USMLE Forum Archives - USMLE Step 1 - 4039
4039
babbu5508 - 02-22-11 04:36
A 40-year-old woman presents to the emergency department with sudden onset of excruciating pain referred to the chest and back. Over the next several hours, she reports that the pain keeps "moving down" slowly. Initially, her ankle and wrist pulses are both strong, but with time the wrist pulses become weak, although the ankle pulses remain strong. Which of the following conditions would be most likely to predispose for the patient's problem?
Options:
A. Atherosclerosis
B. Cystic medial necrosis
C. Diabetes mellitus
D. Polyarteritis nodosa
E. Syphilis
babbu5508 - 02-22-11 04:36
A 40-year-old woman presents to the emergency department with sudden onset of excruciating pain referred to the chest and back. Over the next several hours, she reports that the pain keeps "moving down" slowly. Initially, her ankle and wrist pulses are both strong, but with time the wrist pulses become weak, although the ankle pulses remain strong. Which of the following conditions would be most likely to predispose for the patient's problem?
Options:
A. Atherosclerosis
B. Cystic medial necrosis
C. Diabetes mellitus
D. Polyarteritis nodosa
E. Syphilis
The correct answer and explanation will be available after you answer.
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#5
Re: 4039
babbu5508 - 03-14-11 09:26 The correct answer is B. The patient is experiencing aortic dissection. In this disorder, the pain typically moves downward as the dissection progresses, and involvement of the aortic branches causes weakening of the wrist pulses.
#10
Re: 4039 berserk - 01-21-12 20:21 My answer is: b.
cystic medial necrosis leads to increased susceptibility to aortic dissection as in marfans
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