ข้อสอบ Cvs nl กรี้ดดดดด
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1. The document appears to be a set of medical exam questions in Thai covering various topics in cardiology. It includes 20 multiple choice questions testing knowledge of topics like congenital heart defects, causes of dysphagia, risk factors for atherosclerosis, myocarditis, hypotension in pregnancy, heart anatomy, effects of vasodilators, angiotensin receptor blockers, causes of sudden cardiac death in young athletes, and infective endocarditis. The questions are in Thai and include multiple choice answers in Thai as well.
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This case presentation describes a 58-year-old female patient who presented with fever, myalgia, severe headaches, and generalized weakness. Investigations revealed anemia, elevated inflammatory markers, and a positive transesophageal echocardiogram showing mitral valve vegetation. The patient was diagnosed with infective endocarditis of the mitral valve and underwent mitral valve replacement surgery. The document then provides details on the definition, diagnosis, and treatment of infective endocarditis, including descriptions of the Duke criteria for diagnosis and appropriate antibiotic therapy based on the infecting organism.
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- Infective endocarditis is a microbial infection of the endothelial surface of the heart. The characteristic lesion is vegetation (fibrin, platelets, microorganisms and inflammatory cells).
- It can be classified as acute (systemic toxicity, progression over days to weeks) or subacute (modest toxicity over weeks to months).
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1) Cardiovascular manifestations are common in HIV-infected patients and include pericardial diseases, endocarditis, and dilated cardiomyopathy.
2) Pericardial effusion is the most common manifestation and is associated with advanced HIV disease. Common causes include infections.
3) Endocarditis incidence is similar to other high risk groups but more commonly affects the right-sided valves. Staphylococcus is the most common cause.
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This document summarizes key aspects of infective endocarditis including epidemiology, pathogenesis, microbiology, clinical manifestations, diagnosis, and treatment. Some key points are:
- It affects 10-20,000 people annually in the US and risk factors include structural heart disease, prosthetic valves, and intravenous drug use.
- Bacteria seed non-bacterial thrombotic vegetations on heart valves, adhere and grow within them, potentially causing valve damage.
- Common causative organisms are staphylococci, streptococci, and enterococci. Blood cultures help identify the organism.
- Symptoms include fever and heart murmurs. Echocardiography aids diagnosis.
- Treatment
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Infective endocarditis is a microbial infection of the heart that has proven difficult to treat as its incidence and mortality have not decreased in recent decades despite medical advances. It presents in various forms depending on factors like the microorganism, underlying heart condition, and patient characteristics. Guidelines are often based on expert opinion due to the low incidence of the disease and lack of randomized trials.
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This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
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This document describes the case of a 24-year-old intravenous drug user who presented with a 15-day history of fever, malaise, and shortness of breath for 7 days. On examination, he was found to be pale with a heart murmur. Investigations showed anemia, hepatitis C, and HIV positivity. Echocardiography revealed vegetation on the tricuspid valve. He was diagnosed with right-sided infective endocarditis and treated with antibiotics.
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This document discusses infective endocarditis, including its definition, pathophysiology, classification, clinical situations, manifestations, diagnosis and treatment. Some key points:
- Infective endocarditis is a microbial infection of the endothelial surface of the heart. The characteristic lesion is vegetation (fibrin, platelets, microorganisms and inflammatory cells).
- It can be classified as acute (systemic toxicity, progression over days to weeks) or subacute (modest toxicity over weeks to months).
- It commonly involves the heart valves but can occur on the endocardium. Risk factors include pre-existing valve problems, IV drug use, and implanted devices.
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Presentation shows some real cases from infection diseases hospital and allow you to challenge your knowledge in medicine. After presentation of each case you will see a slide with a question about diagnosis. Try to answer and if you would have problems go to next slide where you will find a hint. Goodluck! If you would interested in new cases please contact Dr Andrey Dyachkov cd4@inbox.ru
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Acute Heart Failure Myocarditis.
A 32-year-old man presented to the emergency department with recent onset chest pressure and dyspnea. He reported having a flu-like illness one week prior. On exam, his heart rate was 108 and regular, blood pressure was 105/70, and he had a pericardial rub and basilar rales. His troponin T level was elevated at 12. An electrocardiogram showed abnormal findings. The patient is likely experiencing myocarditis, which can develop after a viral illness, and immunosuppressive therapy with prednisone and azathioprine is least likely to improve his left ventricular function over the next six months.
