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  #1  
Old 09-13-2012
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Arrow Belindalimm Daily Questions: Pathology #10

A 73-year-old Caucasian male presents to your office with epigastric pain that starts 30-40 mins after meals and does not respond to antacids. He lost several pounds over the last few weeks because he eats less for fear for pain. His past medical history is significant for hypertension, hyperlipidemia, coronary artery bypass grafting, and right-sided carotid endarterectomy. Upper gastrointestinal endoscopy does not reveal any abnormalities. The pathophysiology of this patient's symptoms is most close to that of which of the following?

A. Peptic ulcer disease
B. Esophageal spasm
C. Aortal dissection
D. Pulmonary embolism
E. Stable angina
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  #2  
Old 09-13-2012
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Default A

AA.....patient probably has ischemic colitis which presents with pain after eating,a similar presentation of PUD
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Old 09-13-2012
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With this bunch of risk factors i will choose stable angina
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Old 09-13-2012
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I would also go with stable angina


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Old 09-13-2012
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ya it's E) stable angina...
mimics peptic ulcer disease...but with her history better angina fits here
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Old 09-13-2012
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E...Stable Angina.

The question clearly says "there are no abnormalities found on upper GI endoscopy".
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Old 09-13-2012
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Quote:
Originally Posted by belindalimm View Post
A 73-year-old Caucasian male presents to your office with epigastric pain that starts 30-40 mins after meals and does not respond to antacids. He lost several pounds over the last few weeks because he eats less for fear for pain. His past medical history is significant for hypertension, hyperlipidemia, coronary artery bypass grafting, and right-sided carotid endarterectomy. Upper gastrointestinal endoscopy does not reveal any abnormalities. The pathophysiology of this patient's symptoms is most close to that of which of the following?

A. Peptic ulcer disease
B. Esophageal spasm
C. Aortal dissection
D. Pulmonary embolism
E. Stable angina

obviously with all those multiple risk factors pathophysilogically the answer should be E)
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Old 09-14-2012
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Wink E ?

Yes with these associated risk factors "E" should be the answer.
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Old 09-14-2012
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How about B?
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Old 09-14-2012
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Quote:
Originally Posted by belindalimm View Post
A 73-year-old Caucasian male presents to your office with epigastric pain that starts 30-40 mins after meals and does not respond to antacids. He lost several pounds over the last few weeks because he eats less for fear for pain. His past medical history is significant for hypertension, hyperlipidemia, coronary artery bypass grafting, and right-sided carotid endarterectomy. Upper gastrointestinal endoscopy does not reveal any abnormalities. The pathophysiology of this patient's symptoms is most close to that of which of the following?

A. Peptic ulcer disease
B. Esophageal spasm
C. Aortal dissection
D. Pulmonary embolism
E. Stable angina
A. Peptic ulcer disease is the right ans patient have deudnal ulcer becz of which pain get worse 30-40min after having food
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Old 09-14-2012
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Quote:
Originally Posted by dockhi View Post
How about B?
in esophageal spasm...dysphagia and reflux of acid are more pronounced than epigastric pain......i'm pretty sure it's stable angina
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  #12  
Old 09-14-2012
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Default The answer is stable angina

Although this patient has epigastric pain, which does not respond to antacids and endoscope shows no abnormalities in upper esophageal and gastric duct, we should switch our point away from peptic ulcer disease. The medical history of this patient reveals hyperlipidemia and bypassing grafting on coronary artery, giving us sense of organ blood vessel occlusion by lipid plaque formation. When it is forming in celiac truck, branch of abdominal aorta, delivering blood to esophagus and upper part of stomach, those blood vessels will get narrowed leading to reduced blood as well as oxygen delivered to those organs, causing organ malfunction.

If it is caused by esophagus spasm, we could probably observe the narrowed lumen of esophagus when performing upper gastrointestinal endoscopy.
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Pathophysio similar to stable angina

Its due to GI Angina
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