to account for these findings?
A Essential hypertension
B Cardiomyopathy
C Mitral valve stenosis
D Aortic coarctation
E Left renal artery stenosis
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| dowjunk
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an ez fight for the Q:
A 16-year-old healthy adolescent is involved in a schoolyard gang fight and stabbed in the chest with a knife in the left midclavicular line. He is taken to the emergency department and on arrival his blood pressure is barely obtainable. His lungs are clear to auscultation. His heart sounds are barely audible. Which of the following is the most likely acute condition that may preclude his survival?
A Myocardial contusion
B Aortic laceration
C Pericardial tamponade
D Endocarditis
E Acute infarction
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| dowjunk
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I am sure u guys know this one:
A 19-year-old woman has had increasing malaise for the past 5 months. On physical examination she has a cardiac murmur characterized by a mid systolic click. An echocardiogram demonstrates mitral insufficiency with upward displacement of one leaflet. There is aortic root dilation to 4 cm. She has a dislocated right ocular crystalline lens. A year later she dies suddenly and unexpectedly. The medical examiner finds a prolapsed mitral valve with elongation, thinning, and rupture of chordae tendineae. A mutation involving which of the following genes is most likely to be present in this patient?
A Beta-myosin
B CFTR
C FGFR
D Fibrillin
E Spectrin
F Dystrophin
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| match2010
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1)cyanosis
2)troponin I
3)Calcification
4)coxsackie B virus
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| match2010
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5) athersclerotic aortic aneurysm
6)marantic endocarditis
7) necrotic muscle and neutrophils???
8) essential HTN
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| match2010
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9) PERICARDIAL TAMPONADE??
10) fibrllin
dude i just strted reading so please do pardon me if most of these are wrong cuz i didnt check them from boo or didnt take much time to read it ...just made some wild guesses on some faded memories of cardio path i did 2-3 months before .....so please do tell me the answer !!! thnx
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| match2010
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alrite im checking it right now and i think 3) suld be endocarditis ......
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| dowjunk
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Thx match2010....yup will write the answers for sure ....
Ok can any1 tell me why do we have SOB in tetralogy of Fallot?
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| dowjunk
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match2010 wrote:
alrite im checking it right now and i think 3) suld be endocarditis ......
Remember its sterile vegetations in rheumatic, rite....moreover emboli formation in infec endocarditis is probable, but in rheumatic vegetations: No!
the answer is dystrophic Calcification!
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| bioguy
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dowjunk wrote:
Thx match2010....yup will write the answers for sure ....
Ok can any1 tell me why do we have SOB in tetralogy of Fallot?
ok, extremely wild guess. i think the SOB is due to respiratory center being stimulated and not because of local pulmonary cause.
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| match2010
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please tell me all the answers ....thnx
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| dowjunk
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match2010 wrote:
please tell me all the answers ....thnx
Yeah match 2010, I'll dude.plz as many suggestions and participations are anticipated. I'll PM u the answers, man...i luv ur impatience!
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| bioguy
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Cyanosis
Troponin
Calcification
Coxsackie
Calcific aortic stenosis (doubtful)
Rheumatic fever
Granulation tissue
Mitral valve stenosis
Pericardial tamponade
Fibrillin
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| bioguy
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dowjunk wrote:
A 72-year-old woman has had no major illnesses throughout her life. She has had 3 syncopal episodes over the past 2 weeks. Over the past 2 days she has developed shortness of breath and a cough with production of frothy white sputum. On physical examination she is afebrile. Her blood pressure is 135/90 mm Hg. She has no peripheral edema. A chest radiograph reveals a prominent left heart border in the region of the left ventricle, but the other chambers do not appear to be prominent. There is marked pulmonary edema. Laboratory studies show a total serum cholesterol of 170 mg/dL. Which of the following is the most likely diagnosis?
A Acute rheumatic fever
B Mitral valve stenosis
C Atherosclerotic aortic aneurysm
D Calcific aortic stenosis
E Infective endocarditis
Discussion, anyone?
I think its Calcific aortic stenosis - supporting info:
elderly
syncope (due to reduced blood flow out of the aortic valve into carotids)
LHF (SOB, cough with frothy sputum)
LH enlargement (Xray findings)
the only finding not supporting Aortic stenosis is the Blood pressure. I'd expect low BP due to the stenosis, but the age-dependent aortic changes (loss of elasticity) may lead to increased BP.
can't think of significance of serum cholesterol (that level is expected in elderly, had to look up this one)
any thoughts, friends???
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| bioguy
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dowjunk wrote:
A 25-year-old previously healthy woman dies suddenly and unexpectedly. She had complained only of a slight headache for 3 days before her demise. At autopsy, the medical examiner finds an enlarged, dilated 410 gm heart with only minimal coronary atherosclerosis and normal cardiac valves. Microscopically, the myocardium on both the right and the left ventricles demonstrates infiltration by small lymphocytes, with focal myocyte necrosis. Which of the following infectious agents is most likely to have caused these findings?
A Coxsackie B virus
B Candida albicans
C Aspergillus fumigatus
D Streptococcus, viridans group
E Staphylococcus aureus
F Cytomegalovirus
G Streptococcus, group A
Is there any association of these bugs with CVS except for
Staph aureus - IVDA tricuspid endocarditis
Strep - RF
Strep viridans - Endocarditis after prosthetic valve or dental procedures
how about candida, aspergillus and CMV?
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| bioguy
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dowjunk wrote:
I am sure u guys know this one:
A 19-year-old woman has had increasing malaise for the past 5 months. On physical examination she has a cardiac murmur characterized by a mid systolic click. An echocardiogram demonstrates mitral insufficiency with upward displacement of one leaflet. There is aortic root dilation to 4 cm. She has a dislocated right ocular crystalline lens. A year later she dies suddenly and unexpectedly. The medical examiner finds a prolapsed mitral valve with elongation, thinning, and rupture of chordae tendineae. A mutation involving which of the following genes is most likely to be present in this patient?
A Beta-myosin
B CFTR
C FGFR
D Fibrillin
E Spectrin
F Dystrophin
A Beta-myosin - Hypertrophic cardiomyopathy
B CFTR - Cystic Fibrosis
C FGFR --???? whats this (Fibroblast Growth Factor Receptor???) significance?
D Fibrillin - Marfans
E Spectrin - Hereditary Spherocytosis
F Dystrophin - Duchenne's
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