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This document describes four cases of infective endocarditis. The first case involves a 57-year-old man admitted to the hospital with symptoms including fatigue, fever, night sweats, and weight loss. He has a history of mitral valve prolapse and recent dental work. Physical exam reveals fever, rashes, and murmurs. Blood tests show anemia and elevated inflammatory markers. Cultures grow streptococci.
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Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare autoimmune disease characterized by inflammation of blood vessels. It commonly involves the upper and lower respiratory tracts and kidneys. The disease was first described in 1931 and recognized as a distinct clinical entity in 1936. Common symptoms include nasal inflammation, sinusitis, lung nodules, alveolar hemorrhage, and necrotizing glomerulonephritis. Diagnosis involves meeting criteria established by the American College of Rheumatology or the 2012 revised Chapel Hill criteria through clinical evaluation, biopsy, and ANCA testing. Treatment involves immunosuppressive medications.
Clinical cases from infection diseases hospital
Presentation shows some real cases from infection diseases hospital and allow you to challenge your knowledge in medicine. After presentation of each case you will see a slide with a question about diagnosis. Try to answer and if you would have problems go to next slide where you will find a hint. Goodluck! If you would interested in new cases please contact Dr Andrey Dyachkov cd4@inbox.ru
Acute rheumatic fever ppt final copy
Rheumatic fever is an autoimmune disease that affects the heart, joints, skin, and brain. It occurs as a result of a streptococcal throat infection and abnormal immune response in genetically susceptible individuals. The disease is most common in children aged 5-15 years from developing countries. It can lead to long term heart complications such as rheumatic heart disease if untreated. Prevention involves proper treatment of streptococcal infections with antibiotics.
Cvd n hiv
This document discusses cardiovascular diseases in HIV patients. It notes that cardiovascular disease is more common in HIV patients due to multiple potential factors, including traditional risk factors, HIV itself, antiretroviral therapy, and chronic inflammation. It also discusses specific cardiac complications in more detail, such as cardiomyopathy, pericardial effusion, endocarditis, pulmonary hypertension, vasculitis, and the possible association between viral infections and coronary artery disease.
Acute rheumatic fever
Acute rheumatic fever is an autoimmune disorder caused by an untreated streptococcal throat infection. It commonly affects children ages 5-15 and can cause long-term heart damage through inflammation of the heart valves and muscles. Symptoms include migratory joint pain, skin rashes, and involuntary movements. Treatment involves bed rest, antibiotics to treat strep, aspirin or steroids to reduce inflammation, and lifelong antibiotic prophylaxis to prevent recurrence and further heart damage. Without proper treatment and prevention, it can lead to serious and permanent heart valve problems.
Manifestações cv em hiv
1) Cardiovascular manifestations are common in HIV-infected patients and include pericardial diseases, endocarditis, and dilated cardiomyopathy.
2) Pericardial effusion is the most common manifestation and is associated with advanced HIV disease. Common causes include infections.
3) Endocarditis incidence is similar to other high risk groups but more commonly affects the right-sided valves. Staphylococcus is the most common cause.
4) Dilated cardiomyopathy prevalence was 30% in pre-HAART era and associated with worse outcomes. Causes are multifactorial including direct viral effects.
Cerebral Malaria
Cerebral malaria is a serious neurological complication caused by Plasmodium falciparum infection that can lead to coma and death. It accounts for approximately 20% of adult and 15% of childhood malaria deaths globally each year. The document discusses the epidemiology, transmission, clinical manifestations including retinopathy-specific signs, diagnosis, treatment and management of cerebral malaria. Pathophysiological mechanisms contributing to cerebral malaria are still being investigated.
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This document discusses myocarditis, including its definition, etiology, clinical features, diagnosis, treatment, prognosis, and complications. Myocarditis is defined as inflammation of the heart muscle, which can be caused by various viral and bacterial infections. Clinical features include fever, chest pain, and heart failure symptoms. Diagnosis involves electrocardiograms, cardiac imaging like echocardiograms and MRI, and endomyocardial biopsy. Treatment is supportive with medications, while prognosis depends on the age of onset, with higher mortality in newborns and potential for recovery of heart function in older children and adults.
