cirus
Forum Guru
Topics: 108
Posts: 740
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A 42-year-old man with a history of intravenous drug use comes to a community outreach
clinic complaining of fever, malaise, and cough for the last 6 weeks. Physical examination
reveals a cardiac murmur, which the patient states he has been unaware of. Given his recent
use of intravenous heroine and his chronic symptoms, the man is admitted to the hospital for
further evaluation and treatment. Workup in the hospital includes blood cultures, three sets of
which grow methicillin-resistant Staphylococcal aureus, and a chest radiograph that reveals
multiple bilateral nodular densities. Treatment with intravenous vancomycin is initiated. Cardiac
auscultation is most likely to reveal which of the following?
A. Continuous machinery murmur throughout cardiac cycle
B. Decrescendo diastolic murmur heard best at midprecordium
C. Faint murmur that increases in intensity with inspiration
D. Holosystolic murmur with radiation of murmur to the axilla
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| vanshita
Forum Guru
Topics: 30
Posts: 913
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A
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| doc_clotaire
Forum Guru
Topics: 159
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IE secondary to IV drugs abuser most likely will affect the TRICUSPID VALVE
B. Decrescendo diastolic murmur heard best at midprecordium
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| sprint123
Forum Guru
Topics: 129
Posts: 870
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Clotaire is right---Tricuspid valve is involved in IVDA..
But..Isn't it Tricuspid regurgitation providing a holosystolic murumur rather than the diastolic murmur??I am thinkng of C having this murumur to be faint and increases on inspiration
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| tanmaynator
Forum Senior
Topics: 12
Posts: 153
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C.. i agree.. its tricuspid valve there and it would give a faint murmur increasing in intensity with inspiration..
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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ans should be C b/c MR just as TR are systolic murmurs, and Ispiration measn more blood to the right side of the heart hence the increase in murmur
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| cirus
Forum Guru
Topics: 108
Posts: 740
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uve got it right..the ans is c..
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| cirus
Forum Guru
Topics: 108
Posts: 740
|
uve got it right..the ans is c..good work
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