Wednesday, January 23, 2008

53 - pulsus paradoxus

Q- pulsus paradoxus is seen in all except ?

a- IPPV
b- cardiac tamponade
c- constrictive pericarditis
d- C O P D

the answer is a . intermittent positive pressure ventilation .

normally during inspiration there is decrease in the systolic blood pressure and arterial pulse volume , but in pulsus paradoxus this decrease is greatly accentuated .

the paradox here is that in conditions like cardiac tamponade , airway obstruction and constrictive pericarditis the decrease in systolic blood pressure is so much that the pulse cannot be felt but on auscultation we can hear the heart sounds . thats the paradox here .

the conditions in which pulsus paradoxus is seen are

CARDIAC TAMPONADE

CONSTRICTIVE PERICARDITIS

C . O . P. D /ACUTE SEVERE ASTHMA

SUPERIOR VENACAVAL OBSTRUCTION .

refer harrisons book of medicine - page 1255 - 15 th edition and page 1305 - 16 th edition .

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PULSUS PARADOXUS CLINICALLY , ELECTRICAL ALTERANS ON ECG AND RVDC(right ventricular diastolic collapse) ON

ECHOCARDIOGRAPHY ARE CHARACTERISTIC FEATURES OF CARDIAC TAMPONADE .

Q- electric alterans is seen in ?

a- cardiac tamponade
b- restrictive cardiomyopathy
c- right ventricular infarct
d- constrictive pericarditis

answer is a .

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