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pluto
Hi guys,would really appreciate if u could help answer the question.An explanation wil be appreciated .
A patient with longstanding moderately severe anemia dies in an automobile accident.He was driving and an autopsy was performed to determine the cause of his death.Which of the following cardiac changes will most likely be seen when the heart is examined?
a.Endocarditis
b.fatty change of myocytes
c.Fibrinous pericarditis
d.fibrosis of valve leaflets
e.frank myocardial infarction
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Aa
whay is it fatty change of myocytes??Is it lipofuschin or what??
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stuck
I think its A. I dont know exactly why....I just remember some corelation b/t anemia and it causing the development of murmers when its long standing and murmers are a RF for endocarditis.
But anemia also causes MIs for sure! So that could be the answer.
Why do you guys think B?
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nicholas
man, i would go for B. my reasoning is not perfect, but it is how i think in questions which i don't have the answer for. i would reason like this: anemia causes the heart to work increasingly hard, maybe that causes some fatty change of myocytes in its adaptation. the others i would exclude something like this:
A. why would he have endocarditis? no reason to suspect.
C. the same with fibrinous pericarditis (isn't that caused by post-MI, SLE etc)
D. why would he have that? is he old? nothing in the text about that or about valvular defects.
E. well, it is quite common, but probably B is the answer and it sounds like a change which could be caused by increased workload.
maybe not very wise of me showing my lack of knowledge like this, but i think one must have a way of making good guesses on the questions you don't really know.
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kiddyfriend
Anemia produces chronic hypoxemia. Chronic hypoxemia leads to fatty change in myocytes.
This fatty change is not the same as lipofuszin.
BTW, I don't think that this fatty change is the cause of his death. It's unrelated.
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pluto
the answer given is b,fatty change.
I would have gone for myocardial infarction which may have resulted from acute hemorrage during the accident.I also agree that fatty change resulting from chronic anemia was a finding,but because the patient died, he probably had an ischemia of the heart and other organs resulting fron injuries sustained during the accident,thus findings of myocardial ischemia.
please enlighten me on why this may be wrong.
thanks
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Mom
E
Cheonic Anemia leads to low cardiac output, leads to decrease
O2 & perfusion & ischemia of cardiac, brain & other vital cells of the body. If we placed a swan in a dying heart, we would see decreased CI & CO. <3 is not competible w/ life & therefore is cosidered MI resulting fron cadiogenic shock. Its a trick q.
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ani
it is a trick question
this patient died of a myocardial infarction. The question stated he was driving (it didnt need to). Myocardial infarction with arrythmia is one of the common causes of loss of vehicular loss of control leading to accidents (another is seizures). However the answer is CAN NOT be E (frank myocardial infarction) because there would be no histological changes in his heart as he died immediately. He would have to survive a day even to see FRANK myocardial infarction.
So given that the answer is not E and that he did die of a myocardial infarction, it follows that there must have been an incidental abnormality of the heart which did not cause death but was seen on examination.
Of all the options given only B can be correct (as the other 3 cause symptoms, and are pathological, there is nothing in the history to point to them and none cause sudden death). Fatty change on the other hand is inconsequential and would not on its own cause any symptoms.
For questions like this it is possible to get the right answer even if you had never known (like me) that anaemia is indded associated with fatty change. By doing Q-bank and following the logic there you can acquire the skill of correctly answering questions of which you do not actually know the answer.
