NBME Form 1, Section 1, Q# 3 - USMLE Forums
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  #1  
Old 04-21-2011
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Arrow NBME Form 1, Section 1, Q# 3

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
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Old 04-21-2011
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DVT and most probably died from PE
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Old 04-21-2011
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Default B) dvt

The clue here is bedridden .. DVT and death from pulmonary embolism
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Old 04-21-2011
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Hey

The answer is DVT

But cud u guys say how u excluded other options too
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Old 04-21-2011
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Quote:
Originally Posted by noothan View Post
Hey

The answer is DVT

But cud u guys say how u excluded other options too
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.
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Old 04-22-2011
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Also keep that in mind malignancies also predispose to DVT by causing a Hypercoaguable state.
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Old 04-22-2011
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Quote:
Originally Posted by doc_study View Post
Also keep that in mind malignancies also predispose to DVT by causing a Hypercoaguable state.
yeap...im w/u

DVT
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Old 06-05-2011
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nice qtn with nice discussion thanks
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Old 06-06-2011
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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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