USMLE Forum Archives - USMLE Step 2 CK - liver
liver
conym5 - 03-24-10 10:21
66-year-old alcoholic male comes with the complaints of abdominal distention and respiratory distress. He also complains of weight loss o. On examination, he has diffuse rales in the chest, 2+ pedal edema, and shifting dullness in abdomen. His vitals are: PR: 90/min, Temperature: 37.2C(99F), RR: 18/min. What should be the next best step in the management of this patient?
conym5 - 03-24-10 10:21
66-year-old alcoholic male comes with the complaints of abdominal distention and respiratory distress. He also complains of weight loss o. On examination, he has diffuse rales in the chest, 2+ pedal edema, and shifting dullness in abdomen. His vitals are: PR: 90/min, Temperature: 37.2C(99F), RR: 18/min. What should be the next best step in the management of this patient?
The correct answer and explanation will be available after you answer.
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#2
Re: liver ammulufy - 03-24-10 18:31 My answer is: b.
Probably the patient is in failure.....hence we have to confirm it further through procedures like ecg or cxr.......instead of us scan or ct scan abdomen.......however his chronic alcoholic history is consistent for liver involvement but the probable cardiac abnormality is to be ruled out frst.
#3
Re: liver
conym5 - 03-25-10 13:48 d. surgical procedure is the right answer, hidden answer is diagnostic and therapeutic paracentesis..i got it wrong too..
@ammulufy : CXR ???
#5
Re: liver mtniharika - 04-30-10 07:52 My answer is: a.
the patient is probably suffering from liver cirrhosis due to chronic alcohol intake...and the signs are suggestive of right failure...
#6
Re: liver bingousmle - 05-04-10 07:29 My answer is: d.
since the man is in respiratory distress a procedure which will be diagnostic as well as therapeutic like an abdominal paracentesis and culture and analyisis is the best thing
#14
Re: liver babbu5508 - 05-20-10 02:44 My answer is: d.
diagnostic and therapeutic paracentesis is the surgical procedure which partially aids to the diagnosis and importantly,relieves the distress...
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