11/22/04 20:13:43 [USMLE_Step_1] Lorena: lets start
11/22/04 20:13:55 [USMLE_Step_1] kmonica26: yep
11/22/04 20:14:13 [USMLE_Step_1] Lorena: name some factors that
decrease diastolic pressure
11/22/04 20:15:46 medstudent Logs in
11/22/04 20:15:57 medstudent Joins Subroom Clinical_Skills
11/22/04 20:15:58 [USMLE_Step_1] Lorena: *beep*
11/22/04 20:16:02 medstudent Joins Subroom USMLE_Step_1
11/22/04 20:16:15 [USMLE_Step_1] medstudent: hi
11/22/04 20:16:33 [USMLE_Step_1] Lorena: hi
11/22/04 20:16:48 [USMLE_Step_1] Lorena: are you guys there?
11/22/04 20:16:50 [USMLE_Step_1] medstudent: are you guys studying for
the usmle?
11/22/04 20:17:18 [USMLE_Step_1] Lorena: yes
11/22/04 20:17:31 [USMLE_Step_1] Lorena: we are discussing physio,
muscle and cardio
11/22/04 20:17:40 [USMLE_Step_1] medstudent: ok.
11/22/04 20:17:45 [USMLE_Step_1] medstudent: can I join you guys
11/22/04 20:18:00 [USMLE_Step_1] Lorena: sure, everybody is welcome
11/22/04 20:18:05 [USMLE_Step_1] kmonica26: carotid massage, volume
overload???
11/22/04 20:18:36 [USMLE_Step_1] crusher: diastolic pressure dec in
aortic stenosis?
11/22/04 20:19:28 [USMLE_Step_1] Lorena: in gral. a decrease in total
peripheral resistance decreases , also decreased diastolic pressure,
heart rate, decreased stroke volume and decreased vessel compliance
11/22/04 20:19:53 jwls29 Logs in
11/22/04 20:20:01 jwls29 Joins Subroom USMLE_Step_1
11/22/04 20:20:25 [USMLE_Step_1] jwls29: sorry
11/22/04 20:20:28 [USMLE_Step_1] jwls29: got kicked off
11/22/04 20:20:36 [USMLE_Step_1] Lorena: yes, diastolic pressure is
decreased in aortic stenosis
11/22/04 20:20:54 [USMLE_Step_1] kmonica26: what"s gral lor....sorry
did not get that one
11/22/04 20:21:05 [USMLE_Step_1] Lorena: carotid massage too moni
11/22/04 20:21:19 crusher Logs Out
11/22/04 20:21:30 [USMLE_Step_1] Lorena: factors that decrease
diastolic blood pressure
11/22/04 20:21:48 [USMLE_Step_1] medstudent: what about the pulse in
aortic stenosis. It is increase right? systolic - diatolic = increase
right?
11/22/04 20:21:51 [USMLE_Step_1] kmonica26: ok
11/22/04 20:22:08 [USMLE_Step_1] kmonica26: pulse pressure increase in
AS
11/22/04 20:22:13 [USMLE_Step_1] Lorena: pulse pressure is increased in
aortic stenosis
11/22/04 20:22:44 [USMLE_Step_1] medstudent: Why not?
11/22/04 20:22:58 [USMLE_Step_1] medstudent: I meant why?
11/22/04 20:24:37 [USMLE_Step_1] Lorena: because the ventricle has to
perform a higher contraction to overcome the valve that doesnt open
correctly
11/22/04 20:25:31 [USMLE_Step_1] kmonica26: PP would increase in AR too
and diastolic pressure would dec in AR too because of retrograde flow
of blood from the Aorta
11/22/04 20:25:56 [USMLE_Step_1] Lorena: ventricular pressure will be
much higher than aortic pressure , so you are right .... BP would not
increase as much as in aortic insufficiency
11/22/04 20:26:22 [USMLE_Step_1] Lorena: i mean PP would not increase
as much as in aortic insufficiency
11/22/04 20:27:02 crusher Logs in
11/22/04 20:27:04 [USMLE_Step_1] medstudent: Also, because aortic
stenosis decrease the diastolic blood pressure because of decrease coronary
artery blood flow
11/22/04 20:27:10 crusher Joins Subroom USMLE_Step_1
11/22/04 20:27:42 [USMLE_Step_1] crusher: sorry got dc
11/22/04 20:28:09 [USMLE_Step_1] Lorena: welcome back crush
11/22/04 20:28:12 [USMLE_Step_1] medstudent: so when diastolic pressure
decrease and systolic pressure is somewhat the same, you have the
formula of pulse pressure = systolic - diastolic
11/22/04 20:28:27 [USMLE_Step_1] medstudent: what kind of murmur is
aortic stenosis?
