WBR0834

Author	PageAuthor::Neeraja Danda M.B.B.S
Exam Type	ExamType::USMLE Step 2 CK
Main Category	MainCategory::Internal medicine
Sub Category	SubCategory::Cardiovascular
Prompt	[[Prompt::A 25-year-old male presents to the physician complaining difficulty in breathing on exertion for the last 2 days. He has had fever, sore throat, diarrhea and vomiting for the last week. He took Tylenol for fever. He has smoked one pack a day for the past year and consumes alcohol occasionally. He is married and lives with his wife and one son. His wife had diarrhea and fever as well during the past week but has recovered. Physical examination reveals jugular venous distension and chest auscultation is significant for an S4 heart sound and rales in the lung bases.]]
Answer A	AnswerA::Angiotensin converting enzyme inhibitors
Answer A Explanation	AnswerAExp::'''Incorrect''' Angiotensin converting enzyme inhibitors improve mortality in cardiomyopathy.
Answer B	AnswerB::Angiotensin receptor blockers
Answer B Explanation	AnswerBExp::'''Incorrect''' Angiotensin receptor blockers like Losartan, telmisartan and valsartan offer mortality benefit in cardiomyopathy
Answer C	AnswerC::Potassium sparing diuretics
Answer C Explanation	AnswerCExp::'''Incorrect''' Potassium sparing diuretics like spironolactone and eplerenone offer mortality benefit in cardiomyopathy
Answer D	AnswerD::Beta blockers
Answer D Explanation	AnswerDExp::'''Incorrect''' Beta blockers play an important role in improving mortality in cardiomyopathy.
Answer E	AnswerE::All of the above
Answer E Explanation	AnswerEExp::All the drugs given in the options improve mortality in cardiomyopathy
Right Answer	RightAnswer::E
Explanation	[[Explanation::History of sore throat, fever and gastrointestinal upset with symptoms suggesting heart failure now might suggest an infection leading to heart failure eventually. Many virus, bacteria, protozoa, fungi and parasites can cause myocarditis or inflammatory cardiomyopathy. Angiotensin receptor blockers, angiotensin converting enzyme inhibitors, potassium sparing diuretics and beta blockers improve mortality in cardiomyopathy, similar to their effect in heart failure. Educational Objective: Angiotensin receptor blockers, angiotensin converting enzyme inhibitors, potassium sparing diuretics and beta blockers improve mortality in cardiomyopathy. References: http://www.wikidoc.org/index.php/Coxsackie_B_virus C. Michael Gibson, M.S., M.D ,Page 93 Master the boards step 2 CK second edition. Educational Objective: References: ]]
Approved	Approved::Yes
Keyword	WBRKeyword::Cardiomyopathy
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::