Diagnosis of Diseases

Question 1

SSx of AAA

Answer 1

Asymptomatic!
Early SSx: bloating, gas, GI upset
Late SSx (about to dissect): deep boring visceral back (lumbosacral) pain or abdominal pain, claudication, worsening HTN (esp. renal art.)

Exam: Pulsatile mass in abdomen, w/ or w/o bruit

Question 2

Imaging choice to Dx AAA

Answer 2

US!!! Then CT

Question 3

SSx of Dissection/Rupture

Answer 3

Sudden severe sharp pain, mimics MI, syncope, cardiac tamponade, pulse waxes & wanes, BPs differ btw limbs, aortic regurg. murmur

Question 4

What is this pulse and what does it represent? Alternans

Answer 4

Alternates high/low, no change w/breath

Death rattle of L ventricle (valve, CHF)

Question 5

What is this pulse and what does it represent? Bigeminus

Answer 5

Every other beat premature = PVC

Question 6

What is this pulse and what does it represent? Bisferens pulse

Answer 6

2x striking, dicrotic pulse, systolic

Question 7

What is this pulse and what does it represent? Paradoxicus pulse

Answer 7

BP falls 8-10 mmHg on inspiration

Massive PE, COPD, rCHF, Emphysema, Asthma, Thoracic outlet syndrome

Question 8

What is this pulse and what does it represent? Paradoxus pulse

Answer 8

BP falls >20 mmHg on inspiration

Tamponade, COPD, Hypovolemic shock, Constrictive pericarditis, PE

Question 9

What is this pulse and what does it represent? Parvus pulse

Answer 9

Small, weak, low output

Low ejection fraction, cardiomyopathy, CHF murmur, BP, shock, MI, Rx, Arrhythmia, PG, cor pulmonale)

Question 10

What is this pulse and what does it represent? Tardus pulse

Answer 10

Slow rise
Output obstruction (aortic stenosis, hypertrophic cardiomyopathy), atherosclerosis, septal fibrosis

Question 11

What is this pulse and what does it represent? sinus arrhythmia

Answer 11

INC w/inspiration, DEC w/expiration, phasic

Common in children, normal