USMLE Forum Archives - USMLE Step 1 - Pathology 22
Pathology 22
TheOne - 10-27-06 13:33
A 30-year-old man with an undiagnosed cardiac anomaly has been unable to do strenuous exercise throughout his life. Auscultation demonstrates an immediate diastolic murmur, which has been be present since childhood. The patient has never been cyanotic. Which of the following disorders would most likely cause the patient's findings?
A. Bicuspid aortic valve
B. Common pattern transposition of the great arteries
C. Patent ductus arteriosus
D. Tricuspid atresia
E. Truncus arteriosus
TheOne - 10-27-06 13:33
A 30-year-old man with an undiagnosed cardiac anomaly has been unable to do strenuous exercise throughout his life. Auscultation demonstrates an immediate diastolic murmur, which has been be present since childhood. The patient has never been cyanotic. Which of the following disorders would most likely cause the patient's findings?
A. Bicuspid aortic valve
B. Common pattern transposition of the great arteries
C. Patent ductus arteriosus
D. Tricuspid atresia
E. Truncus arteriosus
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#3
Re: Pathology 22 simple - 10-31-06 12:00 I think the answer is A. since the murmur is diastolic it most likely would be mitral stenosis when it would be heard during late diastole corresponding to the atrial kick , or aortic insufficiency. if the aortic valve has a defect it can predispose to insufficiency. Transposition of the great arteries and truncus arteriosus should have some degree of cyanosis unless there is significant shunting decause of an ASD or VSD. PDA should give a machine like murmur.im not too sure of what one should find in tricuspid atresia so i would leave it alone. maybe its the answer.
#4
Re: Pathology 22 nrp - 11-01-06 01:15 Me too goes for A. I think , simple, if its tricuspid atresia, the case scenario should b different. Here the patient is 30 yrs old and if affects him only when he tries to do strenuous exercise. Tricuspid atresia is not that compatible with life unless a correction surgery is done or other shunting mechanisms are present
#5
Yup
TheOne - 11-01-06 17:14 Explanation: The correct answer is A. Isolated bicuspid aortic value is a very common congenital anomaly, which may be completely asymptomatic or may cause modest noncyanotic obstruction related to stenosis. It is associated with an immediate diastolic murmur, related to some degree of aortic insufficiency that is often recognized in early childhood. Surgical correction of even mild to moderate stenosis or insufficiency is now recommended to prevent long-term damage to the heart muscle. The common pattern of transposition (choice B) of the great vessels produces early cyanosis. Uncorrected patent ductus arteriosus (choice C) produces a continuous ("machinery") murmur and late cyanosis. Tricuspid atresia (choice D), which is usually accompanied by an atrial septal defect, produces early cyanosis. Truncus arteriosus (choice E) produces early cyanosis.
Oh by the way guys, is the time period between posting a question then an answer works good for you all?
#6
Re: Pathology 22 nrp - 11-01-06 23:25 yes The One. It is really good to post the answer afterwards, gives us a time to think about the question, else it will b so automatic to go through the answer soon after finishing reading the question.And this site is the most useful site concerning USMLE.
#7
Re: Pathology 22 galaxy - 05-27-10 19:34 bicuspid aortic valve may be associated with some degree of aortic insufficiency that was diagnosed in early childhood and the cause of exercise fatigue.
#9
Re: Pathology 22 bingousmle - 06-30-10 22:19 bicuspid aortic valve as the man has undiagnosed cardiac anomaly has been unable to do strenuous exercise throughout his life. Auscultation demonstrates an immediate diastolic murmur,
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