Endocarditis 2005 12
This document summarizes key aspects of infective endocarditis including epidemiology, pathogenesis, microbiology, clinical manifestations, diagnosis, and treatment. Some key points are:
- It affects 10-20,000 people annually in the US and risk factors include structural heart disease, prosthetic valves, and intravenous drug use.
- Bacteria seed non-bacterial thrombotic vegetations on heart valves, adhere and grow within them, potentially causing valve damage.
- Common causative organisms are staphylococci, streptococci, and enterococci. Blood cultures help identify the organism.
- Symptoms include fever and heart murmurs. Echocardiography aids diagnosis.
- Treatment
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Infective endocarditis is an infection of the heart valves or endocardium. It can be classified as native valve, prosthetic valve, intravenous drug abuse related, or nosocomial acquired. Common symptoms include fever, heart murmur, petechiae, and splinter hemorrhages. Blood cultures and echocardiography are used to diagnose. Treatment involves parenteral antibiotics for 4-6 weeks along with possible surgery. Complications can be embolic, from local spread of infection, metastatic spread, or immune complex formation leading to glomerulonephritis. Prevention focuses on antibiotic prophylaxis for high risk patients before certain medical procedures.
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This document presents the case of a 28-year-old male who presented with dyspnea, cough, and lower extremity edema. He was found to have nonischemic cardiomyopathy, severe hypocalcemia, short stature, and other physical features. Genetic testing revealed a loss of function mutation in GNAS1, consistent with pseudohypoparathyroidism type 1a (PHP 1a). PHP 1a causes parathyroid hormone resistance and hypocalcemia due to imprinting of the GNAS1 gene. Hypocalcemia can cause heart failure by impairing cardiac contractility. The patient's hypothyroidism and alcohol use also contributed to his cardiomyopathy. He was treated with calcium supplementation
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Central Nervous System Histoplasmosis Related to Bioprosthetic Endocarditis
Endocarditis caused by Histoplasma capsulatum is a rare occurrence. Involvement of the central nervous system by Histoplasma is also relatively uncommon. This paper reports a case of a 62-year-old woman with a past medical history significant for a myocardial infarct 5 years prior which necessitated coronary artery bypass graft surgery, prosthetic aortic valve replacement 4 years prior, and sarcoidosis, diagnosed 1 year prior, which was treated with methotrexate. She presented with fevers, generalized weakness, night sweats, and chest and throat pain. An echocardiogram done as part of her evaluation showed a vegetation on her prosthetic aortic valve. H. capsulatum was identified on blood cultures, and she was started on antibiotics. She expired shortly thereafter. At autopsy, a diagnosis of Histoplasma endocarditis was confirmed with evidence of embolic disease involving kidneys and digits of the hand. Hilar lymph nodes showed evidence of the fungus. Examination of the brain showed multiple widespread microscopic foci of macrophages, lymphocytes, and microglial cells with associated Histoplasma organisms, highlighted on Gomori methenamine silver staining. This paper will discuss central nervous system involvement by Histoplasma.
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The document discusses two conditions: paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS). PNH is a complement-mediated hemolytic anemia treated with the drug eculizumab, a C5a inhibitor. aHUS is a complement-mediated thrombotic microangiopathy that can cause stroke, heart attack, and kidney failure, and is also treated with eculizumab. The document asks the reader to identify PNH, aHUS, and the mode of action of eculizumab.
Krok 2 Medicine - 2016 Question Paper
The document appears to be a medical exam containing multiple choice questions about various medical cases and diagnoses. Question 1 describes a patient found unconscious after resuscitation from drowning and asks for the diagnosis based on symptoms of unconsciousness, dilated pupils, and convulsions. Question 2 describes a welder complaining of weakness and fever with symptoms of anemia and asks for the cause of anemia.
Krok2 medicine-2016-160930213746
This document contains a series of multiple choice questions related to medicine. The questions cover topics such as diagnosing a patient found unconscious after resuscitation, identifying the cause of anemia in a patient based on lab results, determining the appropriate secondary prevention measures for cardiovascular disease, and selecting the most likely diagnosis for various patient presentations and case histories.
