Podcast
Questions and Answers
What imaging characteristic is associated with hypersensitivity pneumonitis?
What imaging characteristic is associated with hypersensitivity pneumonitis?
- Tree in bud appearance
- Finger in glove appearance
- Tram track appearance
- Mosaic pattern (correct)
Which treatment is considered the first choice for hypersensitivity pneumonitis?
Which treatment is considered the first choice for hypersensitivity pneumonitis?
- Bronchodilators
- Omalizumab
- Itraconazole
- Steroids (correct)
What type of hypersensitivity is primarily involved in hypersensitivity pneumonitis?
What type of hypersensitivity is primarily involved in hypersensitivity pneumonitis?
- Type 3 hypersensitivity (correct)
- Type 1 hypersensitivity
- Type 2 hypersensitivity
- Type 4 hypersensitivity (correct)
Which of the following is NOT a characteristic of hypersensitivity pneumonitis?
Which of the following is NOT a characteristic of hypersensitivity pneumonitis?
Which imaging finding is specifically indicative of central bronchiectasis in hypersensitivity pneumonitis?
Which imaging finding is specifically indicative of central bronchiectasis in hypersensitivity pneumonitis?
What is the mechanism of action of Ivabradine?
What is the mechanism of action of Ivabradine?
Which of the following best describes diastolic dysfunction?
Which of the following best describes diastolic dysfunction?
What conditions are most commonly associated with restrictive cardiomyopathy?
What conditions are most commonly associated with restrictive cardiomyopathy?
Which symptom is typically associated with right-sided heart failure due to diastolic dysfunction?
Which symptom is typically associated with right-sided heart failure due to diastolic dysfunction?
What is a major complication of chronic constrictive pericarditis?
What is a major complication of chronic constrictive pericarditis?
In acute pericarditis, which ECG finding is characteristic?
In acute pericarditis, which ECG finding is characteristic?
What is a common cause of chronic constrictive pericarditis?
What is a common cause of chronic constrictive pericarditis?
Which of the following is NOT a recognized cause of restrictive cardiomyopathy?
Which of the following is NOT a recognized cause of restrictive cardiomyopathy?
What is the characteristic finding in atrial tachycardia?
What is the characteristic finding in atrial tachycardia?
Which medication is typically used for managing AVNRT?
Which medication is typically used for managing AVNRT?
Which of the following cannot be considered a type of atrial fibrillation?
Which of the following cannot be considered a type of atrial fibrillation?
What is a common complication of atrial fibrillation?
What is a common complication of atrial fibrillation?
How is hemodynamically unstable atrial fibrillation primarily managed?
How is hemodynamically unstable atrial fibrillation primarily managed?
Which of the following features is not associated with atrial fibrillation?
Which of the following features is not associated with atrial fibrillation?
What is noted about multifocal atrial tachycardia?
What is noted about multifocal atrial tachycardia?
In the case of an unresponsive patient in ventricular fibrillation, what treatment is appropriate?
In the case of an unresponsive patient in ventricular fibrillation, what treatment is appropriate?
Which leads correspond to the high lateral wall of the heart?
Which leads correspond to the high lateral wall of the heart?
What findings are indicative of an extensive antero high lateral myocardial infarction?
What findings are indicative of an extensive antero high lateral myocardial infarction?
Which condition is characterized by regular RR intervals and no P waves?
Which condition is characterized by regular RR intervals and no P waves?
In the context of narrow QRS tachycardia, what does a long RP interval with morphologically abnormal P waves indicate?
In the context of narrow QRS tachycardia, what does a long RP interval with morphologically abnormal P waves indicate?
Which leads are affected by LAD (D2) corresponding to the anterior wall?
Which leads are affected by LAD (D2) corresponding to the anterior wall?
Which condition is positive in Sjogren’s syndrome?
Which condition is positive in Sjogren’s syndrome?
What is the characteristic finding in AVNRT during examination?
What is the characteristic finding in AVNRT during examination?
Which of the following leads shows ST elevation to indicate ST ↑ in I and aVL?
Which of the following leads shows ST elevation to indicate ST ↑ in I and aVL?
What is a characteristic feature of rheumatoid arthritis (RA) in terms of joint involvement?
What is a characteristic feature of rheumatoid arthritis (RA) in terms of joint involvement?
What does the term 'Golden hour' typically refer to in acute coronary syndrome management?
