Review - Clinical - Presentations V

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V5.5

[Block 1: The beat drops with crunchy guitars. The singers trade off rapid-fire cardiology lines.]
(Male) Aortic regurgitation, Corrigan pulse “sharp upstroke and rapid decline of the carotid pulse”, de Musset “head bobbing”, Hill sign “femoral systolic pressure more than 40 to the brachial. “Austin Flint Murmur; mid-diastolic murmur in severe (Shout) AR at the apex”
(Female) Beck triad “pericardial tamponade” low (Shout) BP, muffled heart sounds, raised (Shout) JVP. Prominent x descent, little or no y descent, paradoxical pulse
(Male) Constrictive pericarditis “prominent “y” descent, Kussmaul sign “inspiratory rise in (Shout) JVP”
(Female) Acute pericarditis “pain during inspiration and supine, friction rub”

[Block 2: The guitars switch to bright, staccato stabs. The flow gets faster, bouncing back and forth.]
(Male) Infective endocarditis “nonspecific constitutional symptoms” “new murmurs” “Osler nodes, small, painful nodules on the palmar surfaces of the fingers”
(Female) “Splinter hemorrhages in the nail beds” “Janeway, hemorrhagic macules on palms or soles” “Roth spots, central pale retinal hemorrhages” “subungual hemorrhages”
(Male) “Acute (β-Hemolytic strep, S. aureus, pneumococci) vs Subacute (low-grade fever; viridans strep, enterococci, CoNS, and (Shout) HACEK)”
(Female) Hereditary hemorrhagic telangiectasia “Osler-Weber-Rendu” (Shout) PRESENTS Telangiectasias, recurrent epistaxis, skin discoloration, arteriovenous malformations, (Shout) GI bleeding, hematuria

[Block 3: A driving drum-and-bass breakdown. The tension builds as they rapid-fire the endocrine syndromes.]
(Male) Sheehan syndrome “post-partum pituitary necrosis” “agalactorrhea, hypothyroidism, hypotension, hypoglycemia, mense problems”
(Female) Pituitary apoplexy “sudden hemorrhage or infarction within the pituitary, mostly in a pituitary adenoma” So “bitemporal hemianopsia, meningeal irritation, headache, then hypopituitarism.”
(Male) Acute adrenal insufficiency (adrenal crisis) “evaluated for sepsis, adrenal metastases, and hemorrhage” (Shout) PRESENTS orthostatic hypotension, confusion, circulatory collapse, abdominal pain, and fever
(Female) (Shout) MEN1 “Pancreatic, pituitary, parathyroid” (Shout) AND
(Male) (Shout) MEN2A “Medullary thyroid carcinoma, parathyroid, pheochromocytoma”
(Both) (Shout) MEN2B “Medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas, marfanoid habitus”

[Block 4: Full stadium-rock energy returns. Guitars are soaring and wide as they tackle the GI tract.]
(Male) Carcinoid syndrome, “flushing, diarrhea, and bronchospasm, tricuspid valve carcinoid plaque”
(Female) Courvoisier sign “painless jaundice and an enlarged gallbladder mean cancer”
(Male) Plummer-Vinson “glossitis, cervical esophageal webs, and iron deficiency, esophageal (Shout) SCC”
(Female) Whipple disease (Tropheryma whipplei) (Shout) PRESENTS Arthralgias, cardiac and neurological symptoms, diarrhea (Shout) OR Localized culture-negative endocarditis
(Male) Peutz-Jeghers (autosomal dominant) (Shout) PRESENTS Hamartomatous (Shout) GI polyps, hyperpigmented macules, malignancy risk (breast, (Shout) GI)
(Female) Gardner syndrome “osteomas, desmoid tumors supernumerary teeth”. Turcot “medulloblastomas, glioblastomas”
(Male) Crigler-Najjar “glucuronosyltransferase deficiency”. Type (Shout) II responds to enzyme induction by phenobarbital. Gilbert disease “mutation of the promoter region of glucuronosyltransferase”
(Female) Rotor syndrome “benign, mild and fluctuating conjugated hyperbilirubinemia” Dubin-Johnson “the defect in hepatic excretory function (secretion of bilirubin), fluctuating jaundice, (Shout) OATP1B”

[Outro: A bouncy pop-rap bridge pushes the track to its climax. The beat strips back to heavy kicks and clapping as they aggressively chant the gallbladder ladder.]
(Male) - Cholelithiasis “4F, biliary colic, prophylactic cholecystectomy for symptomatics”

(Female) - Acute Cholecystitis (Shout) RUQ pain, Murphy, nausea and vomiting, sometimes fever” (Shout) TREAT “cholecystectomy” “high-risk patients, conservative “with (Shout) IV fluids and antibiotics”
(Male) - Choledocholithiasis “biliary colic” (Shout) TREAT (Shout) ERCP and subsequent cholecystectomy within 2 wk”
(Both) - Cholangitis “Charcot triad; fever, (Shout) RUQ pain, and jaundice” “Reynolds pentad hypotension, and altered mental status” (Shout) TREAT (Shout) ERCP, meropenem, imipenem or piperacillin/tazobactam”

[Ending: A massive power chord rings out with a final heavy drum crash. Both singers shout one last triumphant harmony before the track cuts to total silence.]