11/22/04 20:28:38 [USMLE_Step_1] kmonica26: systolic
11/22/04 20:28:41 [USMLE_Step_1] crusher: systolic
11/22/04 20:28:47 [USMLE_Step_1] jwls29: systolic
11/22/04 20:29:17 [USMLE_Step_1] Lorena: systolic, crescendo decresendo
11/22/04 20:29:35 [USMLE_Step_1] crusher: which part of pressure volume
curve is max utilzation of energy?
11/22/04 20:29:54 [USMLE_Step_1] medstudent: why is it systolic?
11/22/04 20:30:00 [USMLE_Step_1] Lorena: isovolumetric contraction
11/22/04 20:30:22 [USMLE_Step_1] crusher: very good,all cros briges but
no change in length
11/22/04 20:31:37 [USMLE_Step_1] Lorena: because the blood has to pass
through a narrower valve , systolic because it is when this valve is
supossed to be open so the blood is expulsed to the aorta
11/22/04 20:31:53 [USMLE_Step_1] medstudent: ok, that makes sense
11/22/04 20:32:20 [USMLE_Step_1] medstudent: I wonder what are the
complications of aortic stenosis?
11/22/04 20:32:45 [USMLE_Step_1] Lorena: what are the vessels with
maximal cross sectional area?
11/22/04 20:32:57 [USMLE_Step_1] crusher: cappilaries
11/22/04 20:33:15 [USMLE_Step_1] Lorena: complications are ventricular
hypertrophy , heart failure
11/22/04 20:33:48 [USMLE_Step_1] Lorena: concentric hypertrophy
11/22/04 20:33:48 [USMLE_Step_1] crusher: dec cardiac out put
also..comp of aortic stenosis
11/22/04 20:33:53 [USMLE_Step_1] medstudent: Why do you you have
ventricular hypertrophy and hear failure?
11/22/04 20:34:17 [USMLE_Step_1] medstudent: Is it because of increase
work load?
11/22/04 20:34:20 [USMLE_Step_1] Lorena: yes crush , thats correct
capillaries
11/22/04 20:34:57 [USMLE_Step_1] medstudent: I wonder what kind of
heart failure is it? Concentric, restricted or dilated heart failure?
11/22/04 20:35:00 [USMLE_Step_1] Lorena: to overcome the narrow valve
has to increase force of contraction to do so it hypertophyes
11/22/04 20:35:04 [USMLE_Step_1] crusher: name the organs that are
autoregulated/
11/22/04 20:35:17 [USMLE_Step_1] Lorena: it is concentric
11/22/04 20:35:20 [USMLE_Step_1] kmonica26: it is concentric
hypertrophy in AS
11/22/04 20:35:30 [USMLE_Step_1] kmonica26: cerebral and coronary
11/22/04 20:35:38 [USMLE_Step_1] Lorena: agree with moni
11/22/04 20:35:51 [USMLE_Step_1] crusher: yes monica also exercising
muscle
11/22/04 20:36:04 [USMLE_Step_1] medstudent: So what organs are not
autoregulated?
11/22/04 20:36:13 [USMLE_Step_1] crusher: what subs used as local
metabolites in each case
11/22/04 20:36:25 [USMLE_Step_1] Lorena: skin, GI are not autoregulated
11/22/04 20:37:12 [USMLE_Step_1] medstudent: glucose?
11/22/04 20:38:08 [USMLE_Step_1] Lorena: i dont get the question
11/22/04 20:38:12 [USMLE_Step_1] medstudent: oh, must be fat
11/22/04 20:38:21 [USMLE_Step_1] crusher: exercising
muscle/coronary=adenosine ..causes vasodilation
11/22/04 20:39:07 [USMLE_Step_1] crusher: i mean metabolites that
regulate blood flow
11/22/04 20:39:18 [USMLE_Step_1] Lorena: i will be right back
11/22/04 20:39:43 [USMLE_Step_1] medstudent: ok,
11/22/04 20:39:54 [USMLE_Step_1] medstudent: what murmur is aortic
regurgitation?
