Q- all of the following features may be seen in cardiac tamponade ,except
a- kussmaul's sign
b- pulsus paradoxus
c- electric alterans
d- right ventricular diastolic collapse on echo
answer is a . kussmaul's sign is seen in constrictive pericarditis , where as it is very rare in cardiac tamponade .
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Q- all of the following features are seen in cardiac tamponade , except
a- raised JVP
b- kussmaul's sign
c- rapid y descent
d- pulsus paradoxus
answer is c .
this is a tricky question . rapid y descent is a feature of constrictive pericarditis and not the cardiac tamponade . as i have already told u , kussmaul's sign is rare in cardiac tamponade , nonetheless present and so the answer is c.
cardiac tamponade is characterised by AN ABSENT OR DIMUNITIVE Y DESCENT AND A PROMINENT X DESCENT .
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solve the following case
Q- A patient presents with engorged neck veins ,BP 80/50 and pulse rate of 100 following blunt trauma to the chest ,the diagnosis is?
a- pneumothorax
b- right ventricular failure
c- cardiac tamponade
d- hemothorax
answer is c .
the characteristic triad of the cardiac tamponade is
1- raised JVP
2- rising venous pressure and falling arterial pressure
3- distant heart sounds ( quiet heart )
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when the question says something about prominent both x and y descent on JVP, the answer is constrictive pericarditis . but if the question says there is a prominent X descent and absent or dimunitive Y descent , then the diagnosis is cardiac tamponade .
the points that support the cardiac tamponade are - PULSUS PARADOXICUS , ELECTRICAL ALTERANS AND ABSENT OR DIMUNITIVE Y DESCENT .
the points that favour constrictive pericarditis are - PROMINENT Y DESCENT , KUSSMAUL'S SIGN AND PERICARDIAL KNOCK ( rare in cardiac tamponade )
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