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[{"id":519946,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:32:24","updated_at":"2018-08-10 05:32:24","questionName":"Uremic pericarditis occurs in patients with uremia who have received dialysis","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519957,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:40:28","updated_at":"2018-08-10 05:40:28","questionName":"The most common type of Atrial fibrillation ","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Types \n\uf0b7 Valvular atrial fibrillation: usually associated with rheumatic heart disease due to MS or MR with left atrial enlargement; *the most common type in our setting*\n\uf0b7 Isolated atrial fibrillation: secondary to another illness (hyperthyroidism, PNA, PE, etc.)\n\uf0b7 Lone atrial fibrillation: age < 65, no history of stroke or HTN, no structural heart disease\n\uf0b7 Paroxysmal atrial fibrillation: intermittent (less than 24 hours) \uf0b7 Persistent atrial fibrillation: lasts > 7 days or requires cardioversion \uf0b7 Chronic atrial fibrillation: atrial fibrillation is the predominant rhythm \uf0b7\n*paroxysmal, persistent, and chronic afib have the same risk of stroke","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519947,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:33:21","updated_at":"2018-08-10 05:33:21","questionName":"usually associated with rheumatic heart disease due to MS or MR with left atrial enlargement","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Types \n\n\uf0b7 Valvular atrial fibrillation: usually associated with rheumatic heart disease due to MS or MR with left atrial enlargement; *the most common type in our setting*\n\uf0b7 Isolated atrial fibrillation: secondary to another illness (hyperthyroidism, PNA, PE, etc.)\n\uf0b7 Lone atrial fibrillation: age < 65, no history of stroke or HTN, no structural heart disease\n\uf0b7 Paroxysmal atrial fibrillation: intermittent (less than 24 hours) \uf0b7 Persistent atrial fibrillation: lasts > 7 days or requires cardioversion \uf0b7 Chronic atrial fibrillation: atrial fibrillation is the predominant rhythm \uf0b7\n*paroxysmal, persistent, and chronic afib have the same risk of stroke","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519944,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:30:43","updated_at":"2018-08-10 05:30:43","questionName":"The three most common types of shock are","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Types of Shock: 1.\n3. Hypovolemic* \u2013 due to loss of fluid or blood\n2. Cardiogenic* \u2013 due to decreased cardiac contractility Septic* - due to infection\n4. Anaphylactic \u2013 due to allergic reaction 5.\nObstructive \u2013 due to decreased blood flow to the left ventricle as in cardiac tamponade or PE\n6. Endocrine - Adrenal Insufficiency, pituitary failure etc","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519949,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:34:51","updated_at":"2018-08-10 05:34:51","questionName":"The second most common valve findings in rheumatic heart disease is","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Mitral stenosis is most common finding, followed by aortic stenosis. Some studies suggest that over 70% of MS is caused by RHD. Even though stenosis occurs 10-20 years after infection symptoms may be delayed as late as 40 years. If antibiotic treatment is not adequate in ARF (not available vs. more virulent strains causing earlier adhesion of leaflets), onset of symptoms often occurs earlier.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519956,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:40:01","updated_at":"2018-08-10 05:40:01","questionName":"The most valvular disease are","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"The most valvular diseases are \n\uf0b7 Rheumatic, \n\uf0b7 Congenital or \n\uf0b7 Degenerative.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519948,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:34:11","updated_at":"2018-08-10 05:34:11","questionName":"The term cardiomyopathy should be restricted to the conditions which primarily affect the myocardium.","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"The cardiomyopathies are a group of diseases that primarily effect the heart muscles and are not the result of congenital, acquired valvular, hypertensive, coronary arterial, or pericardial abnormalities.\n\uf0b7 The term cardiomyopathy should be restricted to the conditions which primarily affect the myocardium.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519952,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:37:42","updated_at":"2018-08-10 05:37:42","questionName":"The only reliable sign of HTN is the blood pressure","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Symptoms\/Signs Most patients with HTN are asymptomatic! Symptoms and signs develop only with complications of HTN or in cases of secondary HTN. The only reliable sign of HTN is the blood pressure.\nMeasuring the BP \u2013 The blood pressure cuff must be large enough so that the bladder of the cuff encircles the arm + 30%! If the cuff is too small the blood pressure will be falsely elevated.