| Author | 6 Posts |
dr_jojo
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A 62-year-old woman is brought to the emergency department 1 hour after a 1-minute episode of loss of consciousness; her symptoms began when she stood up after she passed a dark, watery stool. She has had diarrhea and dark stools for 2 days. She has been receiving warfarin therapy for deep venous thrombosis for 2 weeks. On arrival, her blood pressure is 82/60 mm Hg, and pulse is 150/min and regular. She is unable to stand. The lungs are clear to auscultation. A grade 2/6 systolic murmur is heard at the second right intercostal space with no radiation. Examination shows a soft, nontender abdomen. There is 1+ edema of the right lower extremity with no tenderness. Test of the stool for occult blood is positive.
AS OR
OTHOSTATIC hypotension
A
) Aortic stenosis
B
) Carotid sinus hypersensitivity
C
) Conversion reaction
D
) Hypertrophic obstructive cardiomyopathy
E
) Hypoglycemia
F
) Mitral valve prolapse
G
) Orthostatic hypotension
H
) Pulmonary embolus
I
) Seizure
J
) Vasovagal syncope
K
) Vertebrobasilar insufficiency
Edited by dr_jojo on 03/08/07 - 09:59 AM
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| dr_jojo
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AND explain plz
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| huyniid
Forum Elite
Topics: 9
Posts: 195
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Orthostatic hypotension due to blood loss. The cause of blood loss maybe in the colon and be aggravated by warfarin use. Pts with AS often have vascular ectasia in the colon. Don't know if it is right cause it remains in my old memory
Good luck dr jojo
Edited by huyniid on 03/08/07 - 06:05 AM
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| Dr_kholioo
Forum Junior
Topics: 9
Posts: 74
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it is clear
orthostatic hypotention
1st why not ?!! he is bleeding heavily
2nd see his pulse it is 150
3rd the 2/6 grade of murmer is so imnnocent to cause this desturbance
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| robin082006
Forum Hero
Topics: 471
Posts: 5,123
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there is another choice,
cerebral blood insufficiency in this q, I chose this choice because this patient has persistent hypotension, not only orthostatic hypotension.
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The Key to Succeed is Patience.
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| fongch
Forum Elite
Topics: 71
Posts: 316
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I will go for orthostatic hypotension. Vertebrobasilar insufficiency refers to a temporary set of symptoms due to decreased blood flow in the posterior circulation of the brain. Vertigo is the most recognizable and quite often the sole symptom.
Edited by fongch on 05/12/07 - 12:59 PM
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