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  #1  
Old 05-14-2012
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Stethoscope Presence of S3 & S4 Cause

A 78-year-old male come to your clinic with dyspnea on exertion, edema, and S3 murmur in early diastolic is appreciated; a drug with a direct inhibition of N+/K+ ATPase is given within the adequate dose to ameliorate him. After 4 days, the patient back to the clinic with hypertension and S4 murmur appreciation in late diastolic, ventricular hypertrophy. Of following, which should be the cause(S) of this patient abnormaly?

A) Crescendo-descrecendo murmur
B) Bolcked atrioventricular conduction
C) Hypertrophy ventricular
D) Compression of heart by fluid
E) Hypertension
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Old 05-14-2012
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It would be C) Ventricular hypertrophy.


S3 = when there is rapid ventricular filling
S4 = when the left ventricle is stiff/hypertrophied.


HTN would cause LV hypertrophy which would cause the S4.
The drug in question in Digoxin.
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Originally Posted by Hope2Pass View Post
It would be C) Ventricular hypertrophy.


S3 = when there is rapid ventricular filling
S4 = when the left ventricle is stiff/hypertrophied.


HTN would cause LV hypertrophy which would cause the S4.
The drug in question in Digoxin.
This was one of the famous question I had when I sat for the test I'll nerver forget because is not found in wathever Qbank and reference book for the test. You pick the answer I picked but you and I are wrong

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Originally Posted by alfjof View Post
This was one of the famous question I had when I sat for the test I'll nerver forget because is not found in wathever Qbank and reference book for test. You pick the answer I picked but you and I are wrong
Is it Blocked AV Conduction ..because that's a side effect of Digoxin .. that's the only other thing I can think of but I don't know how it would lead to S4 ? Man, good question..I guess I'll wait for you to put up the answer then lol
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Is it Blocked AV Conduction ..because that's a side effect of Digoxin .. that's the only other thing I can think of but I don't know how it would lead to S4 ? Man, good question..I guess I'll wait for you to put up the answer then lol

I nerver know that about digoxin, furthermore, it is not a toxicity sign of digoxin; the propose of this question why S3 and S4 are present togerther? We'll wait for another personne to explain us that ok and I will post the good answer and explanation to clear us
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Old 05-14-2012
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The only thing which occurs to me is Na retention because of the drug n then effusion.....so compression of ventricles by fluid during Diastol.
Choice- D
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Old 05-15-2012
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Originally Posted by kdm0101 View Post
The only thing which occurs to me is Na retention because of the drug n then effusion.....so compression of ventricles by fluid during Diastol.
Choice- D

It is not the answer try another one
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Old 05-15-2012
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Default tell the answer man......

Quote:
Originally Posted by alfjof View Post
A 78-year-old male come to your clinic with dyspnea on exertion, edema, and S3 murmur in early diastolic is appreciated; a drug with a direct inhibition of N+/K+ ATPase is given within the adequate dose to ameliorate him. After 4 days, the patient back to the clinic with hypertension and S4 murmur appreciation in late diastolic, ventricular hypertrophy. Of following, which should be the cause(S) of this patient abnormaly?

A) Crescendo-descrecendo murmur
B) Bolcked atrioventricular conduction
C) Hypertrophy ventricular
D) Compression of heart by fluid
E) Hypertension

it seems question stem is lacking something......its even hard to guess also ......
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Old 05-15-2012
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Quote:
Originally Posted by alfjof View Post
A 78-year-old male come to your clinic with dyspnea on exertion, edema, and S3 murmur in early diastolic is appreciated; a drug with a direct inhibition of N+/K+ ATPase is given within the adequate dose to ameliorate him. After 4 days, the patient back to the clinic with hypertension and S4 murmur appreciation in late diastolic, ventricular hypertrophy. Of following, which should be the cause(S) of this patient abnormaly?

A) Crescendo-descrecendo murmur
B) Bolcked atrioventricular conduction
C) Hypertrophy ventricular
D) Compression of heart by fluid
E) Hypertension

Can you please check everything before posting a question?
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  #10  
Old 05-15-2012
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Quote:
Originally Posted by alfjof View Post
A 78-year-old male come to your clinic with dyspnea on exertion, edema, and S3 murmur in early diastolic is appreciated; a drug with a direct inhibition of N+/K+ ATPase is given within the adequate dose to ameliorate him. After 4 days, the patient back to the clinic with hypertension and S4 murmur appreciation in late diastolic, ventricular hypertrophy. Of following, which should be the cause(S) of this patient abnormaly?

