Clinical Reasoning — Flashcards

Flashcard 641: The initial phase of myocardial infarction (subendocardial infarcts) shows ST-segment _____ on EKG

Answer: depression

Flashcard 642: What type of vomiting is seen with Yellow fever?_____

Answer: Black (bloody) vomiting

Flashcard 643: The symptoms of normal pressure hydrocephalus improve with _____

Answer: lumbar puncture

Flashcard 644: _____ antibodies are diagnostic for pernicious anemia

Answer: Anti-intrinsic factor

Flashcard 645: Central cyanosis typically manifests in the _____, nail beds, and conjunctiva, and other mucosal surfaces

Answer: lips

Flashcard 646: Which electrolyte disturbance causes wide QRS and peaked T waves on ECG? _____

Answer: High K+ (hyperkalemia)

Flashcard 647: Is tropical sprue associated with normal or decreased urinary excretion of D-xylose (D-xylose test)? _____

Answer: Decreased

Flashcard 648: Where is a murmur due to mitral regurgitation the loudest? _____

Answer: Apex (mitral area)

Flashcard 649: Which heart sounds are characteristically heard at the **apex** (using the bell in the **left lateral decubitus** position) in a patient with **hypertrophic obstructive cardiomyopathy (HOCM)**?

Answer: S4 and Mid-systolic murmur

Extra: In Hypertrophic Obstructive Cardiomyopathy (HOCM), the S4 gallop reflects atrial contraction into a stiff, hypertrophied left ventricle. The mid-systolic murmur is caused by dynamic left ventricular outflow tract (LVOT) obstruction. Both are best heard at the apex or left lower sternal border, often using the bell in the left lateral decubitus position for the S4.

Flashcard 650: Which immunodeficiency may be diagnosed with the nitroblue tetrazolium (NBT) test? _____

Answer: Chronic granulomatous disease (CGD)