Ms.Apara
Forum Senior
Topics: 31
Posts: 128
|
A tall man ,thin 25yr old man with sudden chest pain radiating to the left shoulder and breathlessness while cycling has -
unstable angina
acute MI
Plumonary embolism
tension pnemothorax
spontaneous pnemothorax
|
| chemamr
Forum Hero
Topics: 703
Posts: 4,461
|
Spontaneous pneumothorax
Edited by chemamr on 05/29/06 - 03:32 PM
___________________
Any time something is written against me, I not only share the sentiment but feel I could do the job far better myself.
|
| tolito
Forum Fanatic
Topics: 119
Posts: 2,174
|
acute MI?
___________________
It has been a looooong hard journey but I am inches away from my destination...
|
| sridevibandaru24
Forum Guru
Topics: 33
Posts: 434
|
acute MI?
|
| general malaise
Forum Guru
Topics: 14
Posts: 433
|
spontaneous pneumothorax secondary to ruptured subpleural bleb
___________________
"El respeto al derecho ajeno es la paz" Benito Juarez
|
| Ms.Apara
Forum Senior
Topics: 31
Posts: 128
|
plz explain the ans GM.... u r right.... coz the source says it is secondary to marfan syn
as described in q the patient is thin and tall
|
| 26malik
Forum Guru
Topics: 39
Posts: 429
|
Spontaneous Pneumothorax. may be due to mitral valve prolapse --> pulmonary edema --> Ruptured Bleb.
GM Plz explain...
___________________
There is always hope
|
| general malaise
Forum Guru
Topics: 14
Posts: 433
|
well i wasn't necessarily thinking about marfans but of spontaneous idiopathic or primary pneumothorax which usually occurs in tall thin young men due to tiny ruptured subpleural blebs, the air is subsequently reabsorbed leading to recurrent attacks.
___________________
"El respeto al derecho ajeno es la paz" Benito Juarez
|
| chemamr
Forum Hero
Topics: 703
Posts: 4,461
|
yes, this case is some classic, thin/tall/healthy/young man, no cardiovascular risk, chest pain.
___________________
Any time something is written against me, I not only share the sentiment but feel I could do the job far better myself.
|
| chemamr
Forum Hero
Topics: 703
Posts: 4,461
|
it only says the guy is tall and thin (i think is not enough to think in Marfan)
___________________
Any time something is written against me, I not only share the sentiment but feel I could do the job far better myself.
|
| DrPak
Forum Elite
Topics: 49
Posts: 348
|
Remember how goljan says you have to assume all sorts of things? eg, a body-builder is on steriods, etc...
The problem I had with this question of the description of the pain. I think in the real exam they would have mentioned that the pain was pleuritic. We would know something like that in real life by asking the patient, so it's reasonable to expect them to tell us in the question as well.
|
| vallia
Forum Guru
Topics: 98
Posts: 889
|
I don't think we have here enough information. Not usmle style to give such questions. It could be E
___________________
fight possessed
|
| general malaise
Forum Guru
Topics: 14
Posts: 433
|
i think there is enough info in the question to make the diagnosis of spontaneous pneumothorax and also to rule out the other possibilities. look at the history, the guy is 25, not the usual age to have unstable angina or acute MI unless he's on cocaine or has some sort of vasculitis. he wasn't bed ridden so pulmonary embolism is unlikely. there's no history of trauma so no tension pneumothorax. the guy was doing exercise when it happened meaning a greater negative intrapleural pressure which increases the risk of the blebs rupturing.
i do agree there's not enough info to support that the guy definetely had marfans. spontaneous pneumothorax can occur in tall thin young males who don't have marfans
___________________
"El respeto al derecho ajeno es la paz" Benito Juarez
|
| hitesh
.
Topics: 59
Posts: 841
|
agree with you GM. any tall thin individual can have subpleural blebs and spontaneous pneumothorax, this one's a typical question.
___________________
Three down, one to go...
|
| mitty
Forum Guru
Topics: 52
Posts: 376
|
the pain is radiating to the shoulder.His age will not rule out MI completly, b/c he might have familial hypercholesterolemia.Based on the discription of the pain it is MI.
___________________
He will make it happen.
|
|
| |
| | | | | | | | | | | | | | | |
