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Old 06-15-2011
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Heart Hyperdynamic Apical Impulse!

During a routine preparticipation examination, a 13-year-old white male admits to having had two episodes of exertional syncope. A physical examination reveals a hyperdynamic apical impulse and a widespread 3/6 mid- to late systolic murmur that seems to increase when he stands. The pulses are normal and there is no cyanosis or clubbing.

Which one of the following statements is true regarding this patient?

a.All strenuous exercise should be absolutely forbidden pending further evaluation
b.This condition is frequently associated with pectus excavatum and a high, arched palate
c.An EKG is likely to show an increased QT interval
d.An exercise stress test under proper supervision is the test most likely to confirm the diagnosis
e.Digoxin may be appropriate therapy to reduce the likelihood of exercise-induced symptoms
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  #2  
Old 06-15-2011
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could u plz put the 44 q in one post and we will reply on them in same post better than 44 post
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Old 06-15-2011
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this case is hypertrophic cmp
ecg(LVH-STdepression -t inversion
digoxine is CI
echo confirm dx
so the answer is
A - avoid strenuous exercise
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Old 06-15-2011
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my friend
i put more than one q in one thread(it is easear) but admistretor send private messages to put every q in one thread
all thank
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Old 06-15-2011
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yes ans is a...increase in murmur intensity on standing...what is the main clue to tell it is hypertropic hcm in q stem
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Old 06-15-2011
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looks like HOCM so i will go for option A
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Cardiology-, Internal-Medicine-, Step-2-Questions

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