K046061063
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
1. A community health nurse practitioner is teaching a group of fema.docx
1. A community health nurse practitioner is teaching a group of female high school students about the importance of regular Papanicolaou (Pap) smears. The nurse recognizes that which of the following items underlies the rationale for this teaching? (Points : 2)
The active substitution of normal cells in the cervix correlates to cancer risk.
Undifferentiated stem cells are an early indicator of cervical cancer.
Cancer of the uterine cervix develops incrementally at a cellular level.
Dysplasia in the connective tissue of the cervix is a strong precursor to cancer.
Question 2.2. Following a biopsy, a 54-year-old man has been diagnosed as having a benign neoplastic tumor. Which of the following characteristics most likely applies to his tumor? (Points : 2)
The tumor is poorly approximated and has the potential to break loose.
The tumor may secrete hormones or cytokines.
The well-differentiated neoplastic cells are clustered together in a single mass.
It has a rapid rate of growth and can induce ischemia.
Question 3.3. A nurse practitioner is teaching a student NP about the physiologic basis for damage to the circulatory and neurological systems that can accompany hypotension. Which of the following responses by the student would warrant correction by the nurse practitioner?
(Points : 2)
“As vessel wall thickness increases, tension decreases.”
“Smaller blood vessels require more pressure to overcome wall tension.”
“The smaller the vessel radius, the greater the pressure needed to keep it open.”
“Tension and vessel thickness increase proportionately.”
Question 4.4. A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for? (Points : 2)
Hypocoagulation
Iron and ferritin deficiencies
Splenomegaly and hepatomegaly
Neutropenia
Question 5.5. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? (Points : 2)
Signal-averaged ECG
Exercise stress testing
Electrophysiologic study
Holter monitoring
Question 6.6. A nurse practitioner is doing the admission assessment on a patient who has been transferred to the floor after being diagnosed by the emergency room physician with bilateral pleural effusion. Which of the following findings from the nurse practitioner's initial assessment of the patient is incongruent with the patient's diagnosis, and would require further investigation? (Points : 2)
The patient complains of sharp pain exacerbated by deep inspiration.
The patient's breath sounds are diminished on auscultation.
Pulse oximetry indicates that the patient is.
Germany info Geography homework help.docx
This document contains 21 multiple choice questions related to various medical topics including: cervical cancer screening, benign tumors, hypotension, thalassemia, sick sinus syndrome, pleural effusions, autosomal dominant polycystic kidney disease, infectious mononucleosis, viruses, coronary artery bypass grafts, rhinosinusitis, small cell lung cancer, infectious mononucleosis pathophysiology, effects of chemotherapy and radiation, liver disease, urinary retention, fetal anomalies, nephron function, cystic fibrosis diagnosis, polyarteritis nodosa, and gas gangrene assessment findings.
Instructions· This week’s case study will introduce concepts r.docx
Instructions
· This week’s case study will introduce concepts related to the pulmonary system and shock states. Read the scenario and thoroughly complete the questions. Some of the answers will be short answers and may not require a lot of details. For example: what is the most common organism to cause a hospital acquired infection? The answer is pseudomonas aeruginosa. Answers to questions that relate to the pathogenesis of a disease must include specific details on the process. For example: How does hypoxia lead to cellular injury? Simply writing that a lack of blood flow, causes a lack of oxygen available to the cell and the cell cannot function without oxygen is not sufficient. This type of response is NOT reflective of an advanced understanding of the concept or graduate level work. This answer should discuss the cascade of events leading to the lack of oxygen and how it specifically impairs cellular function. All answers to these type of questions should address the effects at the cellular level, then the effects on the organ and then the body as a whole. Additionally describing the normal anatomical and/or physiologic processes underlying the pathogenesis will be necessary to thoroughly answer the question.
It is very likely that you will need to reference multiple sources to answer the questions thoroughly. Your text book will not necessarily have all the answers. Only professional sources may be used to complete the assignment. These include text books, primary and secondary journal articles from peer reviewed journals, government and university websites, and publications from professional societies who establish disease management guidelines and recommendations. Sources such as Wikipedia or other generic websites are not considered professional references and should not be used to complete the case studies.
