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	<owl:Ontology rdf:about="https://www.wikidoc.org/index.php/Special:ExportRDF/WBR0020">
		<swivt:creationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2026-07-31T07:29:21+00:00</swivt:creationDate>
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		<rdf:type rdf:resource="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3AWBRQuestion"/>
		<rdfs:label>WBR0020</rdfs:label>
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		<property:AnswerA rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus bisferiens</property:AnswerA>
		<property:AnswerAExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus bisferiens is a sign where on palpation of the pulse, a double peak in the aortic waveform is observed with each cardiac cycle. This finding is seen in hypertrophic cardiomyopathy.</property:AnswerAExp>
		<property:AnswerB rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus tardus</property:AnswerB>
		<property:AnswerBExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus tardus is the name of the delayed systolic peak seen in aortic stenosis.</property:AnswerBExp>
		<property:AnswerC rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulses bigeminus</property:AnswerC>
		<property:AnswerCExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus bigeminus is a cardiovascular phenomenon characterized by groups of two heartbeats close together followed by a longer pause. The second pulse is weaker than the first. It is caused by premature contractions, usually of the ventricles, after every other beat.</property:AnswerCExp>
		<property:AnswerD rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus paradoxus</property:AnswerD>
		<property:AnswerDExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus paradoxus is the correct answer.</property:AnswerDExp>
		<property:AnswerE rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus parvus et tardus</property:AnswerE>
		<property:AnswerEExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pulsus parvus et tardus, more commonly known as a "slow-rising" or "anacrotic" pulse, is a sign where, upon palpation, the pulse is weak/small (parvus), and late (tardus) relative to contraction of the heart. This finding is seen in aortic stenosis.</property:AnswerEExp>
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		<property:Explanation rdf:datatype="http://www.w3.org/2001/XMLSchema#string">The correct answer is pulsus paradoxus (PP).  The patient in this vignette is suffering from cardiac tamponade most likely secondary to uremic pericarditis.  Tamponade is strongly suggested by the muffled hear sounds, low voltage EKG, dyspnea and chest pain.  The hallmark of cardiac tamponade on physical exam is pulsus paradoxus. Pulsus paradoxus (PP), also called paradoxic or paradoxical pulse, is an exaggeration of the normal variation in the pulse and drop of systolic blood pressure during the inspiratory phase of respiration, in which the pulse becomes weaker as one inhales and stronger as one exhales. It is a sign that is indicative of several conditions including cardiac tamponade and lung diseases (e.g.asthma, COPD).&lt;br/&gt;
'''Educational Objective:''' &lt;br/&gt;
'''References:'''</property:Explanation>
		<property:MainCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Emergency Room</property:MainCategory>
		<property:PageAuthor rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Aarti Narayan MBBS, Raviteja Reddy Guddeti MBBS</property:PageAuthor>
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		<property:Prompt rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A 60 yr old female with chronic kidney disease presented to the ER with symptoms of breathlessness, orthopnea, chest pain, and dizziness. On auscultation, heart sounds were faint. An EKG showed low voltage complexes. Blood pressure was 90/50 mm Hg. Lung fields were clear. What additional finding is expected on palpation of radial pulse?</property:Prompt>
		<property:RightAnswer rdf:datatype="http://www.w3.org/2001/XMLSchema#string">D</property:RightAnswer>
		<property:SubCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Genitourinary</property:SubCategory>
		<property:SubCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Cardiovascular</property:SubCategory>
		<swivt:wikiPageModificationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2020-10-27T23:04:48Z</swivt:wikiPageModificationDate>
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