doc649
Forum Junior
Topics: 18
Posts: 56
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4. An 81-year-old man is hospitalized for acute
onset of shortness of breath and lower extremity
edema. Although he lives by himself, it is
very difficult for him to move around his apartment
without experiencing fatigue. He has not
seen his physician in years but was told in the
past that he had high blood pressure. On physical
examination, his jugular venous pulse is
seen 9 cm above his sternal notch, inspiratory
crackles are heard at his lung bases, and there
is 3+ lower extremity edema. Which of the following
is most likely to confirm the diagnosis?
(A) Cardiac angiography
(B) Echocardiography
(C) Electrocardiogram
(D) Endomyocardial biopsy
(E) Pulmonary function tests
(F) X-ray of the chest
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| doc649
Forum Junior
Topics: 18
Posts: 56
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I dont have the ans buddies....
Pl help me to solve these Qs..
I chose B= Echo for CHF
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| doc649
Forum Junior
Topics: 18
Posts: 56
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5. A 42-year-old man presents to clinic for routine
evaluation. His medical history is significant
only for gallstones. The patient denies
smoking and drinks alcohol occasionally. His
mother had a heart attack at the age of 63. His
vital signs are significant for a blood pressure
of 134/77 mm Hg and on physical examination,
he is overweight with well-healed laparoscopic
cholecystectomy scars. His fasting lipid
panel and other laboratory values are:
Aspartate aminotransferase 37 U/L
Alanine aminotransferase 28 U/L
Alkaline phosphatase 88 U/L
Total cholesterol 268 mg/dL
LDL cholesterol 183 mg/dL
HDL cholesterol 46 mg/dL
Triglycerides 166 mg/dL
What is the most appropriate next step in the
patient’s management?
(A) A trial of lifestyle modification alone (diet,
exercise, and weight loss)
(B) A trial of lifestyle modification combined
with statin and niacin therapy
(C) A trial of lifestyle modification combined
with statin therapy
(D) Niacin therapy
(E) Statin therapy
My ans: A...[I dont have Ans of any of cardio Qs]
thanks
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| hir
Forum Newbie
Topics: 0
Posts: 157
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1) i guess, u r right,,,,,,,,B-echo
2) i think it should be life-style modification with niacin considering his family history,,,but its not there in option...so i dont know ...but his LDL should be <160 ....so
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| nyimalay
Forum Elite
Topics: 9
Posts: 277
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My thoughts,
B.
C. As patient has two risk factors, overwieght and premature MI in mother. But not sure overweight is a risk factor.
More inputs please.
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| liliaeliz
Forum Elite
Topics: 26
Posts: 237
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4 b CHF
5 A Riesk factor familiar , LDL 160 189
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| liliaeliz
Forum Elite
Topics: 26
Posts: 237
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R F. male>45 female>55
smoking
HDL <40
hypertension
F H + CAD mother <65 father <55
obesity I dont know but in this case he has overweith
if HDL is >60 sustracte 1 riesk factor
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| Ivonne
Going for step 3/99
Topics: 50
Posts: 1,396
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First question: Echo-------->to diagnose CHF due to diastolic dysfunction due to hypertension. The answer is clear and there is no other options.
Second question: More that 1 cardiac risk factor therefore life style modifications if LDL is >130 and medication when LDL>160 so in this patient the answer should be CCCCCCCCCCC
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| Pioglitazone
Forum Newbie
Topics: 0
Posts: 15
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B
C
___________________
LoVe FoR AlL ; HaTrEd FoR NoNe
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| peter90036
Forum Elite
Topics: 24
Posts: 219
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the Qs are from the FirstAid: Q&A for the Usmle 2CK
4: B
5: A
Edited by peter90036 on 04/24/08 - 02:26 PM
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| doc649
Forum Junior
Topics: 18
Posts: 56
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hi peter....u r right...do u have ans for cardiology?
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| peter90036
Forum Elite
Topics: 24
Posts: 219
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yes, its in the book.
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