| Author | 9 Posts |
jyn9188
Forum Newbie
Topics: 6
Posts: 11
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I can't figure out these two Qs, please help. thanks
1) A 35-year old woman is brought to the emergency department by her family because of shortness of breath, tightness in her chest, and palpitations for 2 hours. over the past 11 months, she has had five similar episodes; during the last episode 3 weeks ago, she was treated with an intravenous medication that caused conversion to the sinus rhythm. Her bp is 95/60mm Hg,and pulse is 165/min and regular. The lungs are clear to auscultation. Which of the following is the most likely underlying dysrhythmia:
A)Accelerated idioventricular rhythm
B)Accelerated junctional rhythm
C)Atrial fibrillation
D)Multifocal atrial tachycardia
E)Normal sinus rhythm
F)Paroxysmal supraventricular tachycardia
G)Premature supraventricular beats
H)Premature ventricular beats
I)Sick sinus syndrome
J)Sinus bradycardia
K)Sinus tachycardia
L)Ventricular fibrillation
M)Ventricular tachycardia
2)A healthy 27-year old woman comes for a routine maintenance examination. her bp is 185/90 mmHg. Examination shows no other abnormalities except for hypertensive retinopathy. Serum study show a sodium level if 140 mEq/L. potassium level of 4mEq/L, and creatinine level of 1.1 mg/dL. A complete blood count, serum catecholamine levels and urinalysis are within normal limits. At two subsequent visits, her blood pressure is 190/100 and 182/96 mmHg respectively. Which of the following is the most appropriate next step in diagnosis?
A)23-hour urine collection for measurement of creatinine clearance
B)24-hour urine collection for measurement of 17-hydroxycorticosteroid and total 17-ketosteroid levels
C)Measurement of serum aldosterone level
D)Magnetic resonance angiography of renal vessels
E)CT scan of the abdomen
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| peter90036
Forum Elite
Topics: 28
Posts: 315
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1.
regular = not afib
likely PSVT
2.
normal Na,K = not aldosterone
young + HTN likely renal aa ... do angio of renal vessels
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| cool doctor
Forum Junior
Topics: 1
Posts: 231
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agree with peter
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| solitarius
Forum Junior
Topics: 7
Posts: 71
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2. can't be Pheo?so I think answer is B
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| aspire
Forum Senior
Topics: 24
Posts: 158
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1.F
2.Likely renal artery hypertension, as s.creatinine is elevated. Pheochromocytoma is a possiblity as it can present as chronic stable hypertension.
What is the answer?
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| peter90036
Forum Elite
Topics: 28
Posts: 315
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what are the diagnostic labs for pheo?
can you point them in the answers?
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| avesina
Forum Newbie
Topics: 0
Posts: 4
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agree with peter!
___________________
Avesina
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| lq2006
Forum Elite
Topics: 43
Posts: 382
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F
C
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| Markus2009
Forum Senior
Topics: 9
Posts: 191
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1.-F------>PSVT for sure
2.-D------>Fibromuscular dysplasia
It can not be C becuase the electrolytes don't follow the pattern of Conn syndrome.
Pheo has a paroxysmal presentation, it is true that we can not rule it out but what would be a point against fibromuscular dysplasia?
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