Medical Diagnosis Quiz

A sudden feeling of intense fear or discomfort, accompanied by physical symptoms like dizziness, shortness of breath, chest pain, and palpitations.

A condition caused by a drop in blood pressure when standing up from a lying or sitting position, leading to lightheadedness or fainting.

A type of fainting caused by a sudden decrease in blood pressure and heart rate in response to emotional or physical stress.

An excessive sensitivity of the carotid sinus baroreceptors, causing a decrease in heart rate and blood pressure upon stimulation, triggering lightheadedness or fainting.

Inflammation of the cartilage at the rib joints, presenting as chest pain that worsens with palpation or reaching overhead.

A condition characterized by a mid-systolic click heard on auscultation, often caused by prolapse of the mitral valve.

A drop in systolic blood pressure by >20mmHg and diastolic blood pressure by >10mmHg when moving from supine to standing.

A condition characterized by fainting triggered by a stressor, usually an emotional trigger.

A viral infection (Coxsackie B) that causes sharp lateral chest pain due to intercostal muscle spasm.

Viral infection causing inflammation of the pleura (layers covering the lungs), leading to sharp chest pain.

A condition that can mimic angina pain in patients without heart disease, causing chest discomfort.

A condition where the inner lining of the esophagus becomes irritated due to stomach acid refluxing back up.

A condition caused by atherosclerotic disease, which presents with diminished peripheral pulses in patients over 50 who have risk factors like diabetes, smoking, and hypertension.

Inhibition of HMG-CoA reductase, which is the rate-limiting enzyme in cholesterol biosynthesis, and upregulation of LDL receptors on hepatocytes, which increases the uptake of LDL from the circulation.

Blocks cholesterol absorption specifically in the small intestine.

Increase the removal of bile acids from the body, stimulating the liver to produce more bile acids, which requires cholesterol from the blood.

Activate PPAR-alpha, a nuclear receptor, which promotes the expression of lipoprotein lipase, an enzyme that breaks down triglycerides in the blood.

Caused by exertion and occurs predictably with exercise due to atherosclerotic plaques causing >70% occlusion of coronary arteries.

Unpredictable chest pain that can occur at rest due to partial rupture of an atherosclerotic plaque leading to a partial occlusion.

Caused by vasospasm of coronary arteries, typically occurring at rest in younger adults. It is not caused by atherosclerosis.

Dilates both veins and arterioles, leading to a reduction in preload and afterload, respectively. It is used in hypertensive emergencies.

Chest pain caused by spasms in the coronary arteries, often occurring at rest or during sleep.

A life-threatening condition characterized by severely elevated blood pressure (>180/120 mmHg) and evidence of damage to vital organs (brain, kidneys, eyes, heart).

A condition with high blood pressure (>180/120 mmHg), but no signs of organ damage. It's less urgent than an emergency and often managed with oral medications.

Type of shock characterized by low cardiac output due to heart dysfunction, leading to reduced tissue perfusion and oxygen delivery.

Type of shock caused by severe fluid loss, leading to decreased circulating blood volume and consequently reduced tissue perfusion.

A type of shock caused by widespread vasodilation and increased vascular permeability, leading to blood pooling and decreased tissue perfusion.

Type of shock caused by an allergic reaction, characterized by widespread vasodilation and increased vascular permeability, similar to septic shock.

Type of shock caused by a sudden drop in sympathetic nervous system activity, resulting in vasodilation and decreased heart rate, leading to reduced tissue perfusion.

A bacterial infection of a heart valve in a patient without a prior history of heart valve problems. It's often caused by Staphylococcus aureus on the USMLE.

Occurs in patients with a history of valve abnormalities, like congenital bicuspid aortic valve or rheumatic heart disease. It's commonly caused by Streptococcus viridans on the USMLE.

The most common cause of acute endocarditis on the USMLE. It is coagulase-positive.

The most common cause of subacute endocarditis on the USMLE. It's often associated with dental procedures, where bacteria from the mouth can enter the bloodstream and infect a damaged valve.

The location where Staphylococcus aureus commonly causes infection in IV drug users.

A new-onset murmur accompanied by fever is highly suggestive of endocarditis until proven otherwise on the USMLE.

A sign of infection that can occur with endocarditis. It's not specific to this condition, but it's often mentioned in USMLE questions related to endocarditis.

A complication of endocarditis where small pieces of infected heart valve break off (vegetations) and travel to the brain, causing focal neurological symptoms, like stroke.

Vancomycin targets gram-positive bacteria, including MRSA. Gentamicin targets gram-negative bacteria.

Usually ampicillin or a second-generation cephalosporin (e.g., cefoxitin) is used to prevent endocarditis.

Patients with any prosthetic material in the heart, congenital cyanotic heart disease not fully repaired, or a heart transplant with valvular regurgitation require endocarditis prophylaxis.

Mitral valve prolapse (MVP) and valve regurgitations or stenoses are NOT indications for endocarditis prophylaxis.

Rheumatic fever is caused by an immune response to Streptococcus pyogenes (Group A Strep) infection.

Antibodies produced against S. pyogenes M-protein cross-react with the mitral valve, causing inflammation and damage.

Rheumatic fever typically affects the mitral valve, leading to mitral regurgitation initially and mitral stenosis later.

Rheumatic fever presents with the JONES criteria: Joints (polyarthritis), Carditis, Nodules, Erythema marginatum, Sydenham chorea (dance-like movements).