[niks] ok can anyone tell me on which day of the MI does shoulder pain develop
[saimakm] which day?
[perhaps] day 1?
[niks] on the same day
[saimakm] oooh
[niks] good perhaps
[perhaps] what days are the heart softest? easiest to rupture?
[niks] and if apatient comes on the 3rd day of MI which marker should be checked
[perhaps] toponin
[niks] 5-8days perhaps
[saimakm] 3 to 7
[saimakm] ldh
[niks] yes troponin
[niks] till 3 days CKMB is done
[perhaps] rupture most common 3-7 days on Goljan notes, but bulk part both right
[niks] causes of dilated cardiomyopathy?
[niks] yea perhaps
[saimakm] increase pressure
[perhaps] yes
[niks] specific causes...
[niks] ??
[niks] alcohol
[niks] any more?
[perhaps] post partum
[niks] hemochromatosis
[niks] yes post partum
[niks] right
[saimakm] ok tnx
[niks] and also..
[niks] genetic alterations
[niks] acute myocarditis presents with....
[niks] ??
[niks] arrythmias
[niks] and chronic myocarditis?
[niks] anyone
[saimakm] arrythmias
[niks] no
[saimakm] scd
[perhaps] regurgitation?
[niks] dilated cardiomyopathy
[perhaps] oh thanks
[saimakm] ok
[saimakm] what about ch
[niks] what defect is there in hypertrophy in familial cases which is the most common form of hypertrophy?
[niks] hypertrophic cardiomyopathy is related to defect in beta myosin heavy chain...this is important
[niks] this leads to assymertic hypertrophy especially of septum
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[niks] causes of dissecting aortic aneurysm?
[saimakm] htn
[niks] good
[saimakm] collagen defects
[niks] good
[saimakm] syphillis
[niks] no
[niks] not syphillis
[saimakm] ok
[niks] that causes aneurysm of aorta
[saimakm] right tnx
[niks] cystic medial necrosis
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[niks] marfans
[niks] ehler danlos
[saimakm] or ehlors
[niks] yea
[niks] cu deficiency too
[shanmu] cu deficiency
[niks] also pregnanacy
[niks] good shanmu
[shanmu] tx
[niks] what does amyloidosis lead to in heart
[perhaps] restrictive cardiomyopathy
[niks] v good
[perhaps] What ECG change is seen in hypercalcemia?
[niks] ok if apatient has long standing rheumatiod arthritis...which cardio vasc disorder will develop
[usmle.doc] shortened qt interval
[perhaps] yes
[perhaps] amyloid will build up for long standing inflammatory like RA
[niks] yes...
[niks] types of coarctation of aorta?
[usmle.doc] perductal and post ductal
[usmle.doc] in turnes it is preductal
[saimakm] pre and post ducta
[niks] yes...and preductal associated with which syndrome?
[usmle.doc] turners
[niks] good
[perhaps] patient has hypertrophic cardiopathy, took nitroglycerin, how will the murmur change?
[niks] pressure diff in upper and lower pulese in which one?
[usmle.doc] post ductal
[niks] yea...
[saimakm] arm
[niks] murmur will not change...?
[perhaps] it will increase the murmur and make symptoms worse. now vein dilate, less volume, worse occlusion. (Should not Rx I guess)
[niks] oh wow...thanks...
[perhaps] sure
[saimakm] great
[niks] hey perhaps
[niks] I think its the opposite
[perhaps] ?
[niks] like on lying it should worsen
[niks] Im not sure...
[perhaps] i think standing worse in hypertrophic, but better in marfan MVP
[niks] increased venous return will worsen or improve?
[perhaps] increase vein retrun will better, since more blood in the ventricule, sort of kick the block or something
[niks] oh ok
[niks] thanks
[perhaps] what is marantic vegetation associated with outside of heart?
