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Kaplan Qbank USMLE



Author9 Posts
  #1

A 52 y/o woman has long-standing RA and is being treated with corticosteroids and
NSAIDs drugs. Which of the following cardiac complications may arise in this clinical setting?
A. Constrictive pericarditis
B. Dilated cardiomyopathy
C. Hypersensitivity myocarditis
D. Hypertrophic cardiomyopathy
E. Restrictive cardiomyopathy

  #2

I choose B

corticosticoids-->Na and water retention---> hypertension--->congestive (dilated) heart failure

restrictive: often due to endomyocardial fibrosis, other causes are amyloidosis, sarcodosis, hemachromatosis, Pompe's

hypertrophic: often familial, autosomal dominant

contrictive pericarditis: often in tuberculosis

Hypersensitivity: a various range of causes but usually results in restrictive cardiomyopathy

pls correct if I'm wrong


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  #3

well to my knowledge autoimmune disease cause restrictive patern ....as SLE etc?

  #4

scleroderma

  #5

why not constrictive pericarditis

ra is a chronic disease and can lead to amyloid deposit, hence constrictive

not sure, correct me


  #6

i dont tackle risksshaking head

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  #7

RA,SLE causes restricrive lung disease...why not restrictive cardiac?

  #8

i think A, constrictive pericarditis as it true with any of autoimmune/connective tissue disorders. Pericardium is involved most of the time. In this case pericardium must have had effusions leading to constrictive pattern.

I think the clue is "LONG STANDING" , meaning involvement of more than articular spaces.

  #9

plz howtobhaj post the answer...same request to all other who post questions......







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