doc649
Forum Junior
Topics: 18
Posts: 61
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17. A 42-year-old man presents to the ED with a
complaint of increasing shortness of breath
when walking to get his newspaper, difficulty
breathing while lying flat, and a 4.5-kg (10-lb)
weight gain over the last month. He is afebrile,
his pulse is 75/min, and his blood pressure is
98/50 mm Hg. On examination he smells of
alcohol and has 2+ pitting edema in the lower
extremities and a third heart sound. X-ray of
the chest reveals cardiomegaly. What findings,
other than those listed above, must be present
in order to confirm this man’s underlying diagnosis?
(A) Hepatojugular reflux and pulmonary congestion
(B) Left ventricular dilation and aortic insufficiency
(C) Left ventricular dilation and systolic dysfunction
(D) Myocardial thickening and diastolic dysfunction
(E) Pulmonary congestion and diastolic dysfunction
Ans:???CC this man probably has DCM and Biventricular failure
20. A boy is delivered at 37 weeks’ gestation via
spontaneous vaginal delivery. He is the product
of a normal pregnancy and was delivered
without complications. Maternal prenatal laboratory
test results are rubella immune, blood
type B, Rh antibody negative, group B streptococci
negative, rapid plasma reagin negative,
hepatitis B surface antigen negative, and gonorrhea
and chlamydia negative. The patient appears cyanotic. He is breathing at a rate of
60/min and his heart rate is 130/min. He has a
normal S1 and S2. There is a harsh holosystolic
murmur that is loudest at the left lower
sternal border. His examination reveals palpable
nonbounding peripheral pulses bilaterally.
Which of the following is the most likely diagnosis?
(A) Coarctation of the aorta
(B) Dextraposed transposition of the great arteries
(C) Patent ductus arteriosus
(D) Tetralogy of Fallot
(E) Truncus arteriosus
Ans:???Bb
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| drshvetasm
Forum Elite
Topics: 22
Posts: 282
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i disagree on question 20...y not TOF? coz transposition to my knowledge wouldnt give you a holosystolic murmur along the left sternal border...
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| nyimalay
Forum Elite
Topics: 9
Posts: 280
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17. C
20. It should be TOF.
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| Ivonne
Forum Guru
Topics: 55
Posts: 1,451
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C
20: Not sure
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| liliaeliz
Forum Elite
Topics: 38
Posts: 349
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A
b transposition can be associated whith VSD ( harriet lane book) and early cyanosis
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| liliaeliz
Forum Elite
Topics: 38
Posts: 349
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I m soory 17 C
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| liliaeliz
Forum Elite
Topics: 38
Posts: 349
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I m sorry 17 C
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| peter90036
Forum Elite
Topics: 28
Posts: 315
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last Q
just born & cyanotic -- #1 you should think = TGV TGV TGV
yes TGV = Harsh Holo Systolic @ Left Lower Sternal Border
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| nyimalay
Forum Elite
Topics: 9
Posts: 280
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Thanks guys,
I m sorry for my wrong answer. I agree with TGV.
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| chemamr
Moderator and PGY2
Topics: 703
Posts: 4,442
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C & B
key point is what peter90036 said. 
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