CICM SAQ 2010.1 Q3
Questions
3.1 What are the distinguishing features on clinical examination between a neuropathy and a myopathy?
3.2 List 4 causes of a mid diastolic murmur over the apex.
3.3 A previously fit 45 year old man was noted to be in respiratory distress 24 hours following maxillofacial surgery. Clinical examination revealed the following:
- Respiratory rate of 22/min
- Decreased air entry left side
- Crackles left base
- HR-104/min, regular. JVP not raised. Apical impulse 5th left intercostal space anterior axillary line.
Investigations:
- ECG – normal
- Chest X-Ray – complete whiteout on the left side.
(a) What is the likely cause of his respiratory distress?
Answers
Answer and interpretation
3.1 What are the distinguishing features on clinical examination between a neuropathy and a myopathy?
3.2 List 4 causes of a mid diastolic murmur over the apex.
- Mitral stenosis
- Aortic regurgitation
- Left to right shunts – VSD or a PDA
- Severe MR
- Acute rheumatic fever
3.3 A previously fit 45 year old man was noted to be in respiratory distress 24 hours following maxillofacial surgery. Clinical examination revealed the following:
- Respiratory rate of 22/min
- Decreased air entry left side
- Crackles left base
- HR-104/min, regular. JVP not raised. Apical impulse 5th left intercostal space anterior axillary line.
Investigations:
- ECG – normal
- Chest X-Ray – complete whiteout on the left side.
(a) What is the likely cause of his respiratory distress?
Left lung collapse from
- Perioperative blood aspiration
- Aspiration of gastric contents
- Sputum
Examination Library
CICM
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
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