NBME 3 part 3 - bosphor - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 2 CK (https://www.usmleforum.com/forumdisplay.php?fid=3) +--- Thread: NBME 3 part 3 - bosphor (/showthread.php?tid=648732)

NBME 3 part 3 - bosphor - ArchivalUser - 01-21-2012 34. A 10-year-old girl has had fatigue and pallor for 3 weeks. Six weeks ago, she underwent aortic valve replacement with a mechanical prosthesis. She is receiving digoxin therapy. Her temperature is 37°C (98.6°F), blood pressure is 100/60 mm Hg, pulse is 115/min, and respirations are 24/min. A grade 2/6, systolic ejection murmur is heard along the left sternal border, and a grade 2/6, decrescendo diastolic murmur is heard along the left sternal border to the cardiac apex. The liver and spleen are palpable. Her hemoglobin level is 4.6 g/dL. A blood smear shows schistocytes. Which of the following is the most likely cause of the anemia? A) Autoimmune hemolytic anemia В Digoxin-induced hemolytic anemia С Glucose 6-phosphate dehydrogenase deficiency О D) Hemolytic-uremic syndrome D)Hemolytic-uremic syndrome E) Peri prosthetic valve leak 0 - ArchivalUser - 01-21-2012 There are signs of aortic regurg, so it could be peri-prostetic leak. How to explain schistocytes here? mechanical damage of RBC because of mechanical prosthesis? 0 - ArchivalUser - 01-21-2012 ee0yes i agree with u it will be hemolitic anemia due to mechical valve 0 - ArchivalUser - 01-21-2012 I would also go for E. 0 - ArchivalUser - 01-23-2012 Answer E ...for me too 0 - ArchivalUser - 02-19-2012 Please can anyone send me NBME 3 Q and A? I asked so many times here, nobody sent it to me, plz plz plz anyone plz! dr.parveen@live.com 0 - ArchivalUser - 02-19-2012 http://www.usmleforum.com/showthread.php?tid=301869