WBR1013

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Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Physiology
Sub Category SubCategory::Cardiology
Prompt [[Prompt::Cardiovascular parameters are collected from the charts of hospitalized patients with different medical conditions for a retrospective study. One of the patients have the following parameters:

Systolic blood pressure: 160 mmHg
Diastolic blood pressure: 60 mmHg
Pulse: 90 beats per minute

Which of the following medical conditions is possibly present in this patient?]]

Answer A AnswerA::Aortic stenosis
Answer A Explanation [[AnswerAExp::Aortic stenosis is characterized by a decreased pulse pressure.]]
Answer B AnswerB::Cardiac tamponade
Answer B Explanation [[AnswerBExp::Cardiac tamponade is characterized by a decreased pulse pressure.]]
Answer C AnswerC::Heart failure
Answer C Explanation [[AnswerCExp::Progressed heart failure is characterized by a decreased pulse pressure.]]
Answer D AnswerD::Cardiogenic shock
Answer D Explanation [[AnswerDExp::Cardiogenic shock is characterized by a decreased pulse pressure.]]
Answer E AnswerE::Hyperthyroidism
Answer E Explanation [[AnswerEExp::Hyperthyroidism is characterized by an elevated pulse pressure.]]
Right Answer RightAnswer::E
Explanation [[Explanation::The pulse pressure of this patient is:

Pulse pressure= systolic blood pressure - diastolic blood pressure= 160 - 60= 100 mmHg
The patient has an elevated pulse pressure which can be found in hyperthyroidism, aortic regurgitation and obstructive sleep apnea. Aortic stenosis, cardiac tamponade, progressed [heart failure]] and cardiogenic shock are characterized by a low pulse pressure.

Educational objective: Pulse pressure is elevated can be elevated in hyperthyroidism, aortic regurgitation and obstructive sleep apnea; while it can be low in aortic stenosis, cardiac tamponade, progressed [heart failure]] and cardiogenic shock.

Reference: First aid for USMLE step 1, 2014. Page 266.
Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Pulse pressure, WBRKeyword::hyperthyroidism
Linked Question Linked::
Order in Linked Questions LinkedOrder::