155 - cardiac tamponade mcqs - part 2

6q: which of the following raises the suspicion of cardiac tamponade ?

a. unexplained enlargement of the cardiac silhouette
b. reduction of the amplitude of the QRS complexes
c. electrical alterans of the P,QRS or T waves
d. all the above

answer d . all the above .

7q: what is pulsus paradoxus or paradoxical pulse ?

a. greater than normal ( 10 mm Hg ) inspiratory decline in systolic arterial pressure
b. greater than normal ( 10 mm Hg ) inspiratory increase in systolic arterial pressure
c. greater than normal ( 10 mm Hg ) expiratory decline in systolic arterial pressure
d. greater than normal ( 10 mm Hg ) expiratory increase in systolic arterial pressure

answer a . greater than normal ( 10 mm Hg ) inspiratory decline in systolic arterial pressure .

8q: paradoxical pulse or pulsus paradoxus is seen in which of the following conditions ?

a. hypovolemic shock
b. acute obstructive airway disease
c. chronic obstructive airway disease
d. pulmonary embolus
e. cardiac tamponade
f. constrictive pericarditis
g. all except b
h. all except f
i. all of the above

answer h. all of the above . pulsus paradoxus can be observed in one third of patients with constrictive pericarditis . it is also a feature of bronchial asthma .

9q: diagnostic procedure of choice to diagnose cardiac tamponade ?

a. echocardiography
b. X ray
c. ECG
d. MRI

answer a . echocardiography . since immediate treatment of cardiac tamponade can save the life of the patient , it is important to diagnose it early by echocardiography .

10q: what is the treatment of choice to treat a patient with pericardial tamponade ?

a. pericardiocentesis
b. defibrillation
c. conservative treatment
d. opening the thorax surgically and draining the fluid

answer a . pericardiocentesis . echocardiography guided pericardiocentesis using an apical , parasternal or subxiphoid approach must be carried out at once as reduction of the elevated intrapericardial pressure may be lifesaving .