Answer the USMLE practice questions below!

These are the USMLE Content Outline topics that this video covers:

• Diseases of the Myocardium
• Diseases of the Pericardium
• Infectious disorders: Endocarditis

Leave a comment below!

HyGuru High Yield Points

1) -      The patient in the question has bacterial endocarditis likely caused by an oral pathogen that disseminated after a dental procedure most commonly viridans strep, usually low virulence that had a predilection for this man’s repaired aortic valve.

-      Viridans strep which includes strep mutans and mitis is alpha-hemolytic and optochin resistant unlike it’s alpha-hemolytic counterpart strep pneumonie which is optochin sensitive. 

2) -      This case happened to me in residency- a toddler with the characteristic rash of hand-foot-mouth disease caused by coxsackievirus who developed myocarditis. He had the clinical findings of cardiac dysfunction including poor distal perfusion and pulmonary edema. Endeavoring to stabilize his blood pressure, we administered a normal saline bolus which, of course, worsened his cardiac dysfunction.

-      Let this be a lesson

o  Consider the differential of shock in order to understand your strategy for treatment.

o  Always reassess vital signs after an intervention to ensure the desired outcome

3) -      The patient in the question has the characteristic malar rash of systemic lupus erythematosus and chest pain caused by pericarditis, a form of serositis which is another clinical manifestation of lupus. Lupus also causes cytopenias, any cell line, and nephritis.

-      Pericardium is innervated by the phrenic nerve. Pericarditis can therefore cause referred pain to the shoulder. It typically presents with sharp pain worsened by inspiration and alleviated by leaning forward. EKG changes include widespread ST-segment elevation and PR depression.

We hope you enjoyed this video! If you have any questions, please send an e-mail to Rahul ➡️ Rahul@hyguru.com.

Please check out our USMLE Test-Taking Strategies Course as well as our NBME Top Concepts Class to further optimize your USMLE Performance.

If you are interested in 1-on-1 tutoring, please contact Rahul directly.