complication - aashi

[ArchivalUser]

nb form 1q

67 ys man with 3day h/o fever,headache.5yrs ago he had mech valve replacement for Rh.fever sequelae.temp 40.0,bp 110/65 pulse 110, r.r 22,3/6 ejection systolic murmur is heard.neuro exam mild leftt hemiperesis,babinskis positive on left, no nuchal rigidity.
pt is at graettest risk for which compliaction

1 brain abscess
2 carotid artery occlussion
3 encephalitis
4 hydrocephalus
5 venous sinus thrombosis

[ArchivalUser]

2? does he sound like hes having inf endocarditis viz mech valve?

[ArchivalUser]

brain abscess

[ArchivalUser]

Sounds like pt has infectious endocarditis w aortic valvular stenosis, so i choose A. Although all pt w mech valve's put on anticoagulation, but note he's already got brain embolism.