What does the term 'Golden hour' typically refer to in acute coronary syndrome management?
Which joint is not spared in the progression of rheumatoid arthritis?
Which joint is not spared in the progression of rheumatoid arthritis?
What type of joint deformity is characterized by hyperextension of the PIP joint and flexion of the DIP joint?
What type of joint deformity is characterized by hyperextension of the PIP joint and flexion of the DIP joint?
Which of the following is considered a reversible deformity in rheumatoid arthritis?
Which of the following is considered a reversible deformity in rheumatoid arthritis?
Which joints are typically spared in osteoarthritis?
Which joints are typically spared in osteoarthritis?
What does a positive ESR and CRP indicate in rheumatoid arthritis?
What does a positive ESR and CRP indicate in rheumatoid arthritis?
Which arthritis type typically involves the wrist and MCP joints but spares the DIP joints?
Which arthritis type typically involves the wrist and MCP joints but spares the DIP joints?
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Study Notes
Ivabradine
- Administered when heart rate exceeds 70 bpm and patient is on maximum β-blocker dosage.
- Mechanism of action: Inhibits funny currents (Na+ channels).
- Common side effect: Visual field abnormalities.
- Not indicated: Combination of ACE inhibitor and neprilysin inhibitor (e.g., Omapatrilat), Digoxin, ventricular dysfunction.
Heart Failure Types
- Systolic dysfunction: Characterized by impaired pumping ability.
- Diastolic dysfunction: Involves filling defects; typically follows systolic dysfunction.
- Systolic issues often involve the left ventricle, while diastolic issues may involve right ventricle (RV > left ventricle (LV)).
Diastolic Dysfunction
- Leads to elevated right ventricular end-diastolic pressure (RVEDP) and right atrial pressure (RAP).
- Symptoms include ascites, edema, jugular venous pressure (JVP), and hepatomegaly.
- Conditions associated: Chronic constrictive pericarditis leads to more pronounced symptoms over time.
Acute Pericarditis
- Clinical features include elevated ST segment and chest pain.
- ECG characteristics: Global concave ST elevation, especially in all leads except lead V1; absence of reciprocal changes; PR depression.
- Causes: Typically post-viral (e.g., Coxsackie virus), uremia.
- Prolonged episodes can evolve into chronic constrictive pericarditis characterized by a rigid, calcified pericardium.
Chronic Constrictive Pericarditis (CCP)
- Result of multiple relapses of acute pericarditis.
- Symptoms include chronic right heart failure (RHF) manifestations: cachexia, ascites, edema, hepatomegaly.
- Differential diagnoses: Restrictive cardiomyopathy linked to interstitial or intracellular accumulation disorders (e.g., amyloidosis, hemochromatosis).
Acute Coronary Syndrome Management
- Golden hour: Optimal intervention within 6 hours of first medical contact.
- Diagnosis should be prioritized within this timeframe.
Narrow QRS Tachycardia
- Classified by rhythm:
- Regular RR interval: Consider AV nodal reentrant tachycardia (AVNRT) or AV reentrant tachycardia (AVRT).
- Irregular RR interval: Atrial fibrillation, characterized by no identifiable P waves.
- Management strategies vary:
- AVNRT: First-line treatment includes adenosine; consider verapamil in COPD patients.
- Atrial tachycardia: Treated with verapamil or β-blockers.
Atrial Fibrillation (AF)
- Findings include irregular RR intervals and absence of identifiable P waves.
- Classified into types:
- Paroxysmal: Lasts less than 7 days, reverts spontaneously.
- Persistent: Lasts more than 7 days.
- Permanent: Structural LA dilatation >4 cm; rhythm cannot revert.
- Complications involve risk of thromboembolism.
Hypersensitivity Pneumonitis
- Inflammatory lung disorder; involves airway and parenchyma.
- Characterized by absence of IgE/eosinophils; positive precipitin test.
- Hallmarks: Non-caseating granulomas and varied HRCT density patterns, indicative of different stages of disease.
Rheumatoid Arthritis (RA)
- Clinical features include bilateral symmetrical joint involvement (duration over 6 weeks).
- Symptoms include inflammatory markers indicating morning stiffness.
- Progressive deformities correlate with disease severity:
- Reversible: Zigzag deformity; ulna deviation.
- Irreversible: Boutonnière and swan neck deformities.
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