A) Crescendo-descrecendo murmur
B) Bolcked atrioventricular conduction
C) Hypertrophy ventricular
D) Compression of heart by fluid
E) Hypertension
I think AS is causing all this... My answer is A
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  #11  
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I think it's E.

Hypertension can cause ventricular hypertrophy, leading to S4.
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  #12  
Old 05-15-2012
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I think its A too...
he is having CHF from HTN..
My first thought was C too, but since you said that was wrong...
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Quote:
Originally Posted by alfjof View Post
This was one of the famous question I had when I sat for the test I'll nerver forget because is not found in wathever Qbank and reference book for the test. You pick the answer I picked but you and I are wrong

Did you actually get this Q on the exam???? Thats scary !!
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  #14  
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Quote:
Originally Posted by DocSikorski View Post
Can you please check everything before posting a question?

I wish you for now good luck not found error in all Qbank you are doing thing I see in all Qbank I did(I responded questions I nerver got idea what they asked in), because the test is not about grammar. I posted it WELL the thing is the administrator of this forum have been changed it. So, at least it is not a reason if you not desire to respond and discute with us the question or my questions in this forum
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Did you actually get this Q on the exam???? Thats scary !!
Yes, I found it on my real exam that's the reason I posted it in this forum
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  #16  
Old 05-15-2012
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Quote:
Originally Posted by K06100 View Post
it seems question stem is lacking something......its even hard to guess also ......

That I felt when I sat on my test and saw this question man and
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  #17  
Old 05-15-2012
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Quote:
Originally Posted by alfjof View Post
I wish you for now good luck not found error in all Qbank you are doing thing I see in all Qbank I did(I responded questions I nerver got idea what they asked in), because the test is not about grammar. I posted it WELL the thing is the administrator of this forum have been changed it. So, at least it is not a reason if you not desire to respond and discute with us the question or my questions in this forum
What? lol

No, its not about grammar, but most of the time I am unable to understand what you're asking.
I must be dumb, sorry
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Old 05-15-2012
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Originally Posted by DocSikorski View Post
What? lol

No, its not about grammar, but most of the time I am unable to understand what you're asking.
I must be dumb, sorry
No problem, try to anderstand at least the fact what you can conclude to have the best answer, we need to discuss more question if we need to have success in the exam.
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I would go for E , it is the only reasonable for me
waiting for the right answer
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Default Explanation

After I left the exam room I felt deceptionated because they asked me black things, so the reason I posted all those questions so HARD, I want all of you anderstand how the test can be high difficult for you furthermore easier for another one

The diagnosis is SUMMATION GALOP

A) Crescendo-descrecendo murmur: Aortic stenosis it is not a cause of the presence of both S3 & S4, but ejection click and S4 are possible
B) Bolcked atrioventricular conduction: 2 galop in one is called: Summation galop which may result from Tachycardia or Delayed AV conduction or Bolcked atrioventricular conduction(Correct answer)
C) Hypertrophy ventricular: Presence of S4 only e.i not associates with S3
D) Compression of heart by fluid: Cardiac tamponade presence of hypotension, distant heart sound, increased jugular pressure, and in the EKG there is beat-to-beat alteration of QRS
E) Hypertension: Only S4 is present



http://books.google.com/books?id=gU4...causes&f=false
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  #21  
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Quote:
Originally Posted by alfjof View Post
After I left the exam room I felt deceptionated because they asked me black things, so the reason I posted all those questions so HARD, I want all of you anderstand how the test can be high difficult for you furthermore easier for another one

The diagnosis is SUMMATION GALOP

A) Crescendo-descrecendo murmur: Aortic stenosis it is not a cause of the presence of both S3 & S4, but ejection click and S4 are possible
B) Bolcked atrioventricular conduction: 2 galop in one is called: Summation galop which may result from Tachycardia or Delayed AV conduction or Bolcked atrioventricular conduction(Correct answer)
C) Hypertrophy ventricular: Presence of S4 only e.i not associates with S3
D) Compression of heart by fluid: Cardiac tamponade presence of hypotension, distant heart sound, increased jugular pressure, and in the EKG there is beat-to-beat alteration of QRS
E) Hypertension: Only S4 is present



http://books.google.com/books?id=gU4...causes&f=false


that is so tough

thanks for posting those questions
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  #22  
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Originally Posted by mycoplasma View Post
that is so tough

thanks for posting those questions

I forget to mentionate that, all of you have to look for S7 I believe is a summatiom galop too.

I will put the answer of the other question I got in the forum later because I am back to study ok
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