formative Flashcards
what is aortic incompetence?
aortic regurgitation
leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. As a consequence, the cardiac muscle is forced to work harder than normal.
what is pericardial tamponade?
Cardiac tamponade, also known as pericardial tamponade, is when fluid in the pericardium (the sac around the heart) builds up, resulting in compression of the heart. Onset may be rapid or gradual.
what is right ventricular hypertrophy?
Right ventricular hypertrophy (RVH) is a condition defined by an abnormal enlargement of the cardiac muscle surrounding the right ventricle. … Therefore, the main causes of RVH are pathologies of systems related to the right ventricle such as the pulmonary artery, the tricuspid valve or the airways.
what is a pansystolic murmur?
start at S1 and extend up to S2. They are usually due to regurgitation in cases such as mitral regurgitation, tricuspid regurgitation, or ventricular septal defect
what is cyanosis?
Cyanosis refers to a bluish cast to the skin and mucous membranes. Peripheral cyanosis is when there is a bluish discoloration to your hands or feet. It’s usually caused by low oxygen levels in the red blood cells or problems getting oxygenated blood to your body
what are the causes of clubbing?
Cyanotic heart disease/CF Lung cancer/abscess Ulcerative colitis Bronchiectasis Benign mesothelioma Infective endocarditis/idiopathic pulmonary fibrosis Neurogenic tumours Gastrointestinal disease
- what does absence of JVP ‘a’ wave suggest?
2. what does a large jugular ‘V’ wave suggest?
- The absence of ‘a’ waves may be seen in atrial fibrillation.
- An elevated JVP is the classic sign of venous hypertension (e.g. right-sided heart failure).
what causes a left parasternal heave?
Parasternal heave occurs during right ventricular hypertrophy (i.e. enlargement) or very rarely severe left atrial enlargement.
what is pulse paradoxus?
abnormally large decrease in stroke volume, systolic blood pressure and pulse wave amplitude during inspiration
what is a collapsing pulse?
pulse that is bounding and forceful, rapidly increasing and subsequently collapsing, as if it were the sound of a waterhammer that was causing the pulse.
what is the likely diagnosis for the following clinical scenario?
A 54-year-old man with a medical history of hypertension, diabetes, dyslipidaemia, smoking, and family history of premature coronary artery disease presents with retrosternal crushing chest pain (10/10 in intensity), radiating down the left arm and left side of the neck. He feels nauseated and light-headed and is short of breath. Examination reveals hypotension, diaphoresis, and considerable discomfort with diffuse bilateral rales on chest auscultation. ECG reveals convex ST-segment elevation in leads V1 to V6.
STEMI
what is the likely diagnosis for the following clinical scenario?
A 45-year-old woman presents with constant chest pain that is worsened by movement and deep inspiration. The pain started gradually several weeks ago and has been worsening over the past few days. She denies any shortness of breath on exertion and feels otherwise well. She has tenderness over the right third and fourth costochondral junctions. The rest of her examination is unremarkable
chest wall pain/costochondritis
what is the likely diagnosis for the following clinical scenario?
A 60 year old female smoker with a history of CAD presents with chest discomfort on exertion relieved by nitroglycerine or rest. There is no change in intensity, frequency, or duration; no associated diaphoresis, nausea/vomiting, or shortness of breath.
chronic stable angina / angina pectoris
what is the likely diagnosis for the following clinical scenario?
A 65-year-old man presents with a 2-month history of a dry persistent cough and 4.5 kg unintentional weight loss. He denies fevers, dyspnoea, sore throat, rhinorrhoea, chest pain, or haemoptysis. Past medical history is significant for chronic obstructive pulmonary disease and hypertension. Family history is non-contributory. He smoked 1 pack of cigarettes daily for 40 years but quit 5 years ago. No adenopathy was palpable on examination and breath sounds were diminished globally without focal wheezes or rales
lung cancer
what is the likely diagnosis for the following clinical scenario?
