Mastering Pericardial Effusion and Cardiac Tamponade-E-3
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Questions and Answers

Which of the following is a common cause of pericardial tamponade?

  • Heart valve disease
  • Infection of the endocardium
  • Injection of a contaminated substance
  • Rupture of the anterior wall (correct)

    • What is the primary goal in the treatment of pericardial effusion and cardiac tamponade?

  • Medication to reduce heart rate
  • Increase blood pressure
  • Minimize fluid accumulation (correct)
  • Surgical intervention

    • Which of the following is NOT a classic sign of pericardial tamponade?

  • Distant heart sounds
  • Sudden loss of consciousness (correct)
  • Exaggerated drop in blood pressure with inspiration
  • Pulsus paradoxus

    • Which layer of tissue lines the chambers of the heart?

    <p>Endocardium</p> Signup and view all the answers

    What is the leading cause of infective endocarditis?

    <p>Staphylococcus Aureus</p> Signup and view all the answers

    What is the primary portal of entry for bacteria causing infective endocarditis?

    <p>Dental or surgical procedure</p> Signup and view all the answers

    Which of the following is a major sign of Rheumatic Fever according to the Jones criteria?

    <p>Arthralgia</p> Signup and view all the answers

    What is the normal function of heart valves?

    <p>To regulate blood flow</p> Signup and view all the answers

    What is the effect of mitral valve stenosis on the left atrium?

    <p>The left atrial pressure increases</p> Signup and view all the answers

    What is the effect of aortic valve stenosis on the left ventricle?

    <p>The left ventricular wall becomes thicker</p> Signup and view all the answers

    In mitral valve regurgitation, what happens to the left atrial pressure?

    <p>The left atrial pressure increases</p> Signup and view all the answers

    What is the effect of aortic valve regurgitation on the left ventricle?

    <p>The left ventricle becomes dilated</p> Signup and view all the answers

    Which of the following is an inflammatory process of the pericardium?

    <p>Acute Pericarditis</p> Signup and view all the answers

    What is the accumulation of fluid in the pericardial cavity called?

    <p>Cardiac Tamponade</p> Signup and view all the answers

    What is the condition called when there is compression of the heart due to the accumulation of fluid, pus, or blood in the pericardial sac?

    <p>Cardiac Tamponade</p> Signup and view all the answers

    What is the result of continual inflammation of the pericardium leading to fibrosis and the development of constrictive pericarditis?

    <p>Cardiac Tamponade</p> Signup and view all the answers

    What is a prominent early finding in constrictive pericarditis?

    <p>Ascites</p> Signup and view all the answers

    What is the condition called when there is compression of the heart due to the accumulation of fluid, pus, or blood in the pericardial sac?

    <p>Cardiac Tamponade</p> Signup and view all the answers

    Which layer of the heart is affected in pericarditis?

    <p>Pericardium</p> Signup and view all the answers

    What is the primary symptom of pericardial effusion?

    <p>Shortness of breath</p> Signup and view all the answers

    Which condition is characterized by the thickening and stiffening of the pericardium?

    <p>Constrictive pericarditis</p> Signup and view all the answers

    What is the treatment for cardiac tamponade?

    <p>Pericardiocentesis</p> Signup and view all the answers

    Which condition is characterized by an infection of the inner lining of the heart?

    <p>Infective endocarditis</p> Signup and view all the answers

    What is the normal function of the heart valves?

    <p>To prevent backflow of blood</p> Signup and view all the answers

    Which of the following criteria is required for the diagnosis of infective endocarditis according to the Duke criteria?

    <p>2 major or 1 major and 3 minor criteria</p> Signup and view all the answers

    Which of the following is a major criterion for the diagnosis of infective endocarditis?

    <p>Positive blood culture for IE</p> Signup and view all the answers

    Which of the following patients is most likely to have a definite diagnosis of infective endocarditis?

    <p>Roth’s spot, Osler’s nodes, fever, and major arterial emboli</p> Signup and view all the answers

    Which of the following is recommended for the prevention of infective endocarditis?

    <p>Prophylaxis for people with previous IE, congenital heart disease, and prosthetic cardiac valve</p> Signup and view all the answers

    Which of the following is the pathogenesis of rheumatic fever?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a major sign according to the Jones criteria for the diagnosis of rheumatic fever?

    <p>Polyarthritis</p> Signup and view all the answers

    Which type of hypersensitivity reaction is IgE mediated?

    <p>Type I</p> Signup and view all the answers

    What is the initial response to the first exposure to an allergen in type I hypersensitivity?

    <p>Production of specific IgE antibodies</p> Signup and view all the answers

    Which organ involvement is associated with rhinitis in type I hypersensitivity?

