USMLE Forum Archives - USMLE Step 3 - IM 6
IM 6
bingousmle - 06-20-10 05:55
A 72-year-old man presents to the ED with worsening dyspnea. His initial vitals include a HR of 93 beats per minute, BP of 110/50 mm Hg, and RR of 20 breaths per minute with an oxygen saturation of 88% on room air. The patient appears thin and anxious. He is using accessory muscles to breathe. Despite distant breath sounds, you hear end-expiratory rhonchi and a prolonged expiratory phase. An ECG shows peaked P waves in leads
II, III, and aVF. Given this patient’s history and physical examination, which of the following conditions does this patient most likely have?
a. Chronic bronchitis
b. Asthma
c. Emphysema
d. Congestive heart failure (CHF)
e. Pneumothorax
bingousmle - 06-20-10 05:55
A 72-year-old man presents to the ED with worsening dyspnea. His initial vitals include a HR of 93 beats per minute, BP of 110/50 mm Hg, and RR of 20 breaths per minute with an oxygen saturation of 88% on room air. The patient appears thin and anxious. He is using accessory muscles to breathe. Despite distant breath sounds, you hear end-expiratory rhonchi and a prolonged expiratory phase. An ECG shows peaked P waves in leads
II, III, and aVF. Given this patient’s history and physical examination, which of the following conditions does this patient most likely have?
a. Chronic bronchitis
b. Asthma
c. Emphysema
d. Congestive heart failure (CHF)
e. Pneumothorax
The correct answer and explanation will be available after you answer.
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#2
Re: IM 6
bingousmle - 06-20-10 06:35 My answer is: c.
This patient has both as left-sided failure often leads to right-sided failure. Outpatient management for CHF includes a β-blocker to decrease cardiac stress and improve contractility, a loop diuretic to aid in diuresis of excess fluid and an ACE inhibitor for both BP management and renalprotective
effects
#3
Re: IM 6 babbu5508 - 06-20-10 14:15 My answer is: d.
Congestive heart failure (CHF)..as seen bydyspnoea,nd-expiratory rhonchi and a prolonged expiratory phase
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