Clinical Features Vinyette

Question 1

Sudden onset dyspnea
Pleuritic chest pain
Tachypnea
Tachycardia
S1Q3T3 pattern (acute pain on the heart)
Sinus tachycardia
CT pulmonary angiography
Respiratory alkalosis
V/Q mismatch

Answer 1

Pulmonary Edema

Question 2

Site where systemic thrombosis are likely to lodge
And the outcome is

Answer 2

Lower extremities 70%
Brain 10%
Tissue infarction

Question 3

Fracture of long bone
Soft tissue trauma
Burn

Injuries > rupture vascular sinusoids in the marrow/small venules > marrow/adipose tissue herniates into the vascular space > lung
What stain is used for fat

Answer 3

Fat Embolism
Oil Red stain

Question 4

How many days after severe fat embolism shows

Answer 4

1 - 3days

Question 5

 surgery
 obstetric or laparoscopic procedures
 chest wall injury
 decompression sickness

Answer 5

Air Embolism

Question 6

Types of acute decompression sickness
Explain the pathophysiology

Answer 6

Bends
Chokes

Question 7

Chronic decompression sickness causes

Answer 7

persistence of gas emboli in the skeletal system> multiple foci of ischemic necrosis- femoral heads, tibia, and humeri.

Question 8

What’s the morphology of Amniotic fluid embolism

Answer 8

presence of squamous cells shed from fetal skin, lanugo hair, fat from vernix caseosa, and mucin derived from the fetal respiratory or gastrointestinal tract in the maternal pulmonary microvasculature

Question 9

Amniotic fluid pathophysiology

Answer 9

complication of labor and the immediate postpartum period.
Tear in the placental membranes or rupture of uterine veins > infusion of amniotic fluid/fetal tissue into the maternal circulation

Question 10

Fever, pleuritic chest rain, pericardial friction rub (high-pitched scratching sound), and a pericardial and unilateral pleural effusion occurring 3 weeks after an MI suggest

Answer 10

postmyocardinal infarction syndrome [dressler syndrome]

Question 11

Wavy myocardial fibers without inflammatory cells

Answer 11

Seen within the first hrs post MI and followed by coagulate necrosis (4-72hrs post MI)

Complication in this period include ventricular arrhythmia, acute heart fracture and cardiogenic shock.

Question 12

Epigastric pain and vomiting combined with St segment elevation in leads II, Ill and aVF are consistent with

Answer 12

Myocardial infarction

Question 13

Dissociated P waves and QRS complexes are indicative of

Answer 13

Third - degree atrioventricular block
[ occlusion proximal right coronary artery (RCA]

Question 14

ST Elevations - Anterior typically develop in leads………. on ECG
What artery is affected

Answer 14

Leads V1 - V4 as a results of infarcts that involve the proximal LAD

Left anterior descending artery ( LAD )

Question 15

ST Elevations - lateral wall typically develop in leads………. on

What artery is affected

Answer 15

I, aVL, V5, V6

Left circumflex artery

Question 16

ST Elevations - Inferior wall typically develop in leads………. on ECG

What artery is affected

Answer 16

II, III, aVF leads

Posterior descending artery

Branch of right coronary artery 90%

LCX 19%

Question 17

Special complication on inferior MI d/t right ventricular infarction is

Answer 17

Elevated jugular venous pressure
Decrease preload to left ventricle > HYPOTENSION

Question 18

Special complication on inferior MI d/t right ventricular infarction is

Answer 18

Sinus bradycardia and heart block
D/t Vagal stimulation from inferior wall ischemia

Question 19

ST Elevation ( STEMI ) in aVR only with diffuse ST depressions suggests

Answer 19

Left Main Occlusion

Question 20

ST elevation in posterior leads (V7-V9) + Anterior ST depressions with standard leads

Answer 20

Posterior myocardial infarction