Barkley 3p’s pathophysiology, phamacotherapeutics, and physical assessment with complete solutions 2022-2023
You are auscultating Jon's chest. When he
... [Show More] sits up and leans forward, you can hear a high pitched, blowing murmur at S2. What does this type of murmur most likely indicate?
a. Mitral stenosis
b. Aortic Stenosis
c. Mitral regurgitation
d. Aortic regurgitation {{Correct Ans- d. Aortic regurgitation
Aortic regurg is soft, high pitched, blowing diastolic decrescendo that best heard at the 3rd left interspace at base. Murmur initiated w/ S2 and heard when Pt sits up and leans forward. Mitral Stenosis= low pitched diastolic rumble & doesn't radiate. Best heard in apex when in left lateral position. Aortic stenosis= loud, harsh murmur midsystole, radiated down the side of neck and down apex. Mitral regurg= loud blowing murmur heard at apex and is pansystolic.
Which of the following is the most common clinical manifestation of osteoporosis?
a. Bone deformity
b. Bone pain
c. Pathologic fracture
d. Fat embolism {{Correct Ans- a. Bone deformity
most common metabolic bone disease, is chronic, progressive, & systemic; Low bone mass and deterioration of bone tissue, = leads to increased skeletal fragility & deformity. Osteoporosis usually not apparent until AFTER a fracture; 2/3 of vertebral fractures are painless. Fat embolism from fat obstruction d/t injury or trauma & not common in osteoporosis.
A male patient requests a phosphodiesterase inhibitor to treat erectile dysfunction. Which of the following is appropriate?
a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place two or more times per week.
b. Vardenafil (Levitra), 5 mg, may be taken with a high-fat meal four hours before sexual activity
c. Sildenafil (Viagra), 50 mg, may be taken one hour before sexual activity as long as the patient has a resting blood pressure below 170/110 mm Hg
d. Avanafil (Stendra) is recommended at 50 mg for all patients, and may be taken 30 minutes before sexual activity. {{Correct Ans- a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place two or more times per week.
Which of the following is NOT part of Virchow's Triad?
a. Hypercoagulability
b. Damage to endothelial cells
c. Sympathetic tone
d. Turbulent blood flow {{Correct Ans- c. Sympathetic tone
Virchow's triad is a method of describing the three main factors that lead to a thrombosis -- sympathetic tone is not one of those and doesn't affect blood clotting.
Hypercoagulability does lead to clotting, including malignancy, trauma, sepsis, and thrombophilia. Endothelial cell damage is part of Virchow's triad bc it causes blood to clot by promoting platelet adherence to the wall of the vessels; vascular wall injury is the second aspect of Virchow's triad. Lastly, turbulent blood flow is a constituent of circulatory stasis the third component of the triad, which can be caused by atrial fibrillation, venous obstruction, and ventricular dysfunction [Show Less]