Transcript Clinical presentation

Clinical presentation
• 36-year-old male with a recent history of
intravenous drug use presents with three days
of fevers, rigors and malaise
• blood culture reveals gram-positive cocci in
clusters
Echocardiogram
Echocardiogram
Question #1
The echodensities shown on echocardiography
represent
A.
B.
C.
D.
Clusters of bacteria
Cholesterol plaque
Platelet-fibrin aggregates
Mesodermal hyperproliferation
Question #2
Which of the following is not a major clinical
concern?
A.
B.
C.
D.
Pulmonary embolism
Cerebrovascular accident
Mesenteric ischemia
Toxic epidermal necrolysis
Question #3
• This histological specimen
represents
A.
B.
C.
D.
E.
Cross section of mitral valve
Visceral pericardium
Parietal pericardium
Cardiac endothelium
A toenail
Question #4
• A 24-year-old woman was in a motor vehicle
accident and is unconscious upon arrival to
the hospital. An echocardiogram reveals
normal left and regular function with a small
pericardial effusion. Tamponade physiology is
present. Blood pressure is 70/40, heart rate is
150 and she has significant jugular venous
distention.
Which arrow most likely represents this
patient’s position on the pericardial
pressure volume curve?
Question #6
Which of the following represents the correct
reaction to the above clinical scenario?
A.
C.
B.
D.
Question # 7
The degree to which a certain amount of fluid
will cause increased pericardial pressure
depends upon
A. The compliance of the pericardium
B. The rapidity with which the fluid has
accumulated
C. The size of the patient
D. All of the above
Question #8
Which of the following is not a major purpose of
the pericardium?
A. Ligamentous attachments to diaphragm,
sternum and other structures
B. Regulation of blood pressure
C. Barrier to infection
D. Participation in cardiac reflexes
Question #9
Which one of the following organisms is least
likely to cause infective endocarditis?
A.
B.
C.
D.
Streptococcus bovis
Staphylococcus aureus
Staphylococcus epidermidis
Cardiobacterium hominis
Question #10
Where is infective endocarditis least likely to
occur?
A.
B.
C.
D.
Mitral valve
Aortic valve
Pulmonic valve
Tricuspid valve