Anatomy
Pharm
Could Be Anything
Blood Obstructions
Diagnostics/Imaging
100
A pleural effusion happens when fluid accumulates between what 2 membranes?
Between the lining of the lungs and the thoracic cavity (i.e., the visceral and parietal pleurae).
100
How is heparin administered?
Parenteral IV or SC - bc oral is low
bioavailbility
100
Which coagulation factor is inhibited by drugs such as apixaban and rivaroxaban?
"Ban" Factor Xa
100
List 3 symptoms of a PE
sudden-onset dyspnea, tachypnea, pleuritic chest pain
100
What’s the imaging test of choice for PE?
CT pulmonary angiography- filling defects seen
200
What are the 3 layers of the pericardium in order of outer to inner?
Fibrous pericardium parietal pericardium, epicardium (visceral)
200
What should you monitor with heparin use?
PTT - intrinsic pathway
200
Name the condition that presents with nutmeg liver, and no JVD.
Budd Chiari syndrome
200
What is the most common etiology of a PE
DVT
200
How can you best visualize the left atrium?
Transesophageal echocardiography
the left atrium is the posteriormost part of the heart, located directly in front of the esophagus. It can be visualized using TEE
300
What is the embryological remnant of the Ductus Arteriosus?
Ligamentum Arteriosum
300
Does heparin cross the placenta?
No
(warfarin does however --> teratogenic)
300
What are the two types of fluid in pleural effusion?
Fluid that permeates into the pleural cavity through intact pulmonary vessels, e.g., in congestive heart failure (CHF), is called a transudate.
Conversely, fluid that escapes into the pleural cavity through lesions in blood and lymph vessels, e.g., due to inflammation or tumors, is called an exudate.
300
What's the name of the PE that occurs when a blood clot lodges at the bifurcation of the pulmonary trunk as it splits into R and L pulmonary arteries?
Saddle thrombus (PE)
300
What type of imaging is typically used to diagnose pleural effusion?
Pleural effusion is often diagnosed using chest x-ray and ultrasound, but chest CT may be used for very small effusions
400
What are the names of the muscles in the atria?
Pectinate muscles
400
What is the mechanism of action of heparin?
Activates antithrombin, which decreases action primarily of factors IIa and Xa
400
What are the vessels in the umbilical cord and what's their oxygenation state?
1 vein - carry nutrients and O2 from placenta to baby
2 arteries - carry waste from baby to placenta
400
What makes the Virchow triad?
Stasis, hypercoagulability, endothelial damage (exposed collagen triggers clotting cascade)
400
The imaging test of choice for DVT is:
Compression ultrasound with doppler
500
Which vessel is the external iliac vein an upward continuation of?
Femoral veins
500
What are the contraindications of thrombolytics? (at least 4)
Active bleeding, history of intracranial bleeding, recent surgery, known bleeding, diathesis, or severe HTN
500
What embryonic structure becomes the smooth parts of the left and right ventricles?
Bulbus cordis
500
What are 3 main symptoms of DVT?
Swelling, Homan's sign (calf pain on dorsiflexion of foot), warmth, erythema
500
What can a high D-dimer indicate, and what is the next step?
DVT possible - proceed to US