[niks] and can you explain MVP...why it will it get better on standing
[usmle.doc] debilitating disease
[perhaps] good, also colon pancreas tumor
[usmle.doc] which drugs should be avoided in hypertrophic cardiomyopathy
[perhaps] diagoxin
[saimakm] digitalis
[usmle.doc] yes digoxin and vasodilators
[perhaps] niks, for MVP, I need to check
[saimakm] and other vasodil
[niks] thanks perhaps..I'll wait
[usmle.doc] yes
[perhaps] I am wondering if in MVP, if more volume load, the valve has to work harder, and more likely to prolapse backwards? Not too sure
[niks] I was thinking the same too...nevermind it makes sence
[niks] thanks
[perhaps] cool
[niks] where is the deffect in bradyarrythmias
[niks] SA node, AV node or bundle of his?
[perhaps] SA?
[niks] good
[saimakm] pt. with mental retardation,angiomyolipoma and heart tumor diagnosis?
[niks] any rate less than 50 per minute...its always SA responsible
[usmle.doc] tuberous sclerosis
[saimakm] good
[usmle.doc] ok
[niks] what is elevated in type 4 hyperlipidemia
[usmle.doc] vldl
[niks] yea...
[niks] its the most common one
[usmle.doc] yes
[perhaps] pink upper extremeties but cyanotic in legs, what is Dx?
[niks] coarctation
[saimakm] coarctation
[perhaps] PDA?
[usmle.doc] pda with reversal
[perhaps] coarctation is difference of blood pressure, PDA has misxed venous yes
[niks] PDA is cynotic very late in its course
[perhaps] good usmle.doc
[niks] yes youre right perhaps
[perhaps] yes, it is late
[niks] which conditios for early cynosis
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[saimakm] rt to left shunt
[niks] hint....3Ts
[usmle.doc] tetralogy of fallot tricuspid atresia transposition of grt vessels
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[perhaps] trancus
[usmle.doc] and persistent truncus arterious
[niks] yes correct
[niks] tricuspid atresia...not sure?
[niks] rest three all correct
[usmle.doc] ok
[niks] what if you see apatient with capillary hemangioma...what will u suggest...resct or what?
[saimakm] do nothing
[niks] yes...
[niks] leave it as such
[niks] kawasaki assoociated with what
[perhaps] What is the MC congenital heart disease?
[usmle.doc] vsd is the most common congenital hear disease?
[niks] VSD?
[perhaps] Kawasaki coronary artery aneurysm
[niks] yes
[perhaps] yes VSD
[niks] a patient with high blood glucose has a cerebral abscess...what might be the cause?
[saimakm] asper****osis
[niks] hmm
[perhaps] mucor?
[niks] yes perhaps
[saimakm] ok
[niks] v good
[niks] mucor mycosis
[niks] of frontal sinus
[perhaps] what are the risk factors for liver angiosarcoma?
[niks] this is very common in diabetic ketoacidosis
[perhaps] yes
[usmle.doc] vinyl choloride arsenic and thoratrast
[perhaps] good
[perhaps] Patient has cavernous hemangioma of liver, bilateral renal adenocarcinoma, cerebellum tumor, what syndrome?
[niks] pathogenesis of aneurysm in syphillis?
[usmle.doc] vasculitis of vasa vasorum?
[niks] yes right
[usmle.doc] so weakening of the aorta
[niks] whats the answer perhaps....?
[perhaps] von Hipple Lindau
[usmle.doc] vhl
[niks] ohh!!
[mlemle01] What are you going to discuss tomorrow?
[niks] shall we discuss endocrine....?
[mlemle01] Ok, from Goljan?
[niks] yes it goes from golajn
[perhaps] good
[mlemle01] Thanks
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[saimakm] ok good night
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[niks] berry aneurysm associated with?
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[niks] ??
[usmlethings] Polycystic Kidney ds
[niks] yea
[niks] and which part of heart involved in hepatic carcinoid?
[perhaps] right side
[usmle.doc] right side of the heart
[niks] right or left?
[niks] good
[usmle.doc] the endocardium and the valves
[niks] lung acrcinoid?