· Reason for Consultation:
Desaturation to 64% on room air 1 hour ago with associated shortness of breath.
History of Present Illness:
Mrs. X is 73-year-old Caucasian female who was admitted to the general surgery service 3 days ago for a leaking j-tube which was surgically replaced 2 days ago. This morning at 07:30, the RN reported that the patient was sleeping and doing fine, then the CNA made rounds at 0900 and Mrs. X was found to be mildly dyspneic. Vital signs were checked at that time and were; temperature 38.6, pulse 120, respirations 20, blood pressure 138/38. O2 sat was 64% on room air. The general surgeon was notified by the nursing staff of the hypoxia, an order for a chest x-ray and oxygen therapy were given to the RN. The O2 sat is maintaining at 91-92% on 4L NC. The patient was seen and examined at 10:10 a.m. She reported that she has had mild dyspnea for 2 days that has progressively gotten worse. She does not use oxygen at home. Her respiratory rate at the time of this visit was 20 and she feels short of breath. She has felt this way in the past when she had pneumonia. She is currently undergoing radiatio.
Listeria
SF is a 55-year-old male who presented with fever, diarrhea, and altered mental status. Testing revealed Listeria monocytogenes in his blood and cerebrospinal fluid, indicating he had developed listeriosis, an infectious disease. His symptoms improved with antibiotic treatment. Listeria is a foodborne pathogen that commonly causes meningitis and sepsis in high-risk groups like pregnant women, newborns, and immunocompromised individuals. It is found in soil and contaminated foods and enters the body through ingestion.
May 8th
The document appears to contain a collection of multiple choice medical questions covering various topics in pathology, physiology, and clinical diagnosis. Specifically, some of the questions address: types of anemia; liver diseases; acid-base imbalances; cardiovascular conditions; neurological disorders; and endocrine/metabolic diseases. The questions are in a foreign language but appear designed to test medical knowledge through identification of diseases, symptoms, diagnostic tests, or physiological mechanisms.
Krok 2 - 2011 Question Paper (General Medicine)
A patient experienced sudden chest pain radiating to the left arm and then lost consciousness. Objectively, the patient had pale skin, fast breathing, high blood pressure, and then lost pulse and pupils were dilated. This is most likely a heart attack.
A child developed ataxia, nystagmus, intention tremor and muscle hypotonia on the 21st day after a chickenpox rash. Analysis of cerebrospinal fluid showed mild lymphocytic pleocytosis and slightly increased protein. This is likely a varicella zoster virus encephalitis complication.
A 47-year-old patient complained of insomnia, heaviness, depressed mood, feeling worthless and like a burden. On
Case report of atypical seronegative scleroderma
This case report describes an atypical case of seronegative scleroderma in a 73-year-old Asian woman who presented with presyncope and worsening dysphagia and dyspnea. She exhibited clinical features of scleroderma including skin thickening, but was negative for specific scleroderma antibodies. Investigations revealed involvement of multiple organs including lungs, heart, liver, and gastrointestinal tract. This case highlights the importance of considering seronegative scleroderma when a patient presents with scleroderma-like features and multiorgan involvement, even in the absence of antibodies, to allow for early diagnosis and management.
Dr shaf3y cardiology revision
This document contains 14 cardiology cases presenting with various symptoms. It discusses the diagnoses, investigations, and management for conditions like acute myocardial infarction, mitral regurgitation, heart failure, hypertension, arrhythmias, coronary artery disease, and congenital heart disease. Key points addressed in the cases include ST elevation on ECG, hypotension, murmurs, neck vein patterns, and complications of long-standing illnesses. A multidisciplinary approach is needed to diagnose and treat the complex cardiology presentations.
sepsis
A 73-year-old woman presented with symptoms of weakness, cough, and fever. On examination, she was somnolent with a low-grade fever, rapid heart rate and breathing, low blood pressure, and crackles in her right lung. Based on her symptoms and exam findings meeting two SIRS criteria, the most likely diagnosis is systemic inflammatory response syndrome (SIRS) due to a potential infection such as pneumonia. Sepsis occurs when SIRS is caused by a confirmed or suspected infection and can progress to septic shock, organ dysfunction, and death if not properly treated.
