Give detailed answers to above mentioned questions . Reference Harrison book
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All nine questions have been answered comprehensively. Here is a summary of what was covered:
Summary of Topics Covered
Q31-32 - Cardiomyopathy (General + Primary/Secondary):
- Definition, morphologic classification (HCM/DCM/RCM/ARVC)
- Primary vs secondary causes (with full table of systemic diseases)
- Two-hit genetic model of pathogenesis
- General diagnostic workup (Harrison's Ch. 266, p. 2045)
Q33 - Hypertrophic Cardiomyopathy:
- Genetics (1 in 500; sarcomere mutations - MYH7, MYBPC3)
- Dynamic LVOT obstruction mechanism, SAM, hemodynamics
- Clinical features (murmur behavior, S4, bifid pulse)
- Treatment: beta-blockers, verapamil, disopyramide, mavacamten (new FDA-approved myosin inhibitor)
- Surgical: myectomy vs alcohol septal ablation; ICD for sudden death risk
Q34 - Dilated Cardiomyopathy:
- Genetic (titin, lamin A/C) and acquired causes
- Heart failure syndrome presentation + echo/MRI findings
- Four-pillar GDMT: ARNI, beta-blocker, MRA, SGLT2i
- ICD, CRT, transplant indications
Q35 - Restrictive Cardiomyopathy:
- ATTR amyloidosis (tafamidis - FDA-approved), endomyocardial fibrosis, Fabry, sarcoidosis
- Key distinction from constrictive pericarditis (table)
- Treatment of underlying disease
Q36-37 - Infective Endocarditis:
- Vegetation pathology, acute vs subacute, NVE/PVE/CIED-IE
- Duke-ISCVID 2015 criteria (major/minor, definite/possible/rejected)
- Antibiotic regimens by organism
- Surgical indications (HF, uncontrolled infection, embolic risk, abscess)
Q38 - Heart Failure Pathogenesis + Classification:
- RAAS, SNS, natriuretic peptide axes
- HFrEF/HFmrEF/HFpEF by EF; ACC/AHA stages A-D; NYHA I-IV
Q39 - Chronic Heart Failure:
- Detailed symptom complex (LV vs RV failure symptoms)
- Physical exam findings (S3, JVP, crackles, pulsus alternans)
- Labs (BNP/NT-proBNP, troponin, iron studies)
- Instruments (echo, MRI, RHC, CXR with Kerley B lines)
- GDMT treatment with device therapy and advanced options
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