[niks] which part in lung carcinoid?
[niks] its the left part
[usmle.doc] left
[niks] yea...
[usmle.doc] ok
[niks] there occurs fibrosis of endocardium in carcinoid
[usmle.doc] yes
[niks] what cardiac abnormalities in marfans?
[usmle.doc] mvp dissecting aortic aneurysm ar
[niks] good...
[niks] other than heart which abnorm in marfans?
[perhaps] lens dislocation, spider fingers etc,
[niks] yea...skeletal and ocular
[niks] mutation of dystrophin gene causes what?
[niks] ??
[perhaps] Duncheon MD
[niks] yes...
[niks] the gene is located on X chromosome
[niks] ok which is the leading cause of acquired heart disease in USA
[perhaps] dietary and life style?
[niks] no
[usmlethings] Hypertension
[niks] no
[usmlethings] obesity
[niks] its kawasaki syndrome!!
[perhaps] oh. that.
[niks] 20% have the cronary vessel damage
[niks] yea..
[perhaps] why do women on birth control pill have risk of hypertention?
[niks] what happens to the luminal diameter in monkeberg
[perhaps] not changed?
[niks] because of increased viscosity of blood?
[niks] yes perhapse..excellent
[perhaps] Estrogen increase liver synthesis of angiotensinogen.
[niks] oh...
[usmle.doc] ok
[niks] also increased coagulopathy..?
[perhaps] his old note page 54. I agree with the coagulation too niks
[niks] ok thanks
[niks] early severe atherosclerosis in infants...whats the cause?
[niks] aortic atherosclerosis...
[niks] whats the underlying cause
[niks] ??
[usmlethings] Type II Hyperlipidemia?
[niks] yes...familial hyperlipedimias and Diabetese mellitus
[perhaps] you mean the infant has both or one of either?
[niks] pain increases on leg extension...diagnosis
[niks] both perhaps
[usmle.doc] tao
[perhaps] thanks!
[niks] whats tao?
[niks] whats tao usmle.doc?
[usmle.doc] thromboangitis obliterans is the pain increases in that due to vascular claudication
[niks] nono..the answer is DVT
[usmle.doc] ok then is it the homans sign
[niks] tao occurs in the extreme ends like thumb or toe...right?
[niks] yea its the homan's sighn
[niks] where does thrombophlebitis most commonly occur?
[usmle.doc] pelvic and femoral veins
[niks] yes...
[niks] the deep viens
[usmle.doc] ok
[niks] most common primary cardiac tumor in adults?
[niks] and children?
[usmle.doc] atrial myxoma
[niks] yea
[usmle.doc] rhabdomyoma
[niks] and chlidren
[niks] good
[niks] most common cause of SIDS
[niks] ??
[perhaps] lying face down. smoking is bad too
[niks] hmm...what I read is right ventricular hypertrophy
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[perhaps] oh yes, I remember that. thanks
[niks] because of a septal defect
[niks] ok
[perhaps] but i forgot the septal defect part..
[niks] yes a VSD is there
[perhaps] i see now
[niks] and then a rt vent hypertrophy
[niks] which causes SIDS
[perhaps] thank you
[niks] oh..my pleasure
[niks] fragile X syndrome...what cardiac condition?
[niks] MVP and another one...
[niks] ??
[niks] aortic root dilatation
[niks] ok guys..I gotto go..thats all
[usmle.doc] ok thank u niks
[niks] thanks to u too
[niks] shall we take endo tomorrow?
[perhaps] thanks for the qs very nice!
[niks] I shall inform joe too
[perhaps] endo is good
[niks] thanks to u too perhaps
[niks] we will discuss all HY facts...ok?
[niks] I shall write to joe about endo for tomorrow
[niks] also in the forum
[niks] bye..gnight.
[perhaps] yes HY stuff. cool thanks
[usmlethings] Thanks guys!!
[perhaps] bye you take care!
[perhaps] thanks everyone
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