08-15-2006, 02:53 AM
b.
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the other one - dhruva_doctor
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08-15-2006, 02:59 AM
hey are most the peeps in the prep4mle forum american grads. coz one guy said it took him 5 weeks to get 95 on his step 1
08-15-2006, 03:04 AM
E. This patient is presenting with the classic signs and symptoms of hypertrophic cardiomyopathy.
08-15-2006, 03:07 AM
sao & luckyalways...u are correct......it's E
he correct answer is E. This patient is presenting with the classic signs and symptoms of hypertrophic cardiomyopathy. Patients with this condition often initially present with complaints of dyspnea and chest pain. They also may have experienced recent episodes of post-exertional syncope. On examination, there is usually a sustained apical impulse, loud S4, and systolic ejection murmur. The echocardiogram is diagnostic for this condition, as it will typically show systolic anterior motion of the mitral valve, asymmetric left ventricular hypertrophy, and early closing followed by the reopening of the aortic valve. Beta-receptor blocking agents, such as metoprolol, are the most commonly used initial agents in symptomatic patients, especially when dynamic outflow is noted on the echocardiogram. Beta-blockers generally prevent the appearance of dyspnea, angina, and arrhythmias in around 50% of all patients. Calcium channel blockers, such as verapamil, have also been effective in symptomatic patients. Bretylium (choice A) is a class III antiarrhythmic indicated for the treatment of ventricular fibrillation and ventricular tachycardia. Digoxin (choice B) is an antiarrhythmic used primarily for the treatment of atrial fibrillation and flutter; this agent is also used to decrease the signs and symptoms associated with congestive heart failure. Enalapril (choice C) is an angiotensin-converting enzyme (ACE) inhibitor indicated for the treatment of hypertension and congestive heart failure (CHF). Note that ACE inhibitors are indicated for the "initial" and chronic treatment of CHF. Lidocaine (choice D) is a class Ib antiarrhythmic indicated for the treatment of ventricular tachycardia. |
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