    <p>Nasal mucosa</p> Signup and view all the answers

    What is the first-line treatment for anaphylaxis?

    <p>Epinephrine</p> Signup and view all the answers

    Which of the following is a common offending agent for patients presenting with allergic reactions?

    <p>Penicillin</p> Signup and view all the answers

    What is the role of penicillin skin testing and drug desensitization in therapy?

    <p>To distinguish between different types of allergic reactions</p> Signup and view all the answers

    What is the first line treatment for an anaphylactic reaction?

    <p>Epinephrine</p> Signup and view all the answers

    Which book chapter provides information on the function and evaluation of the immune system?

    <p>Ch. e102</p> Signup and view all the answers

    Which of the following is a proposed mechanism for drug hypersensitivity reactions (DHRs)?

    <p>Complement activation</p> Signup and view all the answers

    Which of the following medications is NOT commonly associated with angioedema?

    <p>NSAIDs</p> Signup and view all the answers

    Which of the following is a potential symptom of a pseudoallergic reaction to radiocontrast media?

    <p>Pruritus</p> Signup and view all the answers

    Which of the following is a recommended approach for managing a patient with a history of penicillin allergy?

    <p>Penicillin skin testing</p> Signup and view all the answers

    Which of the following is a common symptom of Drug Fever?

    <p>Elevated eosinophil count</p> Signup and view all the answers

    Which type of reaction is characterized by the presence of autoantibodies and clinical features of an autoimmune disorder?

    <p>Type IV</p> Signup and view all the answers

    Which of the following medications is NOT commonly associated with Drug-induced lupus erythematosus (DILE)?

    <p>Quinidine</p> Signup and view all the answers

    Which of the following is a potential cause of upper or lower respiratory tract reactions to drugs?

    <p>IgE-mediated reaction</p> Signup and view all the answers

    Which type of drug reaction is characterized by the production of an IgE-mediated response typically within one hour of reexposure to the drug?

    <p>Type A</p> Signup and view all the answers

    Which type of drug reaction is typically mediated by T cells and may occur more than one hour after initial exposure, up to weeks or months?

    <p>Type C</p> Signup and view all the answers

    Which type of drug reaction is characterized by the formation of antigen-antibody (IgG or IgM) complexes that deposit on blood vessel walls and activate complement, resulting in a serum sickness-like syndrome or vasculitis?

    <p>Type C</p> Signup and view all the answers

    Which type of drug reaction is delayed and T cell-mediated, causing the activation of T lymphocytes and the release of cytokines and recruitment of effector cells?

    <p>Type IVa</p> Signup and view all the answers

    Which type of hypersensitivity reaction is characterized by the formation of antigen-antibody complexes in blood that deposit in blood vessel walls or tissues?

    <p>Type III</p> Signup and view all the answers

    Which medication is NOT commonly associated with Delayed Type III hypersensitivity reactions?

    <p>Penicillin</p> Signup and view all the answers

    Which type of hypersensitivity reaction is mediated by sensitized T cells and can manifest as contact dermatitis, bullous exanthems, maculopapular eruptions, and pustular exanthems?

    <p>Type IV</p> Signup and view all the answers

    Which mucocutaneous disorder is characterized by T-cell response and keratinocyte apoptosis, resulting in severe blistering and skin sloughing?

    <p>Toxic Epidermal Necrolysis Syndrome (TEN)</p> Signup and view all the answers

    Which of the following is the major determinant used in Penicillin Skin Testing Agent PPL?

    <p>Pre-Pen</p> Signup and view all the answers

    What is the interpretation if there is no wheal or erythema or wheal <5 mm diameter after 15 minutes in the PPL scratch test?

    <p>Proceed with intradermal test</p> Signup and view all the answers

    What is the interpretation if there is a wheal or erythema >5-15 mm diameter within 15 minutes in the PPL scratch test?

    <p>Choose alternative agent</p> Signup and view all the answers

    What is the interpretation if there is a negative response in the intradermal test with PPL at 20 minutes?

    <p>No increase in size of original bleb, no greater than reaction at control site</p> Signup and view all the answers

    What is the interpretation if there is a positive response in the intradermal test with Penicillin G potassium?

    <p>Itching &amp; increase in size of original bleb &gt;5 mm and &gt; than saline control</p> Signup and view all the answers

    What is the interpretation if there is a positive response in the scratch test with Penicillin G potassium?

    <p>Itching &amp; increase in size of original bleb &gt;5 mm and &gt; than saline control</p> Signup and view all the answers

    Which type of drug reaction is characterized by the presence of autoantibodies and clinical features of an autoimmune disorder?

    <p>Type B</p> Signup and view all the answers

    What is the interpretation if there is a positive response in the scratch test with Penicillin G potassium?

