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  #1  
Old 09-26-2011
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Default Neurological condition caused by heart valve problem.

A 36-year old female with a three week history of progressive fatigue and low-grade fevers is brought to the emergency dept. with sudden onset right-sided weakness and speech difficulty. She is admitted, but dies two hours later. Gross autopsy specimen of her heart shows vegetations on the mitral valve. Which of the following conditions predisposed patient to this disease?

A) Rheumatic heart disease.
B) Atrial septal defect
C) Mitral annulus calcification
D) Coronary heart disease
E) Hypertrophic cardiomiopathy
F) Mitral valve prolapse.


Found this interesting Q. in UW. it comes with a picture but i have added all the necessary info from the pic to the question stem.
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  #2  
Old 09-26-2011
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Correct Answer A

A is correct. A case of endocarditis with embolic complication in the CNS. The underlying pathology would be mitral valve stenosis and regurgitation due to rheumatic heart disease in this young patient.
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Old 09-26-2011
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prolapse? wats the ans?
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  #4  
Old 09-26-2011
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A) Rheumatic heart disease.

AF->embolic shower->complications->death.
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Old 09-26-2011
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A.rheumatic heart dz
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Old 09-26-2011
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F) Mitral valve prolapse.

I think patient is suffering from SABE .
Rheumatic also can be answer,but i go with MVP
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Old 09-27-2011
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It's MVP. these are not the symptoms of RH n also rheumatic fever don't have vegetations
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Old 09-27-2011
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Its not typical case od Rheumatic Heart..although it is said that there are valvular vegetations..on the other side RH is immune mediated(type 2 hypersensitivity) even thought it is caused by grA beta-hemolytic streptococci and early deaths occur due to myocarditis- not the case here.
So i suppose its mitral valve prolapse EARLY LESION (as q ask) and coplicated with emboli... Am i right?
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  #9  
Old 09-27-2011
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Here is the picture include... so people can see it =)

Attached Thumbnails
Neurological condition caused by heart valve problem.-question.png  
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Old 09-27-2011
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Correct Answer

Yes guys, I also ansvered first rheumatic heart disease and so did 50% of those who answered this question in UW qbank.

But the actual answer is F) Mitral Valve Prolapse.
It is a predisposing condition. So whenever person brushes her teeth or somehow else causes an episode of bacteremia, there is always a risk for vegetations formation on the valve.

Thank you for your responses.
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  #11  
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Quote:
Originally Posted by DocSikorski View Post
Yes guys, I also ansvered first rheumatic heart disease and so did 50% of those who answered this question in UW qbank.

But the actual answer is F) Mitral Valve Prolapse.
It is a predisposing condition. So whenever person brushes her teeth or somehow else causes an episode of bacteremia, there is always a risk for vegetations formation on the valve.

Thank you for your responses.
Thanks for your explanation! Good question
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