Medicine ospe
This document contains summaries of several medical cases presented as questions with answers. Some key cases summarized include:
- A case of mitral stenosis presenting with dyspnea, dysphagia, and hoarseness with relevant investigations like ECG, CXR, echocardiogram and management options including medications, balloon valvuloplasty, and valve replacement.
- A case of Conn's syndrome presenting with headache, polyuria, muscle cramps with diagnosis, best drug as spironolactone, drugs that can cause hypertension, and effect on plasma renin.
- A case of Graves' disease in a woman with irritability, weight loss, oligomenorrhea and relevant lab tests
CARDIAC PATHOLOGY (MCQ QUESTIONS & ANSWERS)
ALL THE QUESTIONS ARE HAVING VERY STANDARD ANSWERS FROM THE STANDARD BOOKS)
REF : ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE.
COMPREHENSIVE IMAGE BASED REVIEW OF PATHOLOGY BY SONI .
GARG & GUPTA PATHOLOGY REVIEW & GENETICS.
Sudden unexpected death in infancy
Sudden unexpected death in infancy (SUDI) describes the sudden death of infants under 1 year of age that remains unexplained. The leading cause is sudden infant death syndrome (SIDS), where infants die in their sleep from unknown causes. Risk factors for SIDS include prone sleeping position, soft sleeping surfaces, maternal smoking, and co-sleeping. Theories on the cause of SIDS involve immature development of the brainstem resulting in failure of respiratory arousal from asphyxia. A thorough autopsy is required to determine the cause of SUDI and rule out other potential causes like infection, cardiac issues, metabolic disorders, or accidental suffocation.
Case Presentation
A 47-year-old female presented with acute severe pain in her limbs. Examination found absent pulses. Imaging showed diffuse narrowing of arteries without atherosclerosis. She was found to be HIV positive and on antiretroviral therapy. Her condition improved with steroids. HIV can cause various types of vasculitis. This case represents a large vessel vasculitis seen in HIV, termed Category III, which is a distinct clinical entity associated with HIV. Treatment involves steroids and antiretrovirals.
1. CC I have been having terrible chest and arm pain for the p.docx
1. CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dlHis diagnosis is an acute inferior wall myocardial infarction.1 of 2 Questions:Why is HDL considered the “good” cholesterol?
QUESTION 2
. CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dlHis diagnosis is an acute inferior wall myocardial infarction.2 of 2 Questions:Explain the role inflammation has in the development of atherosclerosis.
QUESTION 3
. A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.
Question:
What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?
QUESTION 4.
A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sent home. He says the Tamiflu.
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Central Nervous System Histoplasmosis Related to Bioprosthetic Endocarditis
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- 1. ข้อสอบ cvs NL กรี้ดดดดด!!!! 1.a 4 year girl is admitted to the hospital with high fever . Staphylococcus aureus is isolated from her blood culture and antibiotic therapies is initited. A loud, hash murmur is heard on auscultation. A chest radiograph shows prominent pulmonary arteries. Echocardiography shows all the valves to be normal. Which congenital heart disease most likely explains these finding ? 1. atrial septal defect 2. TOF 3. coarctation of aorta 4. PDA 5. aortic atresia 2.a 42 year old is admitted to the hospital with an inability to speak. The patient’s personal history reveals that she has experienced hoarseness for the past month. A chest radiograph reveals a mass at aorticopulmonary window. Which of following nerves is most likely compressed? 1. vagus 2. phrenic 3. Lt recurrent laryngeal 4. Rt recurrent laryngeal 5. Greater thoracic splanchnic 3. A 68-year-old male patient in the cardiology ward complains at each mealtime of difficulty in swallowing (dysphagia). Radiography study reveal significant cardiac hypertrophy. A barium swallow,followed by radiographic examination of the thorax, reveals esophageal constriction directly posterior to the heart. Which of following is the most likely cause of the patient’s dysphagia? 1. mitral valve stenosis 2. pulmonary valve stenosis 3. Regurgitation of the aorta 4. Anterior interventricular artery occlusion 5. Posterior interventricular artery occlusion
