robin082006
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A 40-year old female immigrant from Asia comes for evaluation of her dyspnea. Her dyspnea was mild 6 months ago but it has now progressed to dyspnea, even at rest. She denies any chest pain, syncope, or palpitations. She is a non-smoker and non-alcoholic. Her past medical history is significant for pulmonary tuberculosis. Her PR: 82/min; BP: 135/70 mmHg; Temperature: 37.1C(98.8F); RR: 14/min. On her examination, significant physical findings are jugular venous distension, bilateral ankle edema, and tender hepatomegaly. Chest x-ray shows pericardial calcifications. Which of the following set of physical findings is most likely to be present in this patient?
A. Early third heart sound and inspiratory increase in jugular venous pulse
B. Water hammer pulse and pistol shot femorals
C. Tapping apex beat and malar flush
D. Pulsus paradoxus and hypotension
E. Pansystolic murmur at left lower sternal border
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| Aashi
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A---------->early S3 -->pericardial 'knock' and increase of JVP --> kausmauls sign)--->T.B PERICARDITIS
Edited by Aashi on 12/10/06 - 07:33 PM
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| Guptashutosh
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yes agree A
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