Internal Medicine COMAT Review || with Complete Solutions.

causes of a mid-systolic non-radiating murmur correct answers High output states (anemia, fever, thyrotoxicosis, pregnancy). Aortic stenosis (ejecting systolic murmur that radiates to carotids). Aortic sclerosis (valve thickening w/o outflow obstruction). Pulmonic stenosis Hypertrophic cardiomyopathy (consider in younger patients). Where is aortic regurgitation auscultated? correct answers It's an early DIASTOLIC murmur heard in the 2nd LEFT-upper sternal border. Indications for ordering an echocardiogram correct answers 1. Patient is symptomatic w/murmur. 2. Pt has continuous murmur. 3. Pt has diastolic murmur 4. Pt has murmur w/intensity 3/6. Radiographic signs seen occasionally in PE correct answers Hampton hump (shallow wedge-shaped opacity in the periphery of the lung w/its base against the pleural surface). Westermark sign=sign that represents a focus of oligemia (leading to collapse of vessel) seen distal to a PE. It's due to a combo of dilation of the pulmonary arteries proximal to the embolus & collapse of the distal vasculature creating the appearance of a sharp cut off on CXR. Why can TSH be helpful in diagnosing heart failure correct answers Severe hypothyroidism can cause CHF. Hyperthyroidism can cause high output HF. Medications that have been shown to decrease mortality in systolic heart failure correct answers -ACE inhibitors -ARBs (angiotensin receptor blockers) -Beta blockers -Aldosterone blockers -Hydralazine & nitrates Definition of metabolic syndrome correct answers Any three of the following five: 1. Fasting plasma glucose 100 mg/dL (or on medical therapy for hyperglycemia) 2. BP ≥ 130/85 mmHg (or on medical therapy for hypertension) 3. Triglycerides ≥ 150 mg/dL (or on medical therapy for hypertriglyceridemia)