deborah212 Posted October 28, 2011 Share Posted October 28, 2011 I got pimped on this a couple of weeks ago... What's the classic triad (think symptoms) of aortic stenosis? No peeking. What is angina, syncope, and CHF, Alex. Quote Link to comment Share on other sites More sharing options...
andersenpa Posted October 28, 2011 Share Posted October 28, 2011 What is angina, syncope, and CHF, Alex. No it's a type and cross, preop ABX, and an AVR. Quote Link to comment Share on other sites More sharing options...
deborah212 Posted October 28, 2011 Share Posted October 28, 2011 No it's a type and cross, preop ABX, and an AVR. Haha. We just did exactly that to the patient I got pimped on. The only time in my hospitalist career that a syncope admission actually translated into critical AS. Patient, of course, was transferred to cardiac surgery. Quote Link to comment Share on other sites More sharing options...
deborah212 Posted November 13, 2011 Share Posted November 13, 2011 This came up last week in one of my patients: What is the pentad (5 signs) of TTP? Quote Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted November 15, 2011 Share Posted November 15, 2011 I don't know this one off the top of my head, and I refuse to cheat. I'll let someone else give it a try. Quote Link to comment Share on other sites More sharing options...
deborah212 Posted November 15, 2011 Share Posted November 15, 2011 I don't know this one off the top of my head, and I refuse to cheat. I'll let someone else give it a try. 1. 2. 3. 4. 5. You can get 2 of the 5 just by the name: thrombotic thrombocytopenia purpura. For the other 3, think of what microthromboses might cause/go. Quote Link to comment Share on other sites More sharing options...
greenmood Posted November 20, 2011 Share Posted November 20, 2011 Hm. I know one is low platelet count and another is the petechiae and/or ecchymoses. I imagine from your hint that there is some kind of CNS involvement or stroke risk. I also recall something about the kidneys. But that's only 4 things, assuming they're correct. Quote Link to comment Share on other sites More sharing options...
deborah212 Posted November 20, 2011 Share Posted November 20, 2011 Hm. I know one is low platelet count and another is the petechiae and/or ecchymoses. I imagine from your hint that there is some kind of CNS involvement or stroke risk. I also recall something about the kidneys. But that's only 4 things, assuming they're correct. Yes! 1. thombocytopenia 2. microangiopathic hemolytic anemia 3. acute renal failure 4. confusion/neurologic symptoms 5. fever Unfortunately, this patient ended up having hemophagocytic lymphohistocytosis (look it up!) and passed away of liver failure and sepsis. Quote Link to comment Share on other sites More sharing options...
smartinho Posted July 12, 2012 Share Posted July 12, 2012 Portal HTN Complications: Varices/GI Bleed and the big one...Death Quote Link to comment Share on other sites More sharing options...
pato2137 Posted October 22, 2013 Share Posted October 22, 2013 Triad for NPH is the three "W's"--Wacky, Wet, and Wobbly. Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted October 22, 2013 Moderator Share Posted October 22, 2013 What heart sound will you never hear in a patient in a fib? S4 Quote Link to comment Share on other sites More sharing options...
BARONEUS Posted February 9, 2014 Share Posted February 9, 2014 S4 Oneal, will you explain that one for us? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 9, 2014 Moderator Share Posted February 9, 2014 Oneal, will you explain that one for us?S4 comes from atrial kick against a noncompliance ventricle. Can't have an S4 without atrial contraction, which doesn't happen effectively during fibrillation. Quote Link to comment Share on other sites More sharing options...
bike mike Posted February 9, 2014 Share Posted February 9, 2014 What is the CHADS2 score used for? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 9, 2014 Moderator Share Posted February 9, 2014 What is the CHADS2 score used for? stroke risk Quote Link to comment Share on other sites More sharing options...