11/22/04 20:40:06 [USMLE_Step_1] crusher: diastolic
11/22/04 20:40:13 [USMLE_Step_1] medstudent: bravo!
11/22/04 20:40:18 [USMLE_Step_1] jwls29: diastolic
11/22/04 20:40:33 [USMLE_Step_1] medstudent: what happens to the pulse
pressure?
11/22/04 20:40:35 [USMLE_Step_1] crusher: cos of incompetent aortic
valve
11/22/04 20:40:39 [USMLE_Step_1] medstudent: in aortic regurg
11/22/04 20:40:59 [USMLE_Step_1] crusher: inc cos of inc systolic press
11/22/04 20:41:55 kmonica26 Logs Out
11/22/04 20:42:14 [USMLE_Step_1] medstudent: I thought it decreases
because of decrease systolic blood pressure due to blood flowing backward
to the heart
11/22/04 20:42:29 [USMLE_Step_1] crusher: yeah i guess ur right i mixed
11/22/04 20:42:31 kmonica26 Logs in
11/22/04 20:42:31 kmonica26 Joins Subroom USMLE_Step_1
11/22/04 20:43:17 [USMLE_Step_1] medstudent: what murmur is mitral
prolapse
11/22/04 20:43:40 [USMLE_Step_1] kmonica26: systolic
11/22/04 20:43:41 [USMLE_Step_1] crusher: systolic
11/22/04 20:44:02 [USMLE_Step_1] crusher: wht is opening sanap/
11/22/04 20:44:18 [USMLE_Step_1] medstudent: is it in mitral prolapse?
11/22/04 20:45:01 crusher Logs Out
11/22/04 20:45:20 [USMLE_Step_1] medstudent: mitral stenosis
11/22/04 20:45:27 [USMLE_Step_1] kmonica26: and also in MS
11/22/04 20:45:54 [USMLE_Step_1] medstudent: is it true or false?
mitral prolapse is very common in women?
11/22/04 20:47:10 [USMLE_Step_1] jwls29: true
11/22/04 20:47:47 crusher Logs in
11/22/04 20:47:48 crusher Joins Subroom USMLE_Step_1
11/22/04 20:48:01 [USMLE_Step_1] medstudent: Yes. I got this from
emedicine.com
11/22/04 20:48:02 [USMLE_Step_1] medstudent: In the US: Depending on
the stringency of the criteria used, the prevalence rate of MVP is 1.1-5%
of the general population, with increased incidence in women over men.
MVP is more likely to be found in lean individuals.
11/22/04 20:49:09 [USMLE_Step_1] kmonica26: Heart sound S1, S2, S3 and
S4 are produced by?
11/22/04 20:49:31 [USMLE_Step_1] medstudent: opening and closing of the
valves
11/22/04 20:49:56 [USMLE_Step_1] crusher: s1 by clos of mitral/tri S2
closu of Aortic/pulm
11/22/04 20:50:18 [USMLE_Step_1] kmonica26: yes crush
11/22/04 20:50:26 [USMLE_Step_1] medstudent: s3 is pathological?
11/22/04 20:50:30 [USMLE_Step_1] crusher: S3 vol overload....
11/22/04 20:51:11 [USMLE_Step_1] kmonica26: S3 is at the end of rapid
ventricular filling nad associated with dilated CHF
11/22/04 20:51:30 [USMLE_Step_1] Lorena: sorry. i am back
11/22/04 20:51:37 [USMLE_Step_1] medstudent: so if you see s3 then
think of CHF?
11/22/04 20:52:01 [USMLE_Step_1] kmonica26: S4 with hypertrophic
ventricle becuase of high atrial pressure of stiff ventricle
11/22/04 20:52:12 [USMLE_Step_1] crusher: like in HTN
11/22/04 20:52:53 [USMLE_Step_1] kmonica26: true..to my understanding
S4 is considerd more "pathologic"
11/22/04 20:53:07 [USMLE_Step_1] kmonica26: as S3 can be heard in
normal individuals too
11/22/04 20:53:14 [USMLE_Step_1] Lorena: in young kids
11/22/04 20:53:15 [USMLE_Step_1] crusher: where the vol/pressure curve
move in CHf rt/left ?
11/22/04 20:53:26 [USMLE_Step_1] jwls29: and elderly
11/22/04 20:53:35 [USMLE_Step_1] crusher: n S4 in athelete i guess?
11/22/04 20:53:55 [USMLE_Step_1] medstudent: move to the right?
