Notes

A 70-year old male presents to your office with complaints of exertional dyspnea. He is mildly hypertensive on examination. Carotid upstrokes are brisk, with a secondary upstroke. A loud II1 VI systolic murmur is heard along the sternal border radiating to the neck. S, and S2 are normal. An S4 is heard. The murmur increases in intensity with Valsalva and decreases with handgrip. 37. An echocardiogram reveals a less than 2 -m s jet across the left ventricular outflow tract. What is your next...

Chorothaizine Medicine

Trial, which showed that amiodarone increased the likelihood of admission to the hospital after an out-of hospital arrest. This is further supported by the recently presented Amiodarone versus Lidocaine i.'t Pre-Hospital Refractory Ventricular Fibrillation Evaluation (ALIVE) trial. Lidocaine is now considered Class Indeterminate based on the lack of controlled trials supporting its use in pulseless VT VE Procainamide administration .s prolonged and not suitable for rapid administration...

Pwf

Repeat ep s ales of none mliogenit pulmonary edema, s ggests .l.e diagnosis of biir.teral renal artery stenosis. Addition ol further antihyperkns ve medications wo ild be indicated, but not prior to initiating .1 workup < i ena rtery ,teno-< -. . A renal MRI would be the most ap iopriate of th above answers. 6. d. None of the medications listed are contraindicated. A recent Cochrane eview i patients with COPD defined as an FF.V < 80 predicted icund no l.anges in FEV or symptoms with...

Figure

A. abrupt closure of the right coronary artery b. dissection of the right coronary artery c. perforation of the r ie 111 coronary arterv 66. Patients with scleroderma have a. increased coronary flow reserve b. decreased coronary flow reserve c. normal coronary flow reserve 67. The major difference in the morphology of coronary atherosclerotic lesion in patients with end-stage renal failure compared to nonurenm patients is a. significantly more fibrous plaques of coronary arteries in patients w...

Info

Among the risk factors listed,, hypercholesterolemia J has the lowest relative risk for the development of peripheral artc-ria disease with a relative risk of up to double that ot nonsmokers. Smoking increases ris< two- to sixfold, diabetes increases risk two- to fourfold, hypertension i creases j risk two and a half- to fourfold and hyperhomocysteinemia increases risk two- to T.reefold.1' 2. d. 25 . to 2 of patients with lower extremity PAD will present with clini...

Cor

Ascending aorta to right pulmonary anastomosis PAL Increases pulmonary flow (rarely cone anymore) Decreases pulmonary flow Increases mixing of blood for transposition of the great arteries or tricuspid atresia Increases pulmonary flow, nay reestablish proper sequence of low to aorta and PA Correction for aortic stenosis avoids mechanical and bioprostiietic valve Re-establishes proper How sequence to PA and aorta in t'ansposition of the great arte 'es Increases pulmonary blood flow (rarely done...

Examination Notescsp

The Post-CAftG trial studied moderate versus aggressive lip-d lowering a id low dose warfarin versus placebo in patients with a i is'.ory o eoronary artery bypass surgery and found that more aggressive lipid lowering was effec ive ii preventing progression of atherosclerosis in SVGs, .Ait warfarin had no effect. Using variables measured at baseline, we sought the ndependen' prognostic factors for atherosclerosis progression in SVGs, employing the statistical method of generalized...