Cardiovascular System : Physical Examination-I

Cardiovascular System : Physical Examination-I

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What amount of deoxyhemoglobin required to produce central cyanosis?

Correct! Wrong!

ANSWER -A
It is classically described that - 5.0 g/dL of deoxyhemoglobin or greater is required to produce central cyanosis. This was based on an estimate of capillary saturation based on a mean of arterial versus peripheral venous blood gas measurements.
Since estimation of hypoxia is usually now based either on arterial blood gas measurement or pulse oximetry, this is probably an overestimate, with evidence that levels of 2.0 g/dL of deoxyhemoglobin may reliably produce cyanosis.

Cyanosis of the lower extremity but not involving the upper extremity and the head is called –

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ANSWER -B
Differential cyanosis is the bluish coloration of the lower but not the upper extremity and the head.
Differential cyanosis refers to isolated cyanosis affecting the lower but not the upper extremities in a patient with a large patent ductus arteriosus (PDA) and secondary pulmonary hypertension with right-to-left to shunting at the great vessel level.

Differential Cyanosis is seen in which of the following condition?

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ANSWER -C
Patients with a large ductus develop progressive pulmonary vascular disease, and pressure overload of the right ventricle occurs. As soon as pulmonary pressure exceeds aortic pressure, shunt reversal (right-to-left shunt) occurs. Cyanosis of Lower Limb Appears.
The upper extremity remains pink because the brachiocephalic trunk, left common carotid trunk and the left subclavian trunk is given off proximal to the PDA. This is called Differential Cyanosis.

Malar Flush may be seen in cases of advanced –

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ANSWER -C
Malar flush is a plum-red discolouration of the high cheeks classically associated with mitral stenosis due to the resulting CO2 retention and its vasodilatory effects. Also Called Malar telangiectasias.

Palmar crease xanthomas are specific for which type hyperlipoproteinemia –

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ANSWER -C
Type III hyperlipoproteinemia - Two types of skin signs - palmar xanthomata or orange discoloration of skin creases, and tuberoeruptive xanthomata on the elbows and knees. It is characterized by the early onset of cardiovascular disease and peripheral vascular disease.
Xanthomas on the palms of the hands, a condition called xanthoma striata palmaris, is specific to hyperlipoproteinemia type III and has not been reported in any other disorder.

Which is called broad beta disease ?

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ANSWER -C
Type III hyperlipoproteinemia Also known as broad beta disease or dysbetalipoproteinemia. Most common cause for this form is the presence of ApoE E2/E2 genotype.

Frederickson Classification is for –

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ANSWER -B
Frederickson Classification of dyslipidemias The most common dyslipidemias are types IIA, IIB, and IV.

Cobblestoned appearance of the skin in the axilla and neck creases seen in –

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ANSWER -C
Pseudoxanthoma elasticum, a disease associated with premature atherosclerosis, is manifested by a leathery, cobblestoned appearance of the skin in the axilla and neck creases and by angioid streaks on funduscopic examination.

Extensive lentiginoses in skin with multiple atrial myxomas are found in –

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ANSWER -A
Carney complex and its subsets LAMB syndrome and NAME syndrome are autosomal dominant conditions comprising myxomas of the heart and skin, hyperpigmentation of the skin (lentiginosis), and endocrine overactivity.

Carney triad is characterized by all of the following EXCEPT –

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ANSWER -D
Carney triad (CT) is characterized by the coexistence of three types of neoplasms, mainly in young women, including gastric gastrointestinal stromal tumor, pulmonary chondroma, and extra-adrenal paraganglioma.

LUPUS PERNIO is pathognomonic of which condition –

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ANSWER -D
Lupus pernio is a chronic raised indurated (hardened) lesion of the skin, often purplish in color. It is seen on the nose, ears, cheeks, lips, and forehead. It is pathognomonic of sarcoidosis.

All of the following are correct for Lupus pernio EXCEPT –

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ANSWER -B
Lupus pernio is associated with poor outcomes and lower rates of resolution.

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