11/22/04 20:54:04 [USMLE_Step_1] kmonica26: right
11/22/04 20:54:17 [USMLE_Step_1] medstudent: fill in the blank:
Systole refers to contraction, while diastole refers to ______
11/22/04 20:54:19 [USMLE_Step_1] Lorena: S4 in athletes?
11/22/04 20:54:40 [USMLE_Step_1] crusher: yes it move in Rt cos preload
inc n contractilty dec But height is dec.
11/22/04 20:55:45 [USMLE_Step_1] crusher: wht is the co relation of
contractity and preload?
11/22/04 20:56:10 kiranadi Logs in
11/22/04 20:56:10 [USMLE_Step_1] kmonica26: they go in opposite
directions
11/22/04 20:56:13 [USMLE_Step_1] medstudent: you increase in preload,
then you increase in contractiliy
11/22/04 20:56:28 kiranadi Joins Subroom USMLE_Step_1
11/22/04 20:56:33 kiranadi Logs Out
11/22/04 20:56:43 [USMLE_Step_1] Lorena: agree with monica
11/22/04 20:56:44 [USMLE_Step_1] crusher: monica is right they move in
opp direction
11/22/04 20:57:08 [USMLE_Step_1] medstudent: I agree too
11/22/04 20:57:19 [USMLE_Step_1] kmonica26: exception is in heavy
exercise
11/22/04 20:57:27 [USMLE_Step_1] crusher: yep agree
11/22/04 20:57:36 [USMLE_Step_1] medstudent: True or false? Coronary
blood flow occurs mostly during diastole
11/22/04 20:57:52 [USMLE_Step_1] Lorena: does digitalis increase or
decrease preload?
11/22/04 20:58:08 [USMLE_Step_1] Lorena: true medstud
11/22/04 20:58:11 [USMLE_Step_1] medstudent: decrease because it is
positive inotropic
11/22/04 20:58:11 [USMLE_Step_1] crusher: true i guess
11/22/04 20:58:25 [USMLE_Step_1] crusher: dec lorena
11/22/04 20:58:35 [USMLE_Step_1] medstudent: yes, it is true
11/22/04 20:58:38 [USMLE_Step_1] medstudent: Coronary blood flow occurs
mostly during diastole, because during systole the blood vessels within
the myocardium are compressed.
11/22/04 20:58:39 [USMLE_Step_1] Lorena: good crush
11/22/04 20:58:41 [USMLE_Step_1] kmonica26: digitalis increases force
of contracton and contractilily..so would dec preload
11/22/04 20:58:53 [USMLE_Step_1] Lorena: very good moni
11/22/04 20:59:05 [USMLE_Step_1] crusher: dig inc contractilty and its
corel is dec preload
11/22/04 20:59:45 [USMLE_Step_1] Lorena: in an aneurysm , how would the
pressure be compared to a normal blood vessel?
11/22/04 20:59:57 [USMLE_Step_1] crusher: best index to measure
preload
11/22/04 21:00:14 [USMLE_Step_1] kmonica26: increase
11/22/04 21:00:22 [USMLE_Step_1] jwls29: agree with monica
11/22/04 21:00:25 [USMLE_Step_1] Lorena: for preload, end dyastolic
volume
11/22/04 21:00:27 [USMLE_Step_1] crusher: aneursm wall tension inc so
inc
11/22/04 21:00:46 [USMLE_Step_1] medstudent: agree
11/22/04 21:00:56 [USMLE_Step_1] crusher: LVEDV ...left
ventricular...very good all
11/22/04 21:01:18 [USMLE_Step_1] medstudent: what is the formula for
cardiac output (CO)?
11/22/04 21:01:23 [USMLE_Step_1] Lorena: yes everybody
11/22/04 21:01:44 [USMLE_Step_1] crusher: COP-meanP/R
11/22/04 21:01:55 [USMLE_Step_1] Lorena: CO= MAP/TPR
11/22/04 21:02:03 [USMLE_Step_1] jwls29: agree with lorena
11/22/04 21:02:42 [USMLE_Step_1] medstudent: How about CO = HR x SV
11/22/04 21:02:52 [USMLE_Step_1] crusher: that also true
11/22/04 21:02:54 [USMLE_Step_1] Lorena: or stroke volume x heart rate
11/22/04 21:02:56 [USMLE_Step_1] Lorena: yes
11/22/04 21:03:36 [USMLE_Step_1] medstudent: so if you increase the TPR
the CO will decrease. True or false
11/22/04 21:03:55 [USMLE_Step_1] crusher: pulmonary wedge pressure
mearsures whta?
