i’m horrible at tag. i’m not fast or agile and i always end up as IT fruitlessly chasing bright t-shirts over and around the jungle gym that manage to *just* evade my outstretched fingertips. come on now. how uncivilized. let’s sit down and play Scrabble instead.
so that’s my excuse. if you’ve ever tagged me for something blog-related in the past, i probably didn’t notice or didn’t play along. sorry.
if Brigette wasn’t going to be knocking on my door in a little over a month, i might have shamelessly ignored the tagging i just noticed today. as it is, i’m counting on her to bring me some more red licorice, so i guess i should play nice. the rules say “you are supposed to write a note with 25 random things, facts, habits, or goals about you”, but since i do that every day and since i’m supposed to be studying for pathology right now, you get 25 things from an online question bank. here goes…
Rules: Once you’ve been tagged, you are supposed to write a note with 25 random things, facts, habits, or goals about you. At the end, choose 25 people to be tagged.
1. Atherosclerotic aortic aneurysms are typically located in the abdominal portion below the renal arteries.
2. Patients with systemic lupus erythematosus can develop Libman-Sacks endocarditis, but the vegetations are never large and they rarely embolize, so the endocarditis is not clinically significant in most cases.
3. Tetralogy of Fallot producces a right-to left shunt with cyanosis from mixing of right heart blood with left heart blood.
4. Troponin I can be elevated within a few hours of a myocardial infarction, similar to the CK-MB.
5. Malignant hypertension is often preceded by chronic hypertension that leads to left ventricular hypertrophy.
6. A bioprosthesis heart valve has the advantage of not requiring anticoagulation, but it does not wear well with time, and typically must be replaced within 5 to 10 years when its leaflets undergo progressive calcification leading to stenosis.
7. Kev tagged me with a “7 things” meme that i forgot about until just now.
8. The most common cause for a primary myocarditis is a virus (such as Coxsackie virus).
9. Staphylococcus aureus and Pseudomonas aeruginosa are the most likely organisms to be found in infective endocarditits with a history of injection drug use.
10. Uncorrected ventricular septal defects eventually lead to pulmonary hypertension and reversal of the shunt (Eisenmenger complex).
11. The most common valves involved in rheumatic fever are mitral and aortic.
12. A tear in the aortic intima is followed by dissection of blood outward, often to the thoracic cavity, with fatal hemothorax.
13. The most common cardiac defect is a VSD.
14. Although bicuspid aortic valves are present from birth, they do not manifest with significant calcification and stenosis until later adult life.
15. Pancreatic cancers can be associated with a hypercoagulable state (Trousseau’s syndrome) with formation of marantic cardiac valvular vegetations.
16. Atrial myxomas are more often on the left. Though benign, they can occlude the mitral valve and produce sudden loss of cardiac output.
17. A ‘paradoxical embolus’ from a deep vein thrombosis can enter the brain if there is a defect that allows passage from right-to left. This can happen across a patent foramen ovale.
18. Contraction band necrosis has been associated with sudden death and cocaine use. It is thought that it may be mediated by high norepinephrine levels.
19. A primary reason for putting a patient with an acute myocardial infarction in hospital is to prevent arrhythmias.
20. 75% arterial narrowing is the point at which coronary occlusion becomes very serious.
21. In temporal arteritis the elevation of the sed rate is way out of proportion to the extent and amount of inflammation in this one arterial segment.
22. Myofiber disarray is the key feature of hypertrophic cardiomyopathy, an uncommon condition.
23. Mitral valve prolapse can be associated with Marfan’s syndrome.
24. Contraction band necrosis is an initial change as the myocardial fibers begin to die.
25. The cardiomyopathy of chronic alcohol abuse has a dilated or congestive appearance.
i only included snippets from answers i got right. and yes, we’re studying cardiopathology (along with pulmonary and renal) this block. if anyone read that entire list from top to bottom, i will fall off my chair in amazement.
now do you see how exciting my life is? so glamorous. i can’t deny it.
you’re it: Tracy, Beach Bum, Andrea, BCWB, Gio, Wyn, Lauren, Kendra, Kev, Pat, Maggie, Faye, Chad, MzMullerz, Dan, ApK, Kristin, Robyn, Janelle, Tim, White Girl, shisnit, Darlene, Darren, Dr. K, JennW, Michelle, and Mike. whoops. that’s 28.