- 2. 4. Atherosclerosis is associated with numerous well-known risk factor, such as age, smoking, diabetes, hyperlipidemia, and a family history of atherosclerosis. LDL cholesterol is believed to be a key factor in the pathway through which hyperlipidemia cause atherosclerosis. What is most likely the first step in the pathogenesis of atherosclerosis caused by hyperlipidemia? 1. endothelial dysfunction 2. Foam cell formation 3. LDL cholesterol oxidation 4. Monocyte activation 5. Plaque formation 5.ผู้ชายอายุ20 ปี เป็นไข้มา 2 วัน มีอาการเจ็บหน้าอก และอาการของหัวใจล้มเหลว ต่อมาเสียชีวิต ผล autopsy พบว่าหัวใจมี lymphocyte จานวนมากกระจายแทรกอยู่ในกล้ามเนื้อทั่วๆไป พยาธิสภาพดังกล่าวเกิดจากไวรัสชนิดใด 1. adenovirus 2. Influenza virus 3. EBV 4. Coxsackie B virus 5. CMV 6.A 25-year old pregnant woman goes to her gynecologist for her 36 week check up. She complain of light-headedness when she lies down in bed at night. In the office her blood pressure is 120/70 mmHg while sitting upright and 90/50 mmHg while lying supine. Which of the following is the most likely cause of this hypotension? 1. Anemia 2. Cardiogenic shock 3. IVC compression 4. Third space of fluid 5. Vasodilation 7. ช่องระหว่าง aorta กับ pulmonary trunk ที่สามารถสอดนิ้วได้คือ 1. Oblique pericardial sinus 2. Transverse pericardial sinus 3. Anterior mediasternum 4. Medial mediasternum
- 3. 8.ข้อใดต่อไปนี้ผิดเกี่ยวกับยาขยายหลอดเลือดและผลข้างเคียง 1. Diazoxide อาจทาให้เกิดภาวะกลูโคสในเลือดสูง 2. Hydralazine อาจทาให้เกิด lupus-like syndrome 3. Minoxidil อาจทาให้เกิดขนดก hypertrichosis 4. Clonidine อาจทาให้เกิด rebound hypertension ถ้าหยุดยากะทันหัน 5. Reserpine อาจทาให้เกิดอาการท้องผูก constipation 9. ข้อใดต่อไปนี้กล่าวถูกต้องเกี่ยวกับผลทางเภสัชวิทยาของ captopril และ losartan 1. ยาทั้งสองปิดกั้น angiotensin II receptor 2. ยาทั้งสองยับยั้ง ACE 3. ยาทั้งสองทาให้เกิด hyperkalemia 4. Losartan ยับยั้งการทาลาย bradykinin แต่ captropril ไม่มีผล 5. ห้ามใช้captopril ในสตรีมีครรภ์แต่ใช้losartan ในสตรีมีครรภ์ได้ 10. A 17- year-old male high school athlete with no significant medical history. suddenly collapsed during a football practice and could not be resuscitated. At autopsy, the heart is enlarged and there is myocyte disarray on histologic evalucation. what is the most likely diagnosis? a. amyloid heart disease b. glycogen storage disease c. hypertrophic cardiomyopathy d. PDA e. viral myocarditis 11. A 55-year-old woman had left atrial fibrillation that responded poorly to medical treatment. she eventually suffered a massive stroke and died a few days later. The autopsy revealed marked left atrial dilatation and hypertrophy and a stenotic mitral valve. These findings would be best explained if she had a past history of a. alcoholism b. amyloidosis c. chronic lung disease d. mucinous adenocarcinoma e. rheumatic fever
- 4. Worldwide, the most common cause of subacute infective endocarditis is a. Candida albicans b. immune reaction to bacterial toxins c. Staphylococcus aureus d. Streptococcus pneumoniae e. Streptococcus viridans 12. A 32-year-old woman has the onset of fever and chills associated with sublingual, linear, dark-red streaks, small nodular hemorrhages in the palms and soles, and tender nodules of the finger pads. As a child, she had streptococcal sore throat followed by a three-week long episode of fever, joint pain, and a skin rash. The current condition in this patient is most likely a. bacterial endocarditis b. floppy mitral valve c. infiltrative cardiomyopathy d. systemic lupus erythematosus e. tuberculosis 13.
- 5. 14. 15.
- 6. 16. 17.
- 8. 20.