11/22/04 21:04:05 [USMLE_Step_1] crusher: true
11/22/04 21:04:09 [USMLE_Step_1] kmonica26: preload
11/22/04 21:04:17 [USMLE_Step_1] Lorena: agree with mon
11/22/04 21:05:20 [USMLE_Step_1] crusher: yes right preload
11/22/04 21:05:54 [USMLE_Step_1] crusher: but fromwhere it is best
taken ..Left atria.left ventricle..rt atrium?
11/22/04 21:06:07 [USMLE_Step_1] Lorena: left ventricle
11/22/04 21:06:31 [USMLE_Step_1] medstudent: Rigth atrium
11/22/04 21:06:57 [USMLE_Step_1] medstudent: i meant left atrium
11/22/04 21:07:37 [USMLE_Step_1] crusher: i dono thre correct ans of
this q
11/22/04 21:08:21 [USMLE_Step_1] Lorena: ok
11/22/04 21:08:29 [USMLE_Step_1] crusher: i think left ventricle cos
most further away from the venous more reliable it is
11/22/04 21:08:42 [USMLE_Step_1] Lorena: i agree
11/22/04 21:09:05 [USMLE_Step_1] medstudent: wedge it into a small
pulmonary artery
11/22/04 21:09:31 [USMLE_Step_1] medstudent: is that one of the choice?
11/22/04 21:10:04 [USMLE_Step_1] Lorena: it is left ventricle because
the best indice for preloas is end dyastolic volume
11/22/04 21:10:33 [USMLE_Step_1] medstudent: agree
11/22/04 21:10:36 [USMLE_Step_1] Lorena: left ventricular end dyastolic
volume according to kaplan
11/22/04 21:11:35 [USMLE_Step_1] Lorena: less reliable are those
measured in the venous system (left atrial pressure,, pulmonary wedge
pressure)
11/22/04 21:11:55 [USMLE_Step_1] crusher: splitting of 2nd heart sound
dec in which condition?
11/22/04 21:13:18 [USMLE_Step_1] medstudent: ASD
11/22/04 21:13:22 [USMLE_Step_1] Lorena: agree
11/22/04 21:13:31 [USMLE_Step_1] kmonica26: U mean fixed splitting?
11/22/04 21:14:02 [USMLE_Step_1] medstudent: What is the answer?
11/22/04 21:14:35 [USMLE_Step_1] crusher: i mean splitting S2 sound
,,A2 and P2
11/22/04 21:14:53 [USMLE_Step_1] crusher: it dec in left bundle barch
block
11/22/04 21:15:40 [USMLE_Step_1] Lorena: ok, thanks
11/22/04 21:15:46 [USMLE_Step_1] kmonica26: ok thanks
11/22/04 21:16:22 [USMLE_Step_1] medstudent: True or false: blood flow
is proportion to radius to the 4th power?
11/22/04 21:16:56 [USMLE_Step_1] Lorena: false
11/22/04 21:17:20 [USMLE_Step_1] medstudent: why is it false?
11/22/04 21:17:49 [USMLE_Step_1] crusher: res=1/r4
11/22/04 21:18:02 [USMLE_Step_1] Lorena: no, it is true
11/22/04 21:18:08 [USMLE_Step_1] crusher: and COP=P/R
11/22/04 21:18:31 [USMLE_Step_1] medstudent: true.
11/22/04 21:18:41 [USMLE_Step_1] Lorena: becauss resistance is
inversely proportional to radius to the 4th power , and resistance is inversely
proportional to flow
11/22/04 21:19:05 [USMLE_Step_1] crusher: agree
11/22/04 21:20:01 [USMLE_Step_1] medstudent: It makes sense because the
bigger the pipe the more blood can flow in it
11/22/04 21:20:24 [USMLE_Step_1] Lorena: i get confused with all the
terms
11/22/04 21:20:46 [USMLE_Step_1] Lorena: but it makes sence
11/22/04 21:21:18 [USMLE_Step_1] crusher: which one donot have Ca
channel.=skeletal muscle,,cardiac muscle...smooth muscle
11/22/04 21:21:54 [USMLE_Step_1] Lorena: skeletal?
