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 Gastro and cardio  

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Author15 Posts

patient who recently underwent a gastrectomy procedure complains of
nausea, diarrhea, sweating, palpitations, and flushing soon after eating
a meal. This patient should be instructed to

A. eat less frequent, larger meals that are high in carbohydrates
B. eat less frequent, smaller meals that are high in fat
C. eat more frequent, larger meals that are high in protein
D. eat more frequent, smaller meals that are high in carbohydrates
E. eat more frequent, smaller meals that are high in fat


A 25-year-old pregnant woman is referred to you for evaluation of a heart murmur that was noted during the second trimester of this pregnancy, which is her first. The patient has no history of cardiovascular disease, and the murmur was not heard during previous medical evaluations. She is asymptomatic. Examination shows a mildly displaced apical impulse and lower extremity edema. S1 and S2 are normal, and S3 is noted at the apex. A grade 2/6 early to mid-peaking systolic murmur is audible at the left sternal border. Based on the patients history and physical findings, which of the following is the most likely cause of the murmur?
A. Bicuspid aortic valve with mild to moderate stenosis
B. Congenitally abnormal pulmonary valve with moderate stenosis
C. Physiologic murmur related to pregnancy
D. Mitral valve regurgitation related to mitral valve prolapse
E. Bicuspid aortic valve with moderate regurgitation




c for 1st quest


c for 2nd also


Could u pls tell me the reasons?


in first its dumping syndrome...

diet recomended for it is frequent diet,smaller meals and rich in protien and low in carbohydrates and fats carbohydrate and fat will cause more osmotic disrubance and dumping syndrome will be aggravated


and in 2nd question it is high output murmur....that is pregancy induced physio. murmur


I agree with u. Thx 4 ur explanations.


There is a blood dilution during pregnancy because of increasing plasma volume, it can be cause of murmur


Hey for that first question, I agree that it is gastric dumping syndrome (inefficient pyloric constriction), which is why I think "more frequent, smaller meals high in fat" is the answer.

Fat slows emptying of the stomach (which is why fatty food is great for nights out drinking, slowing its absorption). So it would be bad with large meals as gastric contents would build up, but smaller meals should allow it to be digested.

Protein activates gastrin secretion which (as well as stimulating parietal cells) increases GIT motility, so this would increase the speed at which food passes through the stomach, worsening the problem.


Oh and for the second question, could I ask why the systolic murmur is present? The displacement and third heart sound make sense to me with the pregnancy, but I'm confused as to how that could lead to a murmur (which I'm guessing is mitral regurgitation?)


E for q1





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