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Quiz Questions (8 questions)
1. S1 is loud and another sound is heard after the S2 suggesting mitral stenosis (MS).
2. Diastolic murmur preceded by an additional sound after S2 - in timing - and finishes before S1 suggesting MS.
3. On doing ECG there is irregular R-R interval associated with fibrillatory waves instead of P wave suggesting atrial fibrillation (AF).
4. Echocardiographic examination shows limited excursion of both of mitral valve leaflets and thickening.
5. The area of the mitral valve opening is 0.7 cm2, and the score is 8/16.
6. Transesophageal echocardiography reveals no left atrial appendage thrombus.
7. Balloon mitral valvuloplasty is a suitable line of treatment.
8. Warfarin for anticoagulation and beta blocker to reduce heart rate if she is not pregnant.
Previous Exam Questions (38 questions)
1. Two risk factors for pulmonary embolism in the presented patient are being overweight (BMI 33) and using contraceptive pills.
2. The gold standard imaging modality for diagnosing pulmonary embolism is not explicitly stated, but generally includes CT pulmonary angiography (CTPA).
3. The patient is experiencing hypoxemic respiratory failure, indicated by a PaO2 of 53 mmHg and SaO2 of 88%.
4. The most appropriate therapeutic approach for this patient with suspected pulmonary embolism includes anticoagulation therapy and supportive care to address the hypoxemia and hypotension.
5. The CURB-65 score is commonly used to assess the severity of patients presenting with community-acquired pneumonia; the risk categories and treatment setting decisions are based on the score obtained.
6. Two typical micro-organisms that cause community-acquired pneumonia are Streptococcus pneumoniae and Mycoplasma pneumoniae.
7. Two treatment options for community-acquired pneumonia in the described diabetic patient include a beta-lactam antibiotic plus a macrolide or a respiratory fluoroquinolone, considering the patient's diabetes.
8. The essential diagnostic test required to confirm the diagnosis of COPD is spirometry, and the diagnostic criteria for COPD based on spirometry is a post-bronchodilator FEV1/FVC ratio of less than 0.70.
9. Two medications used in the treatment of acute exacerbations of COPD are bronchodilators (such as beta-2 agonists and anticholinergics) and systemic corticosteroids.
10. The indication for long-term oxygen therapy in COPD patients is chronic hypoxemia, typically defined as a PaO2 of 55 mmHg or less, or SaO2 of 88% or less.
11. Two positive effects of smoking cessation in COPD patients are a slowing of the decline in lung function and a reduction in respiratory symptoms.
12. The most probable cause of pleural effusion in this patient, given the right-sided pleuritic chest pain, shortness of breath, night fever, weight loss, lymphocyte-rich pleural fluid, and markedly elevated adenosine deaminase (ADA) level, is tuberculosis.
13. Light's Criteria for identifying exudative pleural effusion include a pleural fluid protein to serum protein ratio greater than 0.5, a pleural fluid LDH to serum LDH ratio greater than 0.6, and a pleural fluid LDH greater than two-thirds the upper limits of normal serum LDH.
14. Three invasive procedures that play a role in diagnosing the etiology of pleural effusion are thoracentesis, pleural biopsy, and video-assisted thoracoscopic surgery (VATS).
15. The final diagnosis is ST-elevation myocardial infarction (STEMI).
16. The main treatment strategy that should be adopted in this patient is emergent reperfusion therapy, either percutaneous coronary intervention (PCI) or fibrinolysis, to restore blood flow to the ischemic myocardium and limit infarct size.
17. The groups of anti-thrombotic therapy given as an initial treatment strategy include antiplatelet therapy (aspirin given immediately and a P2Y12 inhibitor such as clopidogrel, prasugrel, or ticagrelor administered as soon as possible) and anticoagulation therapy (unfractionated heparin, enoxaparin, or bivalirudin given immediately).
18. The criteria of typical anginal pain include substernal chest discomfort that is provoked by exertion or emotional stress, relieved by rest or nitroglycerin, and has a characteristic quality (e.g., pressure, tightness, squeezing).
19. The diagnostic workout needed to diagnose and risk stratify this patient includes an electrocardiogram (ECG), cardiac biomarkers (troponin), stress testing (exercise or pharmacological), and coronary angiography.
20. Being overweight (BMI 33) and using contraceptive pills are two risk factors for pulmonary embolism in this patient.
21. Pulmonary angiography is considered the gold standard test for diagnosing pulmonary embolism.
22. This patient is experiencing hypoxemic respiratory failure.
23. The most appropriate therapeutic approach for this patient is anticoagulation therapy.
24. The CURB-65 score is most commonly used to assess the severity of patients presenting with community-acquired pneumonia; risk categories and treatment setting decisions are based on the stratification of the CURB-65 score.
25. Streptococcus pneumoniae and Haemophilus influenzae are two typical micro-organisms that cause community-acquired pneumonia.
26. Two treatment options for community-acquired pneumonia in this patient include beta-lactam antibiotics and macrolide antibiotics.
27. Spirometry is the essential diagnostic test required to confirm the diagnosis of COPD; the diagnostic criteria for COPD based on spirometry is a post-bronchodilator FEV1/FVC ratio of less than 0.70.
28. Two medications used in the treatment of acute exacerbations of COPD are bronchodilators and corticosteroids.
29. The indication for long-term oxygen therapy in COPD patients is chronic hypoxemia, typically defined as a PaO2 of 55 mmHg or less, or SaO2 of 88% or less.
30. Two positive effects of smoking cessation in COPD patients are a slowed decline in lung function and improved survival.
31. The most probable cause of pleural effusion in this patient is tuberculosis.
32. Light's Criteria for identifying exudative pleural effusion include a pleural fluid protein to serum protein ratio greater than 0.5, a pleural fluid LDH to serum LDH ratio greater than 0.6, and a pleural fluid LDH greater than two-thirds the upper limits of normal for serum LDH.
33. Three invasive procedures that play a role in diagnosing the etiology of pleural effusion are thoracentesis, pleural biopsy, and video-assisted thoracoscopic surgery (VATS).
34. The final diagnosis is ST-elevation myocardial infarction (STEMI).
35. The main treatment strategy that should be adopted in this patient is primary percutaneous coronary intervention (PCI) because it is the preferred reperfusion strategy when available within a reasonable timeframe.
36. The groups of anti-thrombotic therapy given as an initial treatment strategy include antiplatelet therapy (aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel, or ticagrelor, given immediately), anticoagulation therapy (unfractionated heparin, enoxaparin, or bivalirudin, given immediately), and glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, or tirofiban, considered during PCI if there is evidence of thrombus or suboptimal results).
37. The criteria of typical anginal pain include substernal chest discomfort with a characteristic quality and duration, provoked by exertion or emotional stress, and relieved by rest or nitroglycerin.
38. The diagnostic workout needed to diagnose and risk stratify this patient includes an electrocardiogram (ECG), cardiac biomarkers (troponin), stress testing (exercise or pharmacological), and coronary angiography.
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Lecture Summary
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Alright, let's dive into **Mitral Valve Diseases**. This is a really important topic, so pay attention. We’re talking about two main problems: **Mitral Stenosis (MS)** and **Mitral Regurgitation (MR)**. **Mitral Stenosis (MS)** First up, **Mitral Stenosis**. This is when the **mitral valve**, whic...
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