11/22/04 21:22:39 [USMLE_Step_1] crusher: yes skeletal muscle dependent
soley on sarcoplasmic Ca not extracellular Ca
11/22/04 21:22:56 [USMLE_Step_1] Lorena: ok, thanks
11/22/04 21:23:16 [USMLE_Step_1] crusher: which cardian n smooth
muscles ECF ca stimulate sarcoplasimc ca.
11/22/04 21:23:53 [USMLE_Step_1] Lorena: why hypocalcemia causes
tetany?
11/22/04 21:26:02 [USMLE_Step_1] crusher: dono exactly
11/22/04 21:26:33 [USMLE_Step_1] Lorena: because low calcium lowers the
nerve's threshold
11/22/04 21:26:45 [USMLE_Step_1] crusher: tetnus result from all cross
briding saturate
11/22/04 21:27:15 [USMLE_Step_1] crusher: oh i see!
11/22/04 21:27:27 [USMLE_Step_1] Lorena: so they are hyperexcitable but
it is not a direct muscle action, it is not refered to the calcium in
SR
11/22/04 21:27:56 [USMLE_Step_1] crusher: so with even low ca ithere is
rapid firing of action pot
11/22/04 21:28:02 [USMLE_Step_1] Lorena: yes
11/22/04 21:30:36 [USMLE_Step_1] Lorena: what mechanical event marks
the end iof isovolumetric contraction?
11/22/04 21:31:28 [USMLE_Step_1] crusher: ejection n opening of aortic
valve
11/22/04 21:31:34 [USMLE_Step_1] Lorena: yes
11/22/04 21:32:01 [USMLE_Step_1] Lorena: and end of isovolumetric
relaxation?
11/22/04 21:32:03 [USMLE_Step_1] medstudent: be back
11/22/04 21:32:39 [USMLE_Step_1] crusher: filling!
11/22/04 21:33:11 [USMLE_Step_1] Lorena: when the mitral valve opens
11/22/04 21:33:20 [USMLE_Step_1] crusher: opening of mitralvalve open
yes
11/22/04 21:33:40 [USMLE_Step_1] Lorena: the 2 isovolumteric events
start with closure of valves and finish with opening
11/22/04 21:35:03 [USMLE_Step_1] Lorena: what determines systolic
interval? contractility or heart rate?
11/22/04 21:35:25 [USMLE_Step_1] crusher: yes if u see pre vol curve
make X corner of each / valve open and corner of another ? valve closes
11/22/04 21:35:59 [USMLE_Step_1] crusher: heart rate i guess!
11/22/04 21:36:08 [USMLE_Step_1] kmonica26: heart rate?
11/22/04 21:36:26 [USMLE_Step_1] Lorena: contractility determines
systolic interval
11/22/04 21:36:38 [USMLE_Step_1] Lorena: heart rate determines
diastolic interval
11/22/04 21:36:51 [USMLE_Step_1] crusher: contractility= force and
HR=rate of contarction
11/22/04 21:37:53 [USMLE_Step_1] Lorena: therefore increase
synmpathetic activity would increase or decrease diastolic interval?
11/22/04 21:38:18 [USMLE_Step_1] kmonica26: increases HR so would inc
dia interval
11/22/04 21:38:31 [USMLE_Step_1] crusher: dec ?
11/22/04 21:38:44 [USMLE_Step_1] Lorena: decrease
11/22/04 21:39:19 [USMLE_Step_1] Lorena: sympathetic increase HR so
decrease diastolic interval
11/22/04 21:39:34 [USMLE_Step_1] kmonica26: ok got it thansk
11/22/04 21:40:16 [USMLE_Step_1] Lorena: what is a good index of
afterload?
11/22/04 21:40:30 [USMLE_Step_1] kmonica26: mean aortic pressure
11/22/04 21:40:45 [USMLE_Step_1] Lorena: yes, very good
11/22/04 21:40:47 [USMLE_Step_1] crusher: there is no good index
11/22/04 21:41:58 [USMLE_Step_1] Lorena: i guess i should have said
acceptable indices
11/22/04 21:42:17 [USMLE_Step_1] crusher:
11/22/04 21:42:37 [USMLE_Step_1] Lorena:
11/22/04 21:42:50 [USMLE_Step_1] crusher: can u tellme pulse pressure
inc/decin aortic stenosis n why?
