Internal Medicine 02 Aquifer with perfect answers 2024

Describe angina pectoris / CAD correct answers- Chest pressure that may radiate to neck/arm/shoulder. May have associated dyspnea. Risk factors include obesity, diabetes, hypertension and hyperlipidemia. - May have abnormal blood pressure, lower extremity edema, cardiac murmurs or normal exam. - May have ST segment abnormalities on EKG. Describe variant angina correct answers- Vasospastic cause of angina, often younger pt with few risk factors. Risk factors include tobacco use. - Between episodes of chest pain physical exam may be completely normal. - Accompanied by transient ST elevation on EKG. Describe cocaine induced chest pain correct answers- Chest pain after cocaine use from infarction or intense coronary spasm. - Urine tox screen positive for cocaine and drug metabolites. Elevated CPK levels may be seen with associated rhabdomyolysis. Describe aortic dissection correct answers- Longitudinal intimal tear forming a false lumen. Associated with hypertension, bicuspid aortic valve, inherited connective tissue disorders (eg, Marfan syndrome). Can present with tearing, sudden-onset chest pain radiating to the back +/− markedly unequal BP in arms. CXR can show mediastinal widening. Can result in organ ischemia, aortic rupture, death. - Two types: Stanford type A (proximal): involves Ascending aorta. May extend to aortic arch or descending aorta. May result in acute aortic regurgitation or cardiac tamponade. - Treatment: surgery. Stanford type B (distal): involves only descending aorta (Below left subclavian artery). Treatment: β-blockers, then vasodilators. Describe pericarditis correct answersInflammation of the pericardium. Commonly presents with sharp pain, aggravated by inspiration, and relieved by sitting up and leaning forward. Often complicated by pericardial effusion. Presents with friction rub. ECG changes include widespread ST-segment elevation and/or PR depression. Causes include idiopathic (most common; presumed viral), confirmed infection (eg, coxsackievirus B), neoplasia, autoimmune (eg, SLE, rheumatoid arthritis), uremia, cardiovascular (acute STEMI or Dressler syndrome), radiation therapy. Treatment: NSAIDs, colchicine, glucocorticoids, dialysis (uremia) Describe myocarditis correct answersInflammation of myocardium high global enlargement of heart and dilation of all chambers. Major cause of SCD in adults < 40 years old. Presentation highly variable, can include dyspnea, chest pain, fever, arrhythmias. Multiple causes: