Clinical presentation

Clinical presentation36-year-old male with a recent history of intravenous drug use presents with three days of fevers, rigors and malaiseblood culture reveals gram-positive cocci in clusters

Echocardiogram

Echocardiogram

Question #1The echodensities shown on echocardiography represent

Clusters of bacteriaCholesterol plaquePlatelet-fibrin aggregatesMesodermal hyperproliferationQuestion #2Which of the following is not a major clinical concern?

Pulmonary embolismCerebrovascular accidentMesenteric ischemiaToxic epidermal necrolysis

Question #3This histological specimen representsCross section of mitral valveVisceral pericardiumParietal pericardiumCardiac endotheliumA toenail

Question #4A 24-year-old woman was in a motor vehicle accident and is unconscious upon arrival to the hospital. An echocardiogram reveals normal left and regular function with a small pericardial effusion. Tamponade physiology is present. Blood pressure is 70/40, heart rate is 150 and she has significant jugular venous distention.

ABCDWhich arrow most likely represents this patients position on the pericardial pressure volume curve?Question #6Which of the following represents the correct reaction to the above clinical scenario?A.C.

B.D.

Question # 7The degree to which a certain amount of fluid will cause increased pericardial pressure depends uponThe compliance of the pericardiumThe rapidity with which the fluid has accumulatedThe size of the patientAll of the aboveQuestion #8Which of the following is not a major purpose of the pericardium? A. Ligamentous attachments to diaphragm, sternum and other structuresB. Regulation of blood pressureC. Barrier to infectionD. Participation in cardiac reflexes

Question #9Which one of the following organisms is least likely to cause infective endocarditis?

Streptococcus bovisStaphylococcus aureusStaphylococcus epidermidisCardiobacterium hominisQuestion #10Where is infective endocarditis least likely to occur?

Mitral valveAortic valvePulmonic valveTricuspid valve