WBR0023: Difference between revisions
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{{WBRQuestion | {{WBRQuestion | ||
|QuestionAuthor=Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS | |QuestionAuthor=Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS | ||
|ExamType=USMLE Step 3 | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|MainCategory=Primary Care Office | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|MainCategory=Primary Care Office | |||
|MainCategory=Primary Care Office | |||
|SubCategory=Cardiovascular, Infectious Disease | |||
|Prompt=A 65 yr old male with a past medical history of tuberculosis presents to the clinic concerned about progressive shortness of breath for the past few months. He also complains of weakness, fatigue, and weight gain. Physical examination shows increased abdominal girth, bilateral pedal edema, hepatomegaly and an increase in jugular venous pressure on deep inspiration. Auscultation revealed an extra diastolic heart sound. Chest X-ray showed calcification in the precordial area and EKG showed diffuse low voltage QRS complexes with flattened T waves. What is the most important therapy to immediately treat this patient? | |Prompt=A 65 yr old male with a past medical history of tuberculosis presents to the clinic concerned about progressive shortness of breath for the past few months. He also complains of weakness, fatigue, and weight gain. Physical examination shows increased abdominal girth, bilateral pedal edema, hepatomegaly and an increase in jugular venous pressure on deep inspiration. Auscultation revealed an extra diastolic heart sound. Chest X-ray showed calcification in the precordial area and EKG showed diffuse low voltage QRS complexes with flattened T waves. What is the most important therapy to immediately treat this patient? | ||
|Explanation=This patient has constrictive pericarditis as a result of tuberculosis. The correct therapy for this patient is pericardial resection. The pericardium is resected to relieve symptoms of systemic and pulmonary congestion, which causes the heart to relax effectively during diastole. | |Explanation=This patient has constrictive pericarditis as a result of tuberculosis. The correct therapy for this patient is pericardial resection. The pericardium is resected to relieve symptoms of systemic and pulmonary congestion, which causes the heart to relax effectively during diastole. | ||
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|AnswerDExp=Antitubercular therapy is used for treating constrictive pericarditis secondary to tuberculosis, however pericardial resection should be done first. | |AnswerDExp=Antitubercular therapy is used for treating constrictive pericarditis secondary to tuberculosis, however pericardial resection should be done first. | ||
|AnswerE=Glucocorticoids | |AnswerE=Glucocorticoids | ||
|AnswerEExp=Glucocorticoids are used when the pericarditis is secondary to a chronic inflammatory process. | |AnswerEExp=Glucocorticoids are used when the pericarditis is secondary to a chronic inflammatory process. | ||
|RightAnswer=B | |RightAnswer=B | ||
|Approved= | |Approved=Yes | ||
}} | }} | ||
{{WBRImage}} | {{WBRImage}} | ||
Revision as of 21:34, 12 February 2013
| Author | PageAuthor::Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS |
|---|---|
| Exam Type | ExamType::USMLE Step 3 |
| Main Category | MainCategory::Primary Care Office |
| Sub Category | SubCategory::Cardiovascular, SubCategory::Infectious Disease |
| Prompt | [[Prompt::A 65 yr old male with a past medical history of tuberculosis presents to the clinic concerned about progressive shortness of breath for the past few months. He also complains of weakness, fatigue, and weight gain. Physical examination shows increased abdominal girth, bilateral pedal edema, hepatomegaly and an increase in jugular venous pressure on deep inspiration. Auscultation revealed an extra diastolic heart sound. Chest X-ray showed calcification in the precordial area and EKG showed diffuse low voltage QRS complexes with flattened T waves. What is the most important therapy to immediately treat this patient?]] |
| Answer A | AnswerA::Pericardiocentesis |
| Answer A Explanation | AnswerAExp::Pericardiocentesis is the treatment for a pericardial effusion. |
| Answer B | AnswerB::Pericardial resection |
| Answer B Explanation | AnswerBExp::Pericardial resection is the correct answer. |
| Answer C | AnswerC::Beta blockers |
| Answer C Explanation | AnswerCExp::Beta blockers are not indicated for the treatment of this patient. |
| Answer D | AnswerD::Antituberculous therapy |
| Answer D Explanation | AnswerDExp::Antitubercular therapy is used for treating constrictive pericarditis secondary to tuberculosis, however pericardial resection should be done first. |
| Answer E | AnswerE::Glucocorticoids |
| Answer E Explanation | AnswerEExp::Glucocorticoids are used when the pericarditis is secondary to a chronic inflammatory process. |
| Right Answer | RightAnswer::B |
| Explanation | [[Explanation::This patient has constrictive pericarditis as a result of tuberculosis. The correct therapy for this patient is pericardial resection. The pericardium is resected to relieve symptoms of systemic and pulmonary congestion, which causes the heart to relax effectively during diastole. Educational Objective: |
| Approved | Approved::Yes |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |
Image [[WBRImage::|]] Caption WBRImageCaption::no-display Position [[WBRImagePlace::|]]