You can fall off your chair, because I read the entire list. :)
Thanks for the tag. I’ve lapsed lately on the blog, this gives me some incentive. :)
Actually I DID read your list! I’m post-call today and am sitting in a Starbucks studying for USMLE Step 3, which I will be writing in a month. In case you need some motivation: studying for Step 3 is much more fun (and a lot less pressure as an IMG)than Step 1, or even Step 2. Enjoy your final months on the island!
yay! it’s fun to be tagged. :)
I read the whole list only because it reminds me partly of studying for MRCP Part 1 and helps a little with Part 2!
I’ve also thought of 25 random things that happened to me today :)
I read the whole thing! It was interesting, and made me realize just how much I need to learn! (I did know numbers 1, 3, 4, and 14 already though, yay).
My physiology flash cards are calling…
I will be the ONLY honest one and say that my eyes started crossing at #3 and was doubting if I was actually retarded in the brain. But! Good list, and this can only prove you will be an excellent doctor.
What’s more fascinating is learning how to manage each of those things on the list :) Here are some questions that you ought to consider:
3. How do you surgically correct ToF? What EKG findings would suggest/correlate with ToF?
4. If you suspect a reinfarction, and you could only order a single lab test, which one would it be? What EKG findings are associated with an (evolving) MI?
5. Before a patient is diagnosed with malignant HTN, what diagnostic tests would you order?
6. When would you suggest a bioprosthetic valve versus a mechanical valve? With the mechanical valve, what is the target INR you want to maintain?
8. How do you diagnose myocarditis, and what is the treatment if you’re thinking it’s viral-related? What EKG findings are typical with myocarditis?
9. What valve(s) are most often involved? What antimicrobial drugs do you use? When would surgical intervention be necessary?
10. What drugs can be used for pulmonary HTN?
11. What clinical signs/symptoms would you see in rheumatic fever?
12. How do you categorize aortic dissections? Who is the oldest person to be treated for an aortic dissection?
14. What is the most common type of heart failure associated with bicuspid aortic valves?
15. What type of pancreatic cancer is most commonly associated with marantic endocarditis? Where on the pancreas are these most often found? What is the surgical treatment for pancreatic cancer? What is the mortality rate?
16. What EKG findings would correlate with a left atrial myxoma?
17. What is the surgical treatment for a PFO? What specific diagnostic test would you run?
18. What is the medical management of cocaine-induced chest pain?
19. What type of arrhythmias are most commonly associated with an MI? What medications do you use to reduce morbidity and mortality? Name the clinical studies associated with the latter.
20. When would you select medical versus surgical management? When is a drug-eluding stent (DES) more preferable versus a bare-metal stent? How do DES’ work? What medication must a patient be on? What is the major complication of stopping that medication? How do you manage that patient if they’re on that medication, and present with bright-red blood per rectum?
21. What clinical signs/symptoms are associated with temporal arteritis? What is the medical management?
23. What other major structures are associated with Marfan’s? What other valves are associated? When auscultating the heart, what are you expecting to hear? What other disease has an associated lens dislocation in the opposite direction? What medications should Marfan’s patients be on?
25. What type of heart failure do alcoholic cardiomyopathy patients typically develop? What is the treatment?
Sorry for the super long post, but these are some very typical questions that you WILL be asked somewhere along the course of your training (and on your block exams, Step 1, 2 and 3, and specialty boards). Enjoy :)
I will be making my list either tonight or tomorrow morning. I really enjoyed reading your list today because it made me feel like I am not waisting time and was actually reminded of a few things : )
[...] 25 things [...]
I read it top to bottom too- quite possibly the most I’ve studied in a very long time. And it scared me.
I was too scared to look at more than the first three lines of Langdon’s comment.
[...] i’m studying cardiovascular all week in prep for the comprehensive final. as such, i figured this would be a good time to tackle one of the comments from the “25 things” post. [...]