11/22/04 21:44:44 [USMLE_Step_1] crusher: hello????any one there/
11/22/04 21:44:48 [USMLE_Step_1] Lorena: i dont know,
11/22/04 21:44:57 [USMLE_Step_1] crusher: ok.
11/22/04 21:45:05 [USMLE_Step_1] Lorena: please explain
11/22/04 21:45:31 [USMLE_Step_1] crusher: i donomyself i was askin but
i use my logic as
11/22/04 21:46:08 [USMLE_Step_1] crusher: aortic stenosis=there is dec
sytolic pressure.as PP=sytolic-diastolic ,,so it would dec
11/22/04 21:46:25 [USMLE_Step_1] Lorena: yes
11/22/04 21:46:27 [USMLE_Step_1] Lorena: maybe
11/22/04 21:46:40 [USMLE_Step_1] Lorena: it makes sense
11/22/04 21:46:55 [USMLE_Step_1] crusher: but i,m not sure...
11/22/04 21:47:20 [USMLE_Step_1] Lorena: it doesnt say in my notes
11/22/04 21:48:40 [USMLE_Step_1] crusher: neither mine but i hear some
where about pp in aortic stenosis
11/22/04 21:49:00 [USMLE_Step_1] crusher: ok i got it
11/22/04 21:49:12 [USMLE_Step_1] Lorena: what is it?
11/22/04 21:49:27 [USMLE_Step_1] crusher: see its in notes ..pulse
pressure inc in AORTIC INSUUFICENCY
11/22/04 21:49:47 [USMLE_Step_1] crusher: while opp in aortic stenosis
11/22/04 21:50:15 [USMLE_Step_1] Lorena: yes, but it doesn say anything
about aortic stenosis, it just says mean aortic pressure is maintained
in normal range
11/22/04 21:50:46 [USMLE_Step_1] crusher: but it says in aortic insuff
11/22/04 21:50:54 [USMLE_Step_1] kmonica26: yes thats what my
understanding was that pp increses in AR
11/22/04 21:51:12 [USMLE_Step_1] crusher: n i,msure about it dec is
aortic stenosis
11/22/04 21:51:39 [USMLE_Step_1] Lorena: but i think it is decreased
because the valve act as a major resistance in series so far from the
increased resistance (the valve) , the pressure will be lower
11/22/04 21:51:53 [USMLE_Step_1] crusher: cos the diff b/w the two is
in systolic pressure which dec in AS and Inc in AR
11/22/04 21:52:38 [USMLE_Step_1] Lorena: look at the figure , the diff
in pressure (diastolic and systolic dont change much) , not much
difference
11/22/04 21:52:55 [USMLE_Step_1] crusher: in AS=blood cannot pumped out
cos of resistance n dec output.
11/22/04 21:54:50 [USMLE_Step_1] Lorena: so, what is it? decreased?
11/22/04 21:54:55 [USMLE_Step_1] crusher: we measure systolic/diatolic
pressure in aorta ...right???
11/22/04 21:55:02 [USMLE_Step_1] Lorena: yes
11/22/04 21:55:24 [USMLE_Step_1] crusher: so in AS=dec sytolic pressure
...so dec pu;lse pressure is it not?
11/22/04 21:55:27 Lorena Logs Out
11/22/04 21:55:39 [USMLE_Step_1] crusher: sorry may be i,m confusing u
11/22/04 21:55:57 Lorena Logs in
11/22/04 21:55:57 Lorena Joins Subroom USMLE_Step_1
11/22/04 21:56:09 [USMLE_Step_1] Lorena: sorry, got kicked out
11/22/04 21:56:38 [USMLE_Step_1] crusher: AS=dce sytolic pressure so
dec pulse pressure
11/22/04 21:57:14 [USMLE_Step_1] Lorena: i think thats what it is , or
my be normal, but definetely not increased
11/22/04 21:57:24 [USMLE_Step_1] kmonica26: In advanced-stage AS, both
systolic blood pressure and pulse pressure are decreased. In
advanced-stage AS, both systolic blood pressure and pulse pressure are decreased.
11/22/04 21:57:28 [USMLE_Step_1] crusher: yep u r right!
