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Clinical presentation

Clinical presentation. 36-year-old male with a recent history of intravenous drug use presents with three days of fevers, rigors and malaise blood culture reveals gram-positive cocci in clusters. Echocardiogram. E chocardiogram. Question #1.

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Clinical presentation

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  1. Clinical presentation • 36-year-old male with a recent history of intravenous drug use presents with three days of fevers, rigors and malaise • blood culture reveals gram-positive cocci in clusters

  2. Echocardiogram

  3. Echocardiogram

  4. Question #1 The echodensities shown on echocardiography represent • Clusters of bacteria • Cholesterol plaque • Platelet-fibrin aggregates • Mesodermal hyperproliferation

  5. Question #2 Which of the following is not a major clinical concern? • Pulmonary embolism • Cerebrovascular accident • Mesenteric ischemia • Toxic epidermal necrolysis

  6. Question #3 Cross section of mitral valve Visceral pericardium Parietal pericardium Cardiac endothelium A toenail • This histological specimen represents

  7. Question #4 • A 24-year-old woman was in a motor vehicle accident and is unconscious upon arrival to the hospital. An echocardiogram reveals normal left and regular function with a small pericardial effusion. Tamponade physiology is present. Blood pressure is 70/40, heart rate is 150 and she has significant jugular venous distention.

  8. Which arrow most likely represents this patient’s position on the pericardial pressure volume curve? C A B D

  9. Question #6 Which of the following represents the correct reaction to the above clinical scenario? A. C. B. D.

  10. Question # 7 The degree to which a certain amount of fluid will cause increased pericardial pressure depends upon • The compliance of the pericardium • The rapidity with which the fluid has accumulated • The size of the patient • All of the above

  11. Question #8 Which of the following is not a major purpose of the pericardium? A. Ligamentous attachments to diaphragm, sternum and other structures B. Regulation of blood pressure C. Barrier to infection D. Participation in cardiac reflexes

  12. Question #9 Which one of the following organisms is least likely to cause infective endocarditis? • Streptococcus bovis • Staphylococcus aureus • Staphylococcus epidermidis • Cardiobacteriumhominis

  13. Question #10 Where is infective endocarditis least likely to occur? • Mitral valve • Aortic valve • Pulmonic valve • Tricuspid valve

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