usmle6789
Forum Senior
Topics: 33
Posts: 49
|
1]28 yr old develops fatigue and orthopnea 3 weeks after the uncomplicated delivery of her first child.bp 115/78, pulse 112.crackles are heard at both lung bases. the point of maximal impulse is laterally displaced and diffuse. S3 is present. There is 2+ pedal edema. An x-ray of chest shows vascular cephalization of pulmonary vasculature kerley B lines. Appropriate next step in management?
1] Measurement of serum creatine kinase and lactate dehydrogenase activity
2] Echocardiography
3] Dipyridamole thallium scan
3] ventilation-perfusion lung scan
4] Myocardial biopsy
I think 2 here. Plz correct me if I am wrong. Is it dilated cardiomyopathy?
2]A 19 yr old comes to the physician becos of 3yr h/o intermittent facial blemishes. She drinks wine occasionally at weekends. She takes no meds. Exam shows multiple 1-2 mm red and white papules and larger red nodules on the forehead and cheeks. initial pharmacotherapy?
1] oral iso tretinoin
2] systemic corticosteroids
3] Topical benzoyl peroxide
3] Topical corticosteroids
4] Topical metronidazole
what is the diagnosis here and answer as well. Is it acne roseace?
|
| tamriko
Forum Elite
Topics: 23
Posts: 296
|
1. The answer is 2. I think it's pulmonary edema. Kerley B lines is characteristic for it.
2. I'm not shure but I think its acne. If it is so, the answer would be 3.
Anyone else? :roll:
|
| usmleasr
Forum Guru
Topics: 105
Posts: 970
|
yeah i also agree with u ...for q 1 ans is 2
(postpartum dilated cardiomyopathy..)
q2 ans 3 (acne )..
usmle6789, what are the answers?
|
| usmle6789
Forum Senior
Topics: 33
Posts: 49
|
these are ccssa q as i mentioned earlier.no answers provided.i
|
| ELM
Forum Guru
Topics: 28
Posts: 936
|
1st q i will go with 2, she's got congestive cadiomyopathy--->Pulm edema.
2nd q i suspect Rosacea over simple acne...if that's true Tx is topical Metro---->so answer is 4.
Not sure with this one though :-k
___________________
ELM
|
| Dani_2005
Forum Senior
Topics: 13
Posts: 81
|
I am with you in both questions - Pulm. Oedema and Acne (not sure about the type though).. Just want to notify that you have mis-numbered the choices of the second question (number 3 is repeated), so with the new numbering I think it will be number 4 (3 currently)..
|
| alenka
Forum Elite
Topics: 22
Posts: 330
|
i'm puzzled on both ones.
on the first one-i think she's got pulmonary edema-probably due to cardiomyopathy.and i'd go also for echo.
but on the second one-having trouble.
|
| frontal
Forum Guru
Topics: 53
Posts: 421
|
1) -Echo
2)-Later. (gotta read up)
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
for Q 1 answer is echo, it definitely is dilated CMP
Q 2 is acne, now i would look for erythomycin or doxy for it, As these are not there in options i will go for benz peroxide as it a case of inflam acne. retinoids are used for no-inflam cases
___________________
Sincerity and hard work are the keys to success!
|
| drk1980
Forum Guru
Topics: 147
Posts: 1,038
|
about Q 2) the patient has evidence of nodular acne on forehead and cheeks....that shd be an indication for oral isotretinoin, since topical might not help. correct me plz.
|
| drdiv
Forum Junior
Topics: 16
Posts: 63
|
ya even my thinking goes in the same direction as u drk 1980
|
| drhyd
Forum Senior
Topics: 7
Posts: 82
|
For 2nd its metro, they r not acne
drhyd
|
| webjeee
Forum Guru
Topics: 99
Posts: 350
|
vascular cephalization of pulmonary vasculature kerley B lines
anybody can explain the pathogenesis?
thanks
|
|
| |
| | | | | | | | | | | | | |
