HY USMLE Q

[@Mehlmanmedical]

Our New USMLE Telegram group (link valid at least at time of this clip): t.me/+mSDYK3fV2wdkNmY0 Instagram: instagram.com/mehlman_medical/ X (Twitter)): x.com/mehlman_medical Mehlman HY Cardio PDF: mehlmanmedical.com/hy-cardio/ Mehlman HY Internal Med PDF: mehlmanmedical.com/hy-internal-medicine/

[@Hellastorytella]

Good morning and good question!!

[@drkundanrathore1613]

how long does it take to set up "compensatory Respiratory Alkalosis" ?

[@jamesvithoulkas9151]

Minutes. The only thing that has to change is the respiratory rate, assuming no underlying pulmonary pathology.

[@drkundanrathore1613]

@@jamesvithoulkas9151 what if someone confuse it with resp alkalosis in this question? or the word compensatory will always be there?

[@jamesvithoulkas9151]

@ it is helpful to consider the primary acid-base disturbance. In this question, the hypotension in the setting of myocardial infarction suggests shock, which implies lactic acidosis due to anaerobic metabolism since the tissues are poorly perused. The primary disturbance is therefore metabolic acidosis, regardless of respiratory compensation. It is easier to do this when you are given a pH and can identify the primary disturbance (acidosis vs alkalosis) and then consider other data points such as serum HCO3, PCO2, etc to identify the source of the derangement. In certain cases like salicylate toxicity, however, you may have a combined respiratory and metabolic acid base disturbance resulting in a normal pH, which can be potentially confusing.

[@Mehlmanmedical]

Respiratory compensation isn’t same as respiratory alkalosis. If you say the latter, it implies there’s a pathology there, like with aspirin where it’s mixed

[@TheMohan004]

Wont there be hyperventilation during MI?

[@Mehlmanmedical]

Even if there is from pulmonary edema that’s not primary or salient acid base disturbance

[@sitthuson]

At first glance, I thought ST-elevation of II, III, and aVF indicated RCA infarct but the answer was not there. so now we have to look at other leads? ST elevation of Anterior precordial leads indicated LAD. Thus the best answer is LAD, which also makes sense because LAD branches out of RCA.

[@innocencedirector]

Bro you’re cooked

[@a_hmd01]

Ok but also PDA is a brach of the RCA 😂😂😂, why picking LAD when ECG is very indicative of inferior M.I (2,3,avf) (PDA)

[@sitthuson]

@@a_hmd01 my thought was inferior M.I. (2,3,avf) which is RCA, we also have to factor in precordial leads V2 and V3 which show St-elevation, which means more likely LAD. We don't have information on PDA (St-elevation V7-V9 or St-depression on V1-V3).

[@user-cd8lc7qk6w]

Thank you Mike ❤my favourite topic

[@JOHNTOWER76]

fantastic question MIKE ,always good stuff

[@imranbhatti3174]

Please make a video on what is next best step in management of subarachnoid hemorrhage in 2CK... This question is constantly appearing now these days and different resources write different things.

[@creativehub-n7c]

Got the answer. Thank you.

[@alanwaterman1328]

Excellent revision. Thanks

[@shakespeares2085]

High yield one ❤❤❤❤

[@Aravon2010]

In Cardiology HY pdf you mentioned ToF as acyanotic disease and eisenmengers syndrome with Left>Right shunt changing to RIght>Left. But isn't this completely opposite, ToF is a cyanotic disease with R>L shunt from birth itself due RVOT obstruction being the reason according to 1st AID and other mutliple resources as well.

[@Mehlmanmedical]

ToF isn’t cyanotic at birth

[@amogeramogus]

thanks dr mike