Tiff
Forum Guru
Topics: 54
Posts: 563
|
A 62 year old breast cancer survivor visits her physician because of weakenss, fatigue, and weight gain. The physician also elicits complaints about abdominal discomfort and exertional dyspnea. Physical examination reveals jugular venous distention that fails to subside on inspiration. A CT scan and an MRI show a normal sized heart with no apparent hypertrophy of the ventricular walls. Which of the following is the most likely diagnosis of this patient?
A. Cardiac tamponade
B. Congestive heart failure
C. Constrictive pericarditis
D, Recurrence of breast cancer
E. Restrictive cardiomyopathy
|
| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,208
|
C
___________________
When men make the rules, God decides the exceptions.
|
| new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
|
C. Constrictive pericarditis
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| Idlehands
Forum Newbie
Topics: 3
Posts: 52
|
D, Recurrence of breast cancer
|
| GoodGirl
.
Topics: 92
Posts: 1,189
|
C
___________________
http://www.youtube.com/watch?v=a5pnDDDzpqg&featur...
|
| jean robert
Forum Guru
Topics: 161
Posts: 663
|
B?
___________________
Great works are performed not by strength, but by perseverance.
|
| angel23
Forum Guru
Topics: 34
Posts: 667
|
B... doxorubicin given in chemotherapy produces CHF as a side effect.....
|
| Idlehands
Forum Newbie
Topics: 3
Posts: 52
|
E. Restrictive cardiomyopathy <<< A shot in the dark   i chose this cause everyone is chosing everything without giving any obvious explanations so i thought i spice it up a bit.
|
| new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
|
The only reason i chose C or Constrictive Pericarditis is
Increased JVP which fails to subside on inspiration is Kussmaul'sign which is mostly commonly observed in patients with Constrictive pericarditis. However its also observed in
1. Restricitve Cardiomyopathy
2. Right Ventricular Infarction
3. Acute Cor Pulmonale
You will have to disregard any other choice because the question also clearly states that there is no hypertrophy of the ventricles and the heart size is normal.
Now one can argue that Constrictive Pericarditis and Restrictive Cardiomyopathy do mimick each other but essential there are differences in the pericardium and atria. There is a possible increase in heart size. And they both are Post irradiation complications
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| Tiff
Forum Guru
Topics: 54
Posts: 563
|
 Choice C is the correct answer. (Constrictive pericarditis).
Constrictive pericarditis interferes with the filling of the ventricles because of granulation tissue formation in the percadium. It can follow purulent viral infections, trauma, neoplastic diseases, mediatinal irradiation, and other chronic diseases. Pericardial thickening and calcification are sometimes apparent on CT scan and MRI.
CHF would be incorrect b/c like NNL says there would be significant enlargement of ventricles. Restrictive cardiomyopathy have also hypertrophied ventricular walls.
|
|
| |
| | | | | | | | | | |
