These are the answers for the questions covering endocarditis, pericarditis, venous and arterial disorders. You can find the review questions here and you can find the article and podcastat if you click on the links above.
1. The answer is B obtain blood cultures. The description leads you to think endocarditis
- If you’re concerned about endocarditis observation is a bad pan
- Blood cultures an ECG and an echo all make sense to me
- I would not start antibiotics with just the information listed in the question. You can start them without a confirmed diagnosis, but there isn’t much information yet.
- This patient may require surgical intervention, but not before a more thorough workup is completed.
2. The answer is A. Giant cell arteritis
3. The answer is A.
- OCP + smoking + surgery + immobilization + severe swelling = DVT until proven otherwise. You can prove it with an U/S (the cast can be exchanged for a splint in the short term)
- A D-dimer can only rule out an DVT and is not nearly as helpful as an u/s
- A DVT is a serious situation and requires intervention.
- Although aspirin may be a good idea to help prevent a DVT once the patient has one adding it alone to her medications is not going to be enough.
4. The answer is D. According to the Duke criteria you must have either two major criteria, one major criteria and three minor criteria or five minor criteria.
5. pain, pallor, pulselessness, paresthesias, poikilothermia (cold), paralysis
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