Lets talk study1 - sammy10

[ArchivalUser]

A 44 year old man comes to the ER for a 7 days fever and a 2 days history of red spots on his eyes. He also reports some lethargy and fatigue. His past medical history is otherwise unremarkable. he does state that when he was a teenager,his physician once told him that he has a heart valve problem. That would require him to take antibiotics on dental visits. His temperate is 38C, BP is 140/75mm, pulse is 92/min and respirations are 16/min. He has bilateral conjunctival hemorrhages and small indurations present on the dorsum of his hands. He has 1/6 systolic ejection murmur best heard at the apex of the heart. The finding most likely to confirm the diagnosis is?

A. Echocardiogram showing mitral regurg
B. Echocardiogram showing a valvular mass
C. elevated ESR
D. Positive V/Q scan
E. Single positive blood culture

[ArchivalUser]

A......

[ArchivalUser]

B..

[ArchivalUser]

B
medicine king- he is coming in for symptomatic endocarditis, who cares if his valve is regurging- a lesion i would think would confirm the dx

[ArchivalUser]

E...........five minor criteria can diagnose infective endocarditis

[ArchivalUser]

b seems correct. But why A when the mass is obvious on the ECHO.

[ArchivalUser]

IE affects valveS and cause vegetations..but to confirm valve involved based on finding ..do.echo to confirm MR..

[ArchivalUser]

E ?

[ArchivalUser]

The correct answer is B.
Only B forms a major criteria for the diagnosis of endocarditis. E is a good distractor. Notice that it says single positive blood culture while the criteria is the positivity of 2 consective blood cultures