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NBME Form 1, Section 1, Q# 3

5K views 8 replies 8 participants last post by  bandar 
#1 ·
A 67-year-old woman has the sudden onset of dyspnea and chest pain and dies within minutes. Stage IV ovarian cancer was diagnosed one year ago and she has been bedridden for 2 months. Which of the following is most likely to be found on autopsy?

A) Acute myocardial infarction
B) Deep venous thrombosis
C) Dissecting aortic aneurysm
D) Renal papillary necrosis
E) Ruptured Berry aneurysm
 
#5 ·
Well, the patient was diagnosed with ovarian cancer over a year ago; this information is just there to distract you from the main question stem. Basically this question is asking this - the patient was bedridden for 2 months and had a sudden onset of chest pain and dyspnea. She died 'suddenly' within minutes.

The clues that the patient was bedridden for 2 months (which is a very long time) and the fact that she died within minutes point towards Deep Vein Thrombosis. IF DVT was not an option I would've gone with option A) Acute Myocardial Infarction since it fits the symptoms and her age.
 
#9 ·
yeah dvt which probably led to a PE. Its a sudden Death, seems like it, coz she dies within "minutes" of onset of symptoms and of all the choices this seems the most likely cause, further supported by bedridden which predisposes and a malignancy which leads to hypercoaguble state, stage 4 i think is metastatic cancer. also im guessing since theyve bothered to mention ovarian and all they want us to think that there is defective estrogen production or something which further points towards a hypercoagulant state...
 
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