Patient with SLE came has a problem for 2 weeks, distant heart sound, pulsus paradoxus and increased JVP which increase with inspiration, what is the most likely diagnosis?
سؤال مجاني 4 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: D. Cardiac tamponade
- إجابة ثانية: A. Constrictive pericarditis
Distant heart sounds plus pulsus paradoxus over a short (2-week) course in a patient with SLE (an autoimmune cause of pericardial effusion) fits cardiac tamponade, whose key findings are the Beck triad and pulsus paradoxus. However, a JVP that rises with inspiration is the Kussmaul sign, which the sources list as a sign of constrictive pericarditis (a chronic process, also linked to connective tissue disease), so the stem mixes features. The intended answer is most likely tamponade.
ليش كل خيار صح أو غلط
-
A
ليش صح
Supported by the Cardiology pericardial summary (p4): constrictive pericarditis lists raised JVP, Kussmaul sign (JVP not falling with inspiration) and pulsus paradoxus, fitting the JVP that rises with inspiration.
✓ CARDIOLOGY - PERICARDIAL DISEASES.pdf · p. 4 -
B
ليش غلط
Acute MI is recognised by ECG changes (ST elevation in STEMI, ST depression/T inversion in NSTEMI) and raised troponin/CK-MB. Distant heart sounds, pulsus paradoxus and raised JVP are not MI findings.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 8 -
C
ليش غلط
Libman-Sacks endocarditis is SLE-related warty valve vegetations that may give regurgitant murmurs or emboli. It does not cause pulsus paradoxus or distant heart sounds.
✓ Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 13 -
D
ليش صح
Supported by Step Up (p7): for cardiac tamponade the key findings are Beck triad (hypotension, muffled heart sounds, elevated JVP) and pulsus paradoxus, matching the distant sounds, raised JVP and pulsus paradoxus.
✓ Step Up To Medicine 6th(Pericardial disease).pdf · p. 7 -
E
ليش غلط
PE presents with dyspnea, tachypnea and tachycardia from hypoxia (pulmonary artery occlusion, impaired gas exchange). Pulsus paradoxus with distant heart sounds is not part of this picture.
✓ 12• Venous Thromboembolism [Notes].pdf · p. 5
- المصدر
- Step Up To Medicine 6th(Pericardial disease).pdf · p. 7
Step Up To Medicine 6th(Pericardial disease).pdf · p. 4 - المحاضرة
- Pericardial Disease · Cardiology · Module B
- ظهر في
- Cardio bank