A 23-year-old man with asthma and seasonal allergies presents to the accident and emergency department with an acute food bolus impaction. He has had solid food dysphagia since primary school, but had always been told to chew more carefully. He has not had any prior evaluation, and has never been to the emergency department before, but does have a sensation of food sticking with almost every meal. He minimises symptoms by eating slowly, chewing thoroughly, and drinking a lot of water with each bite of food. He tends to avoid dry breads and steak, as these always stick. Most of the time when foods stick, if he relaxes himself they will eventually go down. However, sometimes he has to clear the foods with regurgitation. The endoscopic examination shows a food bolus impacted in the proximal oesophagus, which is cleared. The oesophagus is diffusely narrowed, with oedema, rings, and furrows. Biopsies show 85 eosinophils per high-power microscopy field (eos/hpf) from the distal oesophagus and 70 eos/hpf from the proximal oesophagus. He is started on the proton-pump inhibitor (PPI) omeprazole (20 mg orally twice daily) and has a follow-up endoscopy scheduled in 8 weeks’ time. He continues to have frequent dysphagia. The endoscopic findings and biopsy results are unchanged and he is diagnosed with eosinophilic oesophagitis (EoO).
eosinophilic oesophagitis
what is the likely diagnosis for the following clinical scenario?
An otherwise healthy 30-year-old man presents with a several-day history of progressive, severe, retrosternal chest pain that is sharp and pleuritic in nature. The pain is worse on lying down and improved with sitting forward. There is radiation to the neck and shoulders and specifically to the trapezius muscle ridges. The pain is constant and unrelated to exertion. On physical examination, a pericardial friction rub is heard at end-expiration with the patient leaning forward.
pericarditis
what is the likely diagnosis for the following clinical scenario?
A 70-year-old woman presents with slowly increasing dyspnoea. She cannot lie flat without feeling more short of breath. She has a history of hypertension and osteoarthritis, and she has been taking non-steroidal anti-inflammatory drugs with increasing frequency over the previous few months. On physical examination, she appears dyspnoeic at rest, her blood pressure is 140/90 mmHg, and pulse is 90 bpm. Her jugular venous pressure is elevated to the angle of the jaw. The left lung field is dull to percussion with quiet breath sounds basally. Crackles are heard in the right lung field and above the line of dullness on the left. Lower extremities have pitting oedema to the knee
pleural effusion
what is the likely diagnosis for the following clinical scenario?
A 54-year-old smoker with multiple comorbidities (diabetes, hypertension, coronary artery disease) presents with a 2-day history of a productive cough with yellow sputum, chest tightness, and fever. Physical examination reveals a temperature of 38.3°C (101°F), BP of 150/95 mmHg, heart rate of 85 bpm, and a respiratory rate of 20 breaths per minute. His oxygen saturation is 95% at rest; lung sounds are distant but clear, with crackles at the left base. Chest x-ray reveals a left lower lobe infiltrate.
pneumonia
what is the likely diagnosis for the following clinical scenario?
A 65-year-old man presents to the emergency department with acute onset of shortness of breath of 30 minutes’ duration. Initially, he felt faint but did not lose consciousness. He is complaining of left-sided chest pain that worsens on deep inspiration. He has no history of cardiopulmonary disease. A week ago he underwent a total left hip replacement and, following discharge, was on bed rest for 3 days due to poorly controlled pain. He subsequently noticed swelling in his left calf, which is tender on examination. His current vital signs reveal a fever of 38.0°C (100.4°F), heart rate 112 bpm, BP 95/65 mmHg, and an O₂ saturation on room air of 91%.
pulmonary embolism
what is the likely diagnosis for the following clinical scenario?
A 65-year-old man, who smokes and has a history of hypertension and peripheral vascular disease, now presents with increasing frequency and severity of chest discomfort over the past week. He reports that he previously had chest pain after walking 100 metres, but now is unable to walk more than 50 m without developing symptoms. The pain radiates to the left side of the neck and is only eased after increasing periods of rest
unstable angina
what is nocturnal burning chest pain suggestive of?
GORD
what is guillan barre syndrome?
rare but serious autoimmune disorder in which the immune system attacks healthy nerve cells in your peripheral nervous system (PNS). This leads to weakness, numbness, and tingling, and can eventually cause paralysis.
