2.2.17 - 123pass

[ArchivalUser]

17. A 62-year-old woman is brought to the emergency department 1 hour after a 1-minute episode of loss of consciousness; her symptoms began when she stood up after she passed a dark, watery stool. She has had diarrhea and dark stools for 2 days. She has been receiving warfarin therapy for deep venous thrombosis for 2 weeks. On arrival, her blood pressure is 82/60 mm Hg, and pulse is 150/min and regular. She is unable to stand. The lungs are clear to auscultation. A grade 2/6 systolic murmur is heard at the second right intercostal space with no radiation. Examination shows a soft, nontender abdomen. There is 1+ edema of the right lower extremity with no tenderness. Test of the stool for occult blood is positive.


A
) Aortic stenosis

B
) Carotid sinus hypersensitivity

C
) Conversion reaction

D
) Hypertrophic obstructive cardiomyopathy

E
) Hypoglycemia

F
) Mitral valve prolapse

G
) Orthostatic hypotension

H
) Pulmonary embolus

I
) Seizure

J
) Vasovagal syncope

K
) Vertebrobasilar insufficiency

[ArchivalUser]

G.

[ArchivalUser]

is it g?

[ArchivalUser]

is 2/6 systolic murmur of AS normal?

[ArchivalUser]

Murmur may not be normal but if it was sycope due to AS it wont present like this , lost consciousness after standing and BP is low and she cant stand. so i think its G.