11/22/04 21:57:42 [USMLE_Step_1] kmonica26: I got this from an article
on AS in emedicine
11/22/04 21:57:51 [USMLE_Step_1] crusher: oh thanks monica
11/22/04 21:57:57 [USMLE_Step_1] Lorena: thanks
11/22/04 21:58:04 [USMLE_Step_1] kmonica26:
http://www.emedicine.com/med/topic157.htm
11/22/04 21:58:07 [USMLE_Step_1] crusher: n u know why PP inc in aortic
insuff
11/22/04 21:58:23 [USMLE_Step_1] Lorena: yes
11/22/04 21:58:28 [USMLE_Step_1] crusher: thanks monica
11/22/04 21:58:34 [USMLE_Step_1] kmonica26: np
11/22/04 21:58:44 [USMLE_Step_1] Lorena: thank you mon
11/22/04 21:58:53 [USMLE_Step_1] kmonica26:
11/22/04 21:58:58 [USMLE_Step_1] kmonica26: u welcome
11/22/04 21:59:34 [USMLE_Step_1] crusher: in aortic insuff blood
pumpback in ventricle n will pumped out with greater out put,so inc sytolic
pressure =so inc PP.
11/22/04 21:59:47 [USMLE_Step_1] Lorena: yes
11/22/04 22:00:05 [USMLE_Step_1] Lorena: indices of contractility?
11/22/04 22:01:04 [USMLE_Step_1] kmonica26: dp/dt and ejection fraction
11/22/04 22:01:28 [USMLE_Step_1] Lorena: yes
11/22/04 22:02:03 [USMLE_Step_1] jwls29: goodnite
11/22/04 22:02:20 [USMLE_Step_1] Lorena: good nite jwls
11/22/04 22:02:21 [USMLE_Step_1] kmonica26: bye jwls
11/22/04 22:02:22 [USMLE_Step_1] crusher: goodnite jwels
11/22/04 22:02:30 [USMLE_Step_1] kmonica26: are we meeting tomorrow?
11/22/04 22:02:38 [USMLE_Step_1] Lorena: yes
11/22/04 22:02:40 [USMLE_Step_1] Lorena: i am coming
11/22/04 22:02:44 [USMLE_Step_1] Lorena: are you?
11/22/04 22:02:51 [USMLE_Step_1] kmonica26: yes I will
11/22/04 22:03:04 [USMLE_Step_1] kmonica26: How about you jwls and
crush?
11/22/04 22:03:07 [USMLE_Step_1] crusher: i,mnot sure about t.m
11/22/04 22:03:27 [USMLE_Step_1] jwls29: i can't tomorrow
11/22/04 22:03:30 [USMLE_Step_1] jwls29: yes on weds
11/22/04 22:03:37 [USMLE_Step_1] crusher: physion waqs in my revision
today so i came
11/22/04 22:03:44 [USMLE_Step_1] Lorena: i wont come on wednesday
though but tomorrow i will make it mostly for renal
11/22/04 22:03:57 [USMLE_Step_1] kmonica26: ok
11/22/04 22:03:58 jwls29 Logs Out
11/22/04 22:04:14 [USMLE_Step_1] kmonica26: are we done guys?
11/22/04 22:04:21 [USMLE_Step_1] Lorena: i have to go now
11/22/04 22:04:22 [USMLE_Step_1] crusher: but i ,mtahnkful to all of u
11/22/04 22:04:26 [USMLE_Step_1] crusher: ok me too
11/22/04 22:04:29 [USMLE_Step_1] kmonica26: me too
11/22/04 22:04:33 [USMLE_Step_1] kmonica26: bye guys
11/22/04 22:04:34 [USMLE_Step_1] Lorena: crush , thanks to yuo too
11/22/04 22:04:37 [USMLE_Step_1] kmonica26: good nite
11/22/04 22:04:39 [USMLE_Step_1] Lorena: see you tomorrow bye
11/22/04 22:04:40 [USMLE_Step_1] crusher: good nite
11/22/04 22:04:41 [USMLE_Step_1] kmonica26: thanks crush
11/22/04 22:04:48 [USMLE_Step_1] Lorena: if you gusy need anything,
send me PM
11/22/04 22:04:49 [USMLE_Step_1] kmonica26: and LOr
11/22/04 22:04:59 [USMLE_Step_1] kmonica26: sure thanks
11/22/04 22:04:59 [USMLE_Step_1] Lorena: byeee
11/22/04 22:05:02 [USMLE_Step_1] crusher: sure.bye
11/22/04 22:05:03 [USMLE_Step_1] kmonica26: bye
11/22/04 22:05:09 crusher Logs Out
11/22/04 22:05:11 kmonica26 Logs Out
11/22/04 22:05:14 Lorena Logs Out