whoRyou Posted February 9, 2014 Share Posted February 9, 2014 I thought CHADS2 score allows us to predict the risk of stroke in patients with atrial fibrillation and guides us in the use of oral anticoagulants. Quote Link to comment Share on other sites More sharing options...
bike mike Posted February 9, 2014 Share Posted February 9, 2014 I thought CHADS2 score allows us to predict the risk of stroke in patients with atrial fibrillation and guides us in the use of oral anticoagulants. Yep: Criteria Score Recent exacerbation of CHF 1 Hypertension 1 Age (over 75) 1 Diabetes 1 Prior Stroke or TIA 2 CHADS2 score Stroke rate, %/y 0 1.9 1 2.8 2 4.0 3 5.9 4 8.5 5 12.5 6 18.2 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 9, 2014 Moderator Share Posted February 9, 2014 Like I said, stroke risk. I prefer brevity. I have one of my own. Physiology based. In the absence of respiratory disease (ie 99- 100% O2 sat) why is it pointless to give oxygen in MI? Further, why might it be dangerous to place on a non-rebreather? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 10, 2014 Moderator Share Posted February 10, 2014 I'll give a hint: first look at the formula for content of arterial oxygen. Second, what happen to vessels when exposed to CO2 Quote Link to comment Share on other sites More sharing options...
BARONEUS Posted February 10, 2014 Share Posted February 10, 2014 In the lungs: vasoconstriction. Systemic: vasodilation. Looking up formula... Any other takers? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 10, 2014 Moderator Share Posted February 10, 2014 In the lungs: vasoconstriction. Systemic: vasodilation. Looking up formula... Any other takers? Right, so if you were to lower CO2, why could this potentially be bad in an MI? Quote Link to comment Share on other sites More sharing options...
BARONEUS Posted February 10, 2014 Share Posted February 10, 2014 Ok I'm guessing it has something to do w/ HGBs O2 affinity. The higher PaO2 causes a decrease in HGBs affinity for O2, resulting in a less than substantial rise in O2 content compared to the rise in PaO2 (the curve levels off). My guess for the CO2 question would be to say one of the last things you want in a patient with an AMI would be systemic vasodilation (unless you need to practice RSI). As for the NRB question, I'm stumped. Thanks Oneal. Good stuff, even if I'm wrong. 1 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 10, 2014 Moderator Share Posted February 10, 2014 Ok I'm guessing it has something to do w/ HGBs O2 affinity. The higher PaO2 causes a decrease in HGBs affinity for O2, resulting in a less than substantial rise in O2 content compared to the rise in PaO2 (the curve levels off). My guess for the CO2 question would be to say one of the last things you want in a patient with an AMI would be systemic vasodilation (unless you need to practice RSI). As for the NRB question, I'm stumped. Thanks Oneal. Good stuff, even if I'm wrong. I like that you're thinking. The formula is CaO2= (SaO2 x 1.34 x hgb) + (PaO2 x .003) So you see, if the patient is already saturating their hgb to 100%, then you can only raise the O2 content of blood by raising the partial pressure (pao2), which contributed .003 mg/dl per mmHg. So it really doesn't help much. Of course we do it because you don't want to be the guy in court who didn't put O2 on an MI. Just a mental exercise. I think you confused the second part. You theoretically *don't* want to drop CO2, which can happen with a NRB since you are supposedly breathing pure O2, because you cause coronary vasoconstriction as opposed to vasodilation. They use to hyperventilate people with increased ICP to help lower it through vasoconstriction, though I believe this is not done now because they were infarcting brains :/ Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 10, 2014 Moderator Share Posted February 10, 2014 What 4 markers in a patient history of present illness can tell us with 80% certainty they tore an ACL? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 10, 2014 Moderator Share Posted February 10, 2014 What 4 markers in a patient history of present illness can tell us with 80% certainty they tore an ACL? Think about the story. What does the patient say when relating the initial injury to you? Quote Link to comment Share on other sites More sharing options...
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