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#1
11-27-2011
 USMLE Forums Master Steps History: --- Posts: 1,203 Threads: 180 Thanked 1,251 Times in 441 Posts Reputation: 1265
Explanation for the high pulse pressure?

A 65 yr. old male visits his family practitioner for a yearly examination. Measurement of his blood pressure reveals a systolic pressure of 190 mm Hg and a diastolic pressure of 100 mm Hg. His heart rate is 74/min and pulse pressure is 90 mm Hg. A decrease in which of the following is the most likely explanation for the high pulse pressure?
A. Arterial compliance
B. Cardiac output
C. Myocardial contractility
D. Stroke volume
E. Total peripheral resistance
 The above post was thanked by: inno (11-28-2011)

#2
11-27-2011
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decrease in arterial compliance (A)
#3
11-27-2011
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whats the right ans?

e.Total Peripheral resistance

I think thats the answer.Anyone else?
#4
11-27-2011
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It's A

It says decrease to cause high pulse pressure not increase Increase would be all the other except A. A decrease in compliance would lead to high pulse pressure
#5
11-27-2011
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My ans is A too!

Its 'A' bec a decrease in compliance will make the vessels less distensible. Hence, it will lead to increase in pressure much like what occurs in atherosclerosis.
#6
11-28-2011
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decreased arterial compiance
#7
11-28-2011
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Yeah its A ! And as age gives clue to this answer also alongwith pulse pressure and compliance relation
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#8
11-29-2011
 USMLE Forums Veteran Steps History: Not yet Posts: 281 Threads: 74 Thanked 131 Times in 68 Posts Reputation: 141

Hey you guys are right I think its A as when the compliance decreases the elasticity goes up and so the pulse pressure increases. But could any one please explain why in anaemia or septic shock the decrease in the peripheral resistance will increase the pulse pressure which is the E option in the above question.
#9
11-29-2011
 USMLE Forums Master Steps History: --- Posts: 1,203 Threads: 180 Thanked 1,251 Times in 441 Posts Reputation: 1265

A it is..A decrease in arterial compliance indicates that the arterial wall is stiffer (i.e., less distensible). When the compliance of the arterial system decreases, the rise in arterial pressure becomes greater for a given stroke volume pumped into the arteries. In the normal young adult, the systolic blood pressure is about 120 mm Hg and the diastolic blood pressure is about 80 mm Hg. Because the pulse pressure is the difference between the systolic and diastolic blood pressures, the normal pulse pressure is about 40 mm Hg in a healthy young adult. However, in older adults the pulse pressure sometimes increases as much as two times normal because the arteries become hardened by arteriosclerosis

 Tags Cardiovascular-, Physiology-, Step-1-Questions

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