A 40-year-old man who injects drugs has fever, chills and breathlessness. He is febrile and tachycardic, with a pansystolic murmur at the left lower sternal border and bilateral crackles. CXR shows multiple bilateral nodular infiltrates. Which finding is the most specific for confirming infective endocarditis?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Vegetation on the tricuspid valve on echocardiography
Echocardiographic demonstration of a vegetation directly documents endocardial involvement, a Duke major criterion, so it is the most specific finding for confirming IE. Septic pulmonary emboli are only a minor (vascular) criterion. A murmur is nonspecific. S. aureus bacteraemia can come from other sources (e.g. skin or injection sites) without endocarditis.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Septic pulmonary emboli count only as a vascular phenomenon, a Duke minor criterion, so they do not confirm IE on their own.
✓ CARDIOLOGY- VHD+IE.pdf · p. 17 -
B
ليش غلط
A new murmur with fever is the clinical clue that prompts echo and cultures. It suggests valve involvement but is less specific than seeing the vegetation itself on echocardiography.
✓ CARDIOLOGY- VHD+IE.pdf · p. 17 -
C
ليش صح
A vegetation on echocardiography is endocardial involvement, a Duke major criterion that documents the lesion itself.
✓ CARDIOLOGY- VHD+IE.pdf · p. 17 -
D
ليش غلط
Duke lists sustained bacteremia with a typical organism as a major criterion, but a positive culture shows bacteremia, not the endocardial lesion itself that echo demonstrates.
✓ Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 11
- المصدر
- Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 11
CARDIOLOGY- VHD+IE.pdf · p. 17 - المحاضرة
- Valvular Heart Disease · Cardiology · Module B
- ظهر في
- MED42 Compre B