Mehl. conditions confused with cardio (adult part)

Question 1

Mehl. Orthostasis. definition?

Answer 1

Orthostatic hypotension is defined as intravascular fluid depletion causing a drop of systolic BP >20 mmHg and diastolic BP >10 mmHg when going from supine to standing.

Question 2

Mehl. Orthostatic hypotension is defined as intravascular fluid depletion causing a drop of systolic BP >20 mmHg and diastolic BP >10 mmHg when going from supine to standing. Dx?

Answer 2

Orthostasis.

Question 3

Mehl. Orthostasis. Shows up on 2CK IM form as exactly a drop of 20 and 10, respectively, for systolic and diastolic BPs in a patient with fainting -> answer?

Answer 3

intravascular fluid depletion.

Question 4

Mehl. Orthostasis. big risk factor?

Answer 4

Diuretic use is big risk factor.

Question 5

Mehl. Carotid sinus hypersensitivity.
USMLE likes this for both Steps 1 and 2.

Answer 5

.

Question 6

Mehl. Carotid sinus hypersensitivity.
They’ll say dude was shaving then got lightheadedness or fainted.

Answer 6

.

Question 7

Mehl. Carotid sinus hypersensitivity. Mechanism?

Answer 7

Mechanism is incr.­ stretch of carotid sinus baroreceptors -> incr. afferent CN IX firing to solitary nucleus of the medullaà -> incr. efferent CN X parasympathetic firing down to cardiac nodal tissue -> decr. HR -> decr. CO -> decr. cerebral perfusion.

Question 8

Mehl. Diffuse esophageal spasm. CP?

Answer 8

Can cause angina-like pain in patient without cardiovascular disease.

I discuss this in detail in the Gastro section.

Question 9

Mehl. Gastroesophageal reflux, CP?

Answer 9

Can present as chest pain confused for MI. ECG will be normal, clearly.

I discuss GERD in detail in the Gastro section.