    <p>The patient is allergic to Penicillin G potassium.</p> Signup and view all the answers

    Which organ involvement is associated with rhinitis in type I hypersensitivity?

    <p>Nose</p> Signup and view all the answers

    What is the leading cause of infective endocarditis?

    <p>Bacterial infection</p> Signup and view all the answers

    Which type of allergic reaction is delayed and T cell-mediated, causing the activation of T lymphocytes and the release of cytokines and recruitment of effector cells?

    <p>Type IV hypersensitivity</p> Signup and view all the answers

    Which of the following is a common offending agent for patients presenting with allergic reactions?

    <p>Antibiotics</p> Signup and view all the answers

    What is the first line treatment for an anaphylactic reaction?

    <p>Epinephrine</p> Signup and view all the answers

    What is the major determinant used in Penicillin Skin Testing Agent PPL?

    <p>Penicilloyl-polylysine</p> Signup and view all the answers

    Which of the following drugs is NOT commonly associated with drug-induced lupus erythematosus (DILE)?

    <p>Vancomycin</p> Signup and view all the answers

    What is the most common type of drug hypersensitivity reaction?

    <p>Type IV hypersensitivity</p> Signup and view all the answers

    Which of the following is a proposed mechanism for drug hypersensitivity reactions (DHRs)?

    <p>Complement activation</p> Signup and view all the answers

    Which of the following is a risk factor for immediate reactions to radiocontrast media?

    <p>History of asthma</p> Signup and view all the answers

    Which type of hypersensitivity reaction is mediated by IgE antibodies and can manifest as pruritus and urticaria, bronchospasm, respiratory distress, laryngeal edema, circulatory collapse, or death?

    <p>Type I</p> Signup and view all the answers

    What is the first line treatment for anaphylaxis?

    <p>Epinephrine</p> Signup and view all the answers

    What is the recommended dosing of autoinjectable epinephrine for adults in the prevention of recurrence of anaphylaxis?

    <p>0.3 mg</p> Signup and view all the answers

    What is the proposed mechanism for drug hypersensitivity reactions (DHRs)?

    <p>T-cell mediated response</p> Signup and view all the answers

    Which type of drug reaction is characterized by the formation of antigen-antibody (IgG or IgM) complexes that deposit on blood vessel walls and activate complement, resulting in a serum sickness-like syndrome or vasculitis?

    <p>Type III</p> Signup and view all the answers

    Which of the following medications is NOT commonly associated with Drug-induced lupus erythematosus (DILE)?

    <p>Quinidine</p> Signup and view all the answers

    Which type of drug reaction is typically mediated by T cells and may occur more than one hour after initial exposure, up to weeks or months?

    <p>Type IV</p> Signup and view all the answers

    Which of the following is a potential symptom of a pseudoallergic reaction to radiocontrast media?

    <p>Headache</p> Signup and view all the answers

    Which type of hypersensitivity reaction is characterized by the formation of antigen-antibody complexes in blood that deposit in blood vessel walls or tissues?

    <p>Type III hypersensitivity</p> Signup and view all the answers

    Which type of drug reaction is delayed and T cell-mediated, causing the activation of T lymphocytes and the release of cytokines and recruitment of effector cells?

    <p>Type IV hypersensitivity</p> Signup and view all the answers

    Which mucocutaneous disorder is characterized by T-cell response and keratinocyte apoptosis, resulting in severe blistering and skin sloughing?

    <p>Toxic Epidermal Necrolysis Syndrome (TEN)</p> Signup and view all the answers

    Which of the following medications is NOT commonly associated with angioedema?

    <p>Fluoroquinolones</p> Signup and view all the answers

    Which type of test is performed to determine a patient's allergic reaction to Penicillin G potassium?

    <p>Scratch test</p> Signup and view all the answers

    What is the interpretation if there is no wheal or erythema, or wheal less than 5 mm in diameter, after 15 minutes of the puncture test with PPL?

    <p>Proceed with intradermal test</p> Signup and view all the answers

    What is the major determinant in the Penicillin Skin Testing Agent PPL [Pre-Pen]?

    <p>PPL</p> Signup and view all the answers

    What is the positive response in the intradermal test with Penicillin G potassium?

    <p>Itching &amp; increase in size of original bleb &gt;5 mm</p> Signup and view all the answers

    What is the concentration of the Penicillin Skin Testing Agent PPL [Pre-Pen] solution?

    <p>6 x 10-5 mol/L</p> Signup and view all the answers

    When is the intradermal test with Penicillin G potassium considered positive?

    <p>Itching &amp; increase in size of original bleb &gt;5 mm</p> Signup and view all the answers

    Which type of hypersensitivity reaction is characterized by the formation of antigen-antibody complexes in blood vessel walls or tissues?