4805/7500

[Intro: 120 BPM. Palm-muted electric guitars chug a catchy chord progression. A heavy kick drum builds the energy. The Male and Female vocalists hype up the stadium before the full band explodes into the groove.] [Block 1: The beat drops with crunchy guitars. The singers trade off rapid-fire cardiology lines.] (Male) Aortic regurgitation, Corrigan pulse “sharp upstroke and rapid decline of the carotid pulse”, de Musset “head bobbing”, Hill sign “femoral systolic pressure more than 40 to the brachial. “Austin Flint Murmur; mid-diastolic murmur in severe (Shout) AR at the apex” (Female) Beck triad “pericardial tamponade” low (Shout) BP, muffled heart sounds, raised (Shout) JVP. Prominent x descent, little or no y descent, paradoxical pulse (Male) Constrictive pericarditis “prominent “y” descent, Kussmaul sign “inspiratory rise in (Shout) JVP” (Female) Acute pericarditis “pain during inspiration and supine, friction rub” [Block 2: The guitars switch to bright, staccato stabs. The flow gets faster, bouncing back and forth.] (Male) Infective endocarditis “nonspecific constitutional symptoms” “new murmurs” “Osler nodes, small, painful nodules on the palmar surfaces of the fingers” (Female) “Splinter hemorrhages in the nail beds” “Janeway, hemorrhagic macules on palms or soles” “Roth spots, central pale retinal hemorrhages” “subungual hemorrhages” (Male) “Acute (β-Hemolytic strep, S. aureus, pneumococci) vs Subacute (low-grade fever; viridans strep, enterococci, CoNS, and (Shout) HACEK)” (Female) Hereditary hemorrhagic telangiectasia “Osler-Weber-Rendu” (Shout) PRESENTS Telangiectasias, recurrent epistaxis, skin discoloration, arteriovenous malformations, (Shout) GI bleeding, hematuria [Block 3: A driving drum-and-bass breakdown. The tension builds as they rapid-fire the endocrine syndromes.] (Male) Sheehan syndrome “post-partum pituitary necrosis” “agalactorrhea, hypothyroidism, hypotension, hypoglycemia, mense problems” (Female) Pituitary apoplexy “sudden hemorrhage or infarction within the pituitary, mostly in a pituitary adenoma” So “bitemporal hemianopsia, meningeal irritation, headache, then hypopituitarism.” (Male) Acute adrenal insufficiency (adrenal crisis) “evaluated for sepsis, adrenal metastases, and hemorrhage” (Shout) PRESENTS orthostatic hypotension, confusion, circulatory collapse, abdominal pain, and fever (Female) (Shout) MEN1 “Pancreatic, pituitary, parathyroid” (Shout) AND (Male) (Shout) MEN2A “Medullary thyroid carcinoma, parathyroid, pheochromocytoma” (Both) (Shout) MEN2B “Medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas, marfanoid habitus” [Block 4: Full stadium-rock energy returns. Guitars are soaring and wide as they tackle the GI tract.] (Male) Carcinoid syndrome, “flushing, diarrhea, and bronchospasm, tricuspid valve carcinoid plaque” (Female) Courvoisier sign “painless jaundice and an enlarged gallbladder mean cancer” (Male) Plummer-Vinson “glossitis, cervical esophageal webs, and iron deficiency, esophageal (Shout) SCC” (Female) Whipple disease (Tropheryma whipplei) (Shout) PRESENTS Arthralgias, cardiac and neurological symptoms, diarrhea (Shout) OR Localized culture-negative endocarditis (Male) Peutz-Jeghers (autosomal dominant) (Shout) PRESENTS Hamartomatous (Shout) GI polyps, hyperpigmented macules, malignancy risk (breast, (Shout) GI) (Female) Gardner syndrome “osteomas, desmoid tumors supernumerary teeth”. Turcot “medulloblastomas, glioblastomas” (Male) Crigler-Najjar “glucuronosyltransferase deficiency”. Type (Shout) II responds to enzyme induction by phenobarbital. Gilbert disease “mutation of the promoter region of glucuronosyltransferase” (Female) Rotor syndrome “benign, mild and fluctuating conjugated hyperbilirubinemia” Dubin-Johnson “the defect in hepatic excretory function (secretion of bilirubin), fluctuating jaundice, (Shout) OATP1B” [Outro: A bouncy pop-rap bridge pushes the track to its climax. The beat strips back to heavy kicks and clapping as they aggressively chant the gallbladder ladder.] (Male) - Cholelithiasis “4F, biliary colic, prophylactic cholecystectomy for symptomatics” (Female) - Acute Cholecystitis (Shout) RUQ pain, Murphy, nausea and vomiting, sometimes fever” (Shout) TREAT “cholecystectomy” “high-risk patients, conservative “with (Shout) IV fluids and antibiotics” (Male) - Choledocholithiasis “biliary colic” (Shout) TREAT (Shout) ERCP and subsequent cholecystectomy within 2 wk” (Both) - Cholangitis “Charcot triad; fever, (Shout) RUQ pain, and jaundice” “Reynolds pentad hypotension, and altered mental status” (Shout) TREAT (Shout) ERCP, meropenem, imipenem or piperacillin/tazobactam” [Ending: A massive power chord rings out with a final heavy drum crash. Both singers shout one last triumphant harmony before the track cuts to total silence.]

0/500