157 - cardiac tamponade mcqs - part 4

18q: all of the following are true about low-pressure tamponade except ?

a. intrapericardial pressure is increased from its slightly subatmospheric levels to + 5 or + 10 mm Hg
b. central venous pressure is normal or only slightly elevated
c. arterial pressure is unaffected
d. paradoxical pulse is present

answer d . low-pressure tamponade is characterized by the absence of the paradoxical pulse .

19q: thickened pericardium and pericardial calcification is usually seen in which of the following ?

a. cardiac tamponade
b. constrictive pericarditis
c. restrictive cardiomyopathy
d. RVMI

answer b. constrictive pericarditis

20q: cardiac biopsy may be helpful sometimes in which of the following ?

a. cardiac tamponade
b. constrictive pericarditis
c. restrictive cardiomyopathy
d. RVMI

answer c. restrictive cardiomyopathy

21q: kussmaul’s sign is present in which of the following ?

a. cardiac tamponade
b. constrictive pericarditis
c. restrictive cardiomyopathy
d. RVMI

answer b and d are answers. constrictive pericarditis and RVMI

22q: prominent x descent is rare in which of the following ?

a. cardiac tamponade
b. RVMI
c. Constrictive pericarditis
d. Restrictive cardiomyopathy

answer b. RVMI

23q: prominent y descent is absent in which of the following ?

a. cardiac tamponade
b. RVMI
c. Restrictive cardiomyopathy
d. Constrictive pericarditis

answer cardiac tamponade . prominent y descent maybe present but is rare in restrictive cardiomyopathy and RVMI ( right ventricular myocardial infarction ).

24q: a young motorist suffered injuries in a major road traffic accident . he was diagnosed to have fracture of the left femur and left humerus. He was also having fracture of multiple ribs anteriorly on both sides. On examination the blood pressure was 80/60 mm Hg and heart rate was 140 / minute. The patient was agitated , restless and tachypneic . jugular veins are distended. Air entry was adequate in both the lung fields. Heart sounds were barely audible. Femoral pulses were weakly palpable but distally no pulsation could be felt. On priority basis , the immediate intervention would be ?

a. intercostal tube drainage on both the sides
b. rapid blood transfusion
c. urgent pericardial tap
d. fracture of left femur and repair of femoral artery

answer . urgent pericardial tap . ( this question was askedin AIIMS – all Indian institute of medical scienes – delhi - NOVEMEBER 2002 paper ) .