maojemes
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A 70-year-old woman presents with a cough, dyspnea, chest pain, and ankle swelling. She is ill appearing and cachectic. Her blood pressure is 100/70 mm Hg, with no inspiratory decrease, and her pulse is 100/min. She has absent rales on examination. She has jugular venous distention, with a decline during inspiration. Her apical cardiac impulse is decreased. She has an early third heart sound. Her liver is enlarged. An ECG reveals low QRS voltage. A chest x-ray film is clear. The cardiac silhouetteis enlarged. Which of the following findings will most likely appear on an echocardiogram?
A. Collapsed right ventricle in diastole
B. Large right ventricle
C. Pericardial effusion
D. Thick myocardium
E. Thick pericardium
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| drhouse
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B
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| dr19
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C
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| Al Durra
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E. Thick pericardium
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| Vietnamese
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C-
She has jugular venous distention, with a decline during inspiration. Why?
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| usmletopper2
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C,
jvd -its normal to fall during inspiration due to icreased blood flow to right side of heart during inspiration,failure to do so /rise is kussumalls sign(hope i'm right)
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| bppboom
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No it's not normal. Decrease in pulse as one inspires is called Pulsus paradoxus. It is a sign indicating pericarditis, cardiac tamponade, chronic sleep apnea, etc... Answer: C.
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| usmletopper2
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pulsus paradoxus is fall in BP with inspiration as the left side of heart is compressed by the right side as during inspiration there is more blood flow to the right side,normal fall less than 10 mm,if it is more caled as pulsus pardoxsus.it has nothing to do with PULSE
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| WaqasQureshi
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A. Collapsed right ventricle in diastole .... echo sign of tamponad... there is no pulsus paradoxus
B. Large right ventricle......RVH ... umm does have JVD, and all the signs of right heart failure but doesnt explain the heart sound
C. Pericardial effusion .... does explain all .. I would go with this.
D. Thick myocardium ....again RVH
E. Thick pericardium ..... kussmaul sign is present FOR BOARD PURPOSES...which is absent here..rest is fine with this diagnosis..
C
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| mangoshaikh
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i agree its c
thats the triad, Becks triad
Distant heart sounds... distended jvd.... hypotension
they also have pulsus pardoxus and elcectrical alterans
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