An 84-year-old man has central chest pain that has gradually worsened over the last month. He finds it worse on exertion— especially with climbing stairs. He has type-2 diabetes and a hiatus hernia. Vital signs: Temp is 37.1 °C, HR is 95 bpm, BP is 165/95mmHg. ECG and chest X-ray were both reported as 'normal'. Which is the single most likely diagnosis?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: A. Stable angina
- إجابة ثانية: B. Unstable angina
Central chest pain brought on by exertion (stairs) with a normal resting ECG is classic stable angina. In stable angina the resting ECG is usually normal. No rest pain, fever or pericarditis features, and no tearing pain.
- B: the sources define unstable angina as rest/minimal-exertion pain or a crescendo (worsening) pattern. "Gradually worsened over the last month" could be read that way, which makes this ambiguous.
The bank and the exertional picture favour A.
ليش كل خيار صح أو غلط
-
A
ليش صح
Supported by the IHD lecture notes: exertional chest pain with a normal resting ECG fits stable angina, since the resting ECG is usually normal in it.
✓ CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 4 -
B
ليش صح
Supported by the 'Ischemic heart disease' notes: a crescendo pattern (more severe, prolonged or frequent than before) defines unstable angina, which a month of worsening could suggest.
✓ Ischemic heart disease.pdf · p. 3 -
C
ليش غلط
Pericarditis pain is sharp, retrosternal and aggravated by cough, breathing or body position; his pain is exertional and he is afebrile.
✓ Ischemic heart disease.pdf · p. 11 -
D
ليش غلط
Reflux gives deep burning discomfort worsened by lying down after meals and relieved by antacids, not exertional pain.
✓ Ischemic heart disease.pdf · p. 12 -
E
ليش غلط
Aortic dissection pain is tearing, ripping with abrupt onset; his pain built up gradually over a month with exertion.
✓ Ischemic heart disease.pdf · p. 10
- المصدر
- Ischemic heart disease.pdf · p. 3
CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 4 - المحاضرة
- Ischemic Heart Disease · Cardiology · Module B
- ظهر في
- Cardio bank