    <p>Type III</p> Signup and view all the answers

    Which medication is NOT commonly associated with Stevens-Johnson Syndrome (SJS)?

    <p>Fluoroquinolones</p> Signup and view all the answers

    Which of the following is a common manifestation of Serum Sickness?

    <p>Maculopapular rash</p> Signup and view all the answers

    Which subclass of Delayed Type IV hypersensitivity reactions involves the recruitment of macrophages, eosinophils, or neutrophils?

    <p>IVa</p> Signup and view all the answers

    Which of the following is a potential cause of upper or lower respiratory tract reactions to drugs?

    <p>Antibiotics</p> Signup and view all the answers

    What is the effect of aortic valve regurgitation on the left ventricle?

    <p>Increased preload</p> Signup and view all the answers

    Which type of hypersensitivity reaction is characterized by the release of histamine, tryptase, leukotrienes, prostaglandins, and cytokines upon re-exposure to an allergen?

    <p>Type I</p> Signup and view all the answers

    Which type of drug reaction is typically mediated by T cells and may occur more than one hour after initial exposure, up to weeks or months?

    <p>Delayed-type hypersensitivity reaction</p> Signup and view all the answers

    What is the initial response to the first exposure to an allergen in type I hypersensitivity?

    <p>Production of specific IgE antibodies</p> Signup and view all the answers

    What is the condition called when there is compression of the heart due to the accumulation of fluid, pus, or blood in the pericardial sac?

    <p>Pericardial tamponade</p> Signup and view all the answers

    Which of the following is a manifestation of type I hypersensitivity?

    <p>All of the above</p> Signup and view all the answers

    What is the first-line treatment for anaphylaxis?

    <p>Epinephrine</p> Signup and view all the answers

    Which type of drug reaction is immediate and IgE-mediated, resulting in the release of inflammatory mediators within one hour of reexposure?

    <p>Type A</p> Signup and view all the answers

    Which type of drug reaction is delayed and cytotoxic, with cell destruction due to cell-associated antigen and initiated cytolysis by IgG and complement?

    <p>Type B</p> Signup and view all the answers

    What is the major determinant used in Penicillin Skin Testing Agent PPL?

    <p>Penicilloyl Polylysine</p> Signup and view all the answers

    What is the interpretation if there is a positive response in the scratch test with Penicillin G potassium?

    <p>The patient is allergic to Penicillin G potassium.</p> Signup and view all the answers

    Which type of drug reaction is characterized by the formation of antigen-antibody (IgG or IgM) complexes that deposit on blood vessel walls and activate complement, resulting in a serum sickness-like syndrome or vasculitis?

    <p>Type III</p> Signup and view all the answers

    Which mucocutaneous disorder is characterized by T-cell response and keratinocyte apoptosis, resulting in severe blistering and skin sloughing?

    <p>Type IV hypersensitivity</p> Signup and view all the answers

    Which type of reaction is characterized by the presence of autoantibodies and clinical features of an autoimmune disorder?

    <p>Type III</p> Signup and view all the answers

    Which of the following medications is NOT commonly associated with angioedema?

    <p>Penicillins</p> Signup and view all the answers

    Which of the following is NOT a proposed mechanism for drug hypersensitivity reactions (DHRs)?

    <p>IgE-mediated response</p> Signup and view all the answers

    What is the most common symptom of angioedema associated with ACE inhibitors (ACE-I)?

    <p>Cough</p> Signup and view all the answers

    Which of the following is a risk factor for immediate reactions to radiocontrast media?

    <p>Past reaction to contrast</p> Signup and view all the answers

    What is the primary goal in the treatment of pericardial effusion and cardiac tamponade?

    <p>Remove fluid from pericardial cavity</p> Signup and view all the answers

    Which type of test is performed if there is no wheal or erythema, or wheal less than 5 mm diameter after 15 minutes of PPL scratch test?

    <p>Intradermal test with PPL</p> Signup and view all the answers

    What is the interpretation if there is a wheal or erythema greater than 5-15 mm diameter within 15 minutes of PPL scratch test?

    <p>Choose alternative agent and consider desensitization</p> Signup and view all the answers

    What is the purpose of the intradermal test with PPL?

    <p>To raise intradermal bleb</p> Signup and view all the answers

    What is the concentration of the Penicillin G potassium solution used in the scratch test?

    <p>10,000 unit/mL</p> Signup and view all the answers

    What is the interpretation if there is a positive response in the intradermal test with Penicillin G potassium?

    <p>Choose alternative agent and consider desensitization</p> Signup and view all the answers

    What is the interpretation if there is a negative response in the intradermal test with PPL at 20 minutes?

    <p>No increase in size of original bleb, no greater than reaction at control site</p> Signup and view all the answers

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