Clinical Reasoning — Flashcards

Flashcard 631: What imaging technique is the preferred diagnostic imaging study for Toxic Megacolon?_____

Answer: Plain abdominal x-ray

Flashcard 632: Which diagnostic test is used to detect EBV infection?_____

Answer: Monospot test (Heterophile antibody test) aka Paul-Bunnell test

Flashcard 633: How is pulmonary capillary wedge pressure (PCWP) measured?_____

Answer: Pulmonary artery catheter (Swan-Ganz catheter)

Flashcard 634: Open-angle glaucoma is _____ (painful or painless)

Answer: painless

Flashcard 635: Lab results of S. pneumoniae meningitis include _____ CSF glucose (high or low)

Answer: low

Flashcard 636: Herpes Zoster (shingles) is said to have a "dew drops on a rose" appearance in a _____ distribution

Answer: dermatomal

Flashcard 637: What is the diagnostic cutoff for fasting plasma glucose for a diagnosis of diabetes mellitus?

Answer: ≥ 126 mg/dL (7.0 mmol/L)

Flashcard 638: Is tropical sprue associated with normal or decreased urinary excretion of D-xylose (D-xylose test)? _____

Answer: Decreased

Flashcard 639: Which electrolyte disturbance causes wide QRS and peaked T waves on ECG? _____

Answer: High K+ (hyperkalemia)

Flashcard 640: 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.