sunny2
Forum Elite
Topics: 51
Posts: 385
|
A 28 year old woman, an athlete presents with lethargy, dizzy spells and occasional syncope, it has been noted that during a dizzy spell the heart rate is 32 beats/ min. and the BP is 85/60 mmHg.Family history is positive of Diabetes Mellitus, CAD and Hyperthyroidism.
Your diagnosis:
A. Addison disease
B. Insulinoma
C. Structural disease of the cardiac conducting system (Sick sinus syndrome)
D. Sinus tachycardia with 4:1 atrioventricular block
E. Iron deficiency
|
| kpmle2
Forum Elite
Topics: 29
Posts: 290
|
C. Structural disease of the cardiac conducting system (Sick sinus syndrome)
Treatment---single lead ventricular pacemaker.
|
| Ivonne
Forum Guru
Topics: 53
Posts: 1,400
|
(D)
___________________
If you beleive you can do it then you WILL DO IT!! (by Mymeghhi)
|
| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
|
structure disease
C- me too
Edited by hanialkhadher on 10/04/07 - 04:12 PM
___________________
"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
|
| donjuan
Forum Junior
Topics: 9
Posts: 68
|
c
|
| sunny2
Forum Elite
Topics: 51
Posts: 385
|
C -
It is the wrong answer
|
| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
|
 so what is the problem with that patient
___________________
"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
|
| kpmle2
Forum Elite
Topics: 29
Posts: 290
|
B. Insulinoma ??
|
| aaroho
Forum Junior
Topics: 8
Posts: 75
|
Bradycardia with hypotension
I know the 2 causes i.e.3rd degree heart block and neurogenic shock.
So i go with D.
___________________
Life is wonderful when doctors all around
|
| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
|
Is this a some kind of endocrine deficiency? Addison?
___________________
"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
|
| elitoki
Forum Guru
Topics: 54
Posts: 508
|
Answer is D.
...but I still don't understand. 
Could anyone explain it?
Thanks
|
| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
|
if Qs are not explained within 24 hours it really feels boring and you start wondering why posting Qs if you DON'T EXPLAIN IT,
What do you think guys?
___________________
"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
|
| sunny2
Forum Elite
Topics: 51
Posts: 385
|
Sorry guys, I could not get back to the forum earlier !!
So explanation time:
Answer. is - D
Addison diesease may be associated with mild bradycardia, but not a pulse rate of 32 bpm, a rate which strongly suggests a significant degree of heart block.
Iron deficiency that produces anemia will tend to produce a mild tachycardia rather then a supraventricular tacharrythmia with block. I nsulinomas can present with hypoglycemia and syncope but are not associated with such a low pulse rate.
Structural disease of the cardiac conducting system- the sick sinus syndrome could produce episodic heart block and dizziness but would be very uncommon in a woman of this age group like this pt-28 years.
Sinus tachycardia with a 4:1 atrioventricular block would be the MOST likely cause.
I hope this helps 
|
| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
|
Thanks
___________________
"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
|
|
| |
| | | | | | | | | | | | | | |
