Clinical Reasoning — Flashcards

Flashcard 641: Is tropical sprue associated with normal or decreased urinary excretion of D-xylose (D-xylose test)? _____

Answer: Decreased

Flashcard 642: What disease is associated with a spinal cord lesion involving the posterior (dorsal) columns and dorsal roots?

Answer: Tabes dorsalis (tertiary syphilis)

Flashcard 643: 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 644: Which immunodeficiency may be diagnosed with the nitroblue tetrazolium (NBT) test? _____

Answer: Chronic granulomatous disease (CGD)

Flashcard 645: Where is a murmur due to mitral regurgitation the loudest? _____

Answer: Apex (mitral area)

Flashcard 646: Which thyroid imbalance characteristically presents with Myoedema?_____

Answer: Hypothyroidism

Flashcard 647: Does Pneumocystis pneumonia show consolidations on chest xray?_____

Answer: No

Flashcard 648: A patient with abdominal pain and distension, bloody diarrhea, fever and shock in the setting of ulcerative colitis or clostridium difficile is most likely presenting with _____

Answer: Toxic megacolon

Flashcard 649: In Legg-Calve-Perthes, will you often observe pathology on the initial x-ray?_____

Answer: No

Flashcard 650: Diagnosis of pneumonia is made by _____ and sputum & blood gram stain/culture

Answer: CXR