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+--- Thread: qqqq - ebnalfady (/showthread.php?tid=306827)
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qqqq - ebnalfady - ArchivalUser - 05-31-2008
A 4-year-old boy wakes up frequently saying, 'It hurts here' while pointing to his chest. He was born prematurely but has done well otherwise. On examination he has a 2/6 ejection systolic murmur between the left sternal border and the apex that radiates to the base and is accompanied by an apical S3. The most likely diagnosis is
a) reflux esophagitis
b) aortic stenosis
c) pericarditis
d) pleuritis
e) costochondritic pain
0 - ArchivalUser - 05-31-2008
b ?
0 - ArchivalUser - 05-31-2008
premature most likely b?
0 - ArchivalUser - 05-31-2008
b?
0 - ArchivalUser - 05-31-2008
not a, e,b. left with c and d. i go with C because of the heart murmurs
0 - ArchivalUser - 05-31-2008
B?
0 - ArchivalUser - 05-31-2008
this finding can be normal in children(innocent murmurs) & s3 also. I go for e,costochondritis
0 - ArchivalUser - 05-31-2008
is it c?
pain upon waking make me think so. in AS, pain comes when exercising. and i am not sure if some child can develop AS so early. people develop it in 60-80s. s3 is normal in childeren. i am not sure abt ejection systolic murmer in childeren. chostochondrtitis i think is common in female and young at 4th iCS and that is tenderness.
0 - ArchivalUser - 05-31-2008
DD
0 - ArchivalUser - 05-31-2008
THIS IS THE ONLY QS IN USMLE MAKE U LAUGH TILL THE DAY OF THE EXAM