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Clinical Review Quiz

  Review Questions: Shock with Jugular Venous Distention

Ketul Chauhan, MD, and Douglas D. Schocken, MD

Dr. Chauhan is a fellow in cardiovascular disease, and Dr. Schocken is a professor of medicine; both are at the Division of Cardiovascular Disease, Department of Internal Medicine, University of South Florida, College of Medicine, Tampa, FL.

The questions below are based on the article “Shock with Jugular Venous Distention”.

Choose the single best answer for each question.

1. What is the treatment of choice for massive right atrial thrombus with hemodynamic compromise?
  1. AngioJet aspiration
  2. Heparin plus glycoprotein IIb/IIIa inhibitors
  3. Surgical extraction of the thrombus
  4. Thrombolytics
Click here to compare your answer.

2. All of the following findings are present in cardiac tamponade EXCEPT

  1. Bilateral crackles
  2. Distant heart sounds
  3. Equalization of cardiac chamber pressures
  4. Pulsus paradoxus
  5. Rapid x and y descent on jugular venous distension
Click here to compare your answer.

3. The differential diagnosis of shock with JVD includes all of the following conditions EXCEPT

  1. Anaphylaxis
  2. Cardiac herniation
  3. Constrictive pericarditis
  4. Massive pulmonary embolism
  5. Tamponade
Click here to compare your answer.

4. Massive pulmonary embolism can commonly present with any of the following electrocardiogram manifestations EXCEPT

  1. Sinus tachycardia
  2. S1Q3T3 pattern
  3. T-wave inversion
  4. Bradycardia
  5. Right bundle branch block
Click here to compare your answer.

5. Routine treatment of right ventricular myocardial infarction includes all of the following EXCEPT
  1. Anticoagulation
  2. Evaluation for revascularization with percutaneous coronary intervention
  3. Intravenous fluids
  4. Nitrates
Click here to compare your answer.

6. Thrombolytics can be used as the treatment of first choice for any of the following pathologies EXCEPT

  1. Acute myocardial infarction
  2. Pericardial thrombus
  3. Massive pulmonary embolism
  4. Massive right atrial thrombus
Click here to compare your answer.

7 PR-segment elevation on an electrocardiogram in the setting of acute myocardial infarction indicates which of the following?

  1. Atrial infarction related to proximal right coronary artery occlusion
  2. Lower likelihood of having heart block
  3. Normal variant
  4. Pericarditis
Click here to compare your answer.

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Updated 1/04/08 • kkj