Clinical Reasoning — Flashcards

Flashcard 641: Central cyanosis typically manifests in the _____, nail beds, and conjunctiva, and other mucosal surfaces

Answer: lips

Flashcard 642: _____ antibodies are diagnostic for pernicious anemia

Answer: Anti-intrinsic factor

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

Answer: Apex (mitral area)

Flashcard 645: Which electrolyte disturbance causes wide QRS and peaked T waves on ECG? _____

Answer: High K+ (hyperkalemia)

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

Answer: Hypothyroidism

Flashcard 647: Brain arteriovenous malformations are developmental vascular lesions that present with intracranial _____, seizure, headache, or focal neurologic deficits

Answer: hemorrhage

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