A 35-year-old man complains of substernal chest pain aggravated by inspiration relieved by sitting up. He has a history of tuberculosis. Lung fields are clear on auscultation, and heart sounds are distant. Chest x-rav shows widened mediastinum and an enlarged cardiac silhouette. Which of the following is the best diagnostic test?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: B. Echocardiogram
Pleuritic chest pain relieved by sitting up, a TB history, distant heart sounds and an enlarged cardiac silhouette suggest tuberculous pericarditis with pericardial effusion. Echocardiography is the imaging procedure of choice: the most sensitive and specific way to confirm pericardial fluid. Catheterization is invasive and not needed, a decubitus film is for pleural effusion, and serial ECG/markers target ACS.
ليش كل خيار صح أو غلط
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A
ليش غلط
Cardiac catheterization is reserved for when noninvasive methods are inconclusive, so it is not the best first diagnostic test for a suspected effusion.
✓ CARDIOLOGY - PERICARDIAL DISEASES.pdf · p. 4 -
B
ليش صح
Echocardiography is the imaging procedure of choice for pericardial effusion and the most sensitive and specific way to show pericardial fluid (even about 20 mL).
✓ Step Up To Medicine 6th(Pericardial disease).pdf · p. 5 -
D
ليش غلط
Serial ECG and troponin/CK-MB are the work-up of ischemic chest pain (ACS). This patient has pleuritic pain relieved by sitting up, distant heart sounds and an enlarged silhouette, pointing to effusion rather than ischemia.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 8
- المصدر
- Step Up To Medicine 6th(Pericardial disease).pdf · p. 5
CARDIOLOGY - PERICARDIAL DISEASES.pdf · p. 3 - المحاضرة
- Pericardial Disease · Cardiology · Module B
- ظهر في
- Cardio bank