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519945,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:31:42","updated_at":"2018-08-10 05:31:42","questionName":"This is an irregularly irregular rhythm in which the atria depolarize chaotically and are not able to properly contract.","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"ARRHYTHMIAS (emphasis on Atrial Fibrillation) Definition: Abnormality in cardiac conduction that can manifest as either change in rate or rhythm\nTypes and etiologies Bradyarrhythmia: any rhythm that results in a ventricular rate of less than 60 beats per minute.\n\nSinus bradycardia: sinus rate of less than 60 beats\/minute. Has normal P wave configuration consistent with origin in sinus node area. Etiology: increased vagal tone, hypothyroidism, ischemia, medication such as digoxin, beta blockers, calcium channel blockers\nAV Block\n\uf0b7 1st degree: conduction delay within AV node, with prolonged PR interval on ECG > 200 msec. Etiology: medication, CHF, ischemia, electrolyte abnormalities. No therapy needed.\n\uf0b7 2nd degree Type I (Wenckebach): progressive PR interval prolongation before a blocked or dropped beat. Etiology: medication, electrolyte abnormalities, ischemia. If symptomatic, can give atropine.\n\uf0b7 2nd degree Type II: abrupt AV conduction block without evidence of PR prolongation. No change in PR interval and then sudden dropped beat. Etiology: ischemia, conduction system disease. Need pacemaker.\n\uf0b7 3rd degree: dissociation of atrial beats and ventricular beats. Atrial impulses fail to conduct to the ventricle. And ventricle is beating on its own with a slower rate. Etiology: medication toxicity, ischemia, infiltrative disease (sarcoid, amyloid), Lyme disease, Chagas disease. Need pacemaker.\nTachyarrhythmia: any rhythm with a rate in excess of 100 beats per minute\n\uf0b7 Narrow Complex Tachycardia or Supraventricular (narrow QRS < 120 msec) o Sinus Tachycardia. Etiology: pain, fever, hypovolemia, hypoxia, anemia, anxiety, thyroid disease; rate not greater than 220-age\no AV nodal reentrant tachycardia (AVNRT): reentrant circuit using AV node and accessory pathway, rate can be > 150.\no Atrial flutter: macro-reentry usually within right atrium (atrial rate is 300 and usually conducts 2:1 for HR = 150)\no Atrial fibrillation: see below for more\n\uf0b7 Wide Complex Tachycardia (wide QRS > 120 msec) o Ventricular tachycardia: monomorphic (QRS all the same size) or polymorphic Etiology: ischemia, cardiomyopathy, structurally abnormal heart, prior MI\n\nAtrial Fibrillation Definition: Most common arrhythmia for which patients seek treatment. This is an irregularly irregular rhythm in which the atria depolarize chaotically and are not able","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519943,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:29:18","updated_at":"2018-08-10 05:29:18","questionName":"We treat HTN because it is a major risk factor for stroke, MI, CCF, CKD, retinopathy and peripheral vascular disease","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519951,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:36:58","updated_at":"2018-08-10 05:36:58","questionName":"The presence of severe disease tends to reflect recurrent episodes of acute rheumatic fever","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"This is disease of the poor, the overcrowded and the poorly housed. The presence of severe disease tends to reflect recurrent episodes of acute rheumatic fever. In most patients with carditis, if the recent attacks could be prevented they would eventually lose their murmur and the heart would return to normal or near normal.\nWorldwide an estimated 10-20 million people get acute RF yearly. Rheumatic heart disease is the most common cause of valvular heart disease in the world. Most common in children ages 4-9 years old, but adults can get acute rheumatic fever also.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519950,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:35:22","updated_at":"2018-08-10 05:35:22","questionName":"The risk of hypertensive complications decreases continuously throughout the BP range.","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519954,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:38:57","updated_at":"2018-08-10 05:38:57","questionName":"The most valvular disease are","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"The most valvular diseases are \n\uf0b7 Rheumatic, \n\uf0b7 Congenital or \n\uf0b7 Degenerative.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519953,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:38:19","updated_at":"2018-08-10 05:38:19","questionName":"The most valvular disease are","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"The most valvular diseases are \n\uf0b7 Rheumatic, \n\uf0b7 Congenital or \n\uf0b7 Degenerative.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":519955,"quiz_id":"26312","answer_id":null,"answerType_id":"0","created_at":"2018-08-10 05:39:27","updated_at":"2018-08-10 05:39:27","questionName":"The most common valve findings in rheumatic heart disease is","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Mitral stenosis is most common finding, followed by aortic stenosis. Some studies suggest that over 70% of MS is caused by RHD. \n\nEven though stenosis occurs 10-20 years after infection symptoms may be delayed as late as 40 years. \n\nIf antibiotic treatment is not adequate in ARF (not available vs. more virulent strains causing earlier adhesion of leaflets), onset of symptoms often occurs earlier.","question_score_id":null,"lang":null,"questionAudioPath":null}]