Heart failure; Most accurate test to confirm the diagnosis? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 06-19-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 51
Threads: 7
Thanked 79 Times in 32 Posts
Reputation: 89
Heart Heart failure; Most accurate test to confirm the diagnosis?

A 61-year-old woman presents to the outpatient department complaining of shortness of breath. Over the previous 3 months, the patient has felt progressively dyspneic. She used to be able to climb the stairs of her house with little problem, but now finds it increasingly difficult and occasionally has to stop halfway up the stairs to catch her breath. She now has trouble playing with her grandchildren. She complains of extreme fatigue following 5 minutes of interacting with her grandchildren. She also describes waking up in the middle of the night with shortness of breath. She finds these episodes distressing and has to rush to a nearby open window to catch her breath. She denies chest pain. Her vital signs are temperature 37.1 C (98.8 F), pulse 74/min, blood pressure 150/94 mmHg. On physical examination the patient becomes mildly dyspneic on transferring from the chair to the examination table. There is evidence of jugulovenous distension and pedal edema. There is no chest wall tenderness, although there are scattered, fine crackles throughout the chest. Cardiovascular examination reveals heart sounds that are regular in rate and rhythm, with absence of murmurs or rubs. What is the most accurate test to confirm the diagnosis?

A) Coronary angiography
B) Echocardiography
C) Electrocardiogram
D) MUGA scan
E) Stress test
Reply With Quote Quick reply to this message



  #2  
Old 06-19-2011
b.abid's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS+3
Posts: 167
Threads: 56
Thanked 90 Times in 43 Posts
Reputation: 100
Default

Echocardiogram
Reply With Quote Quick reply to this message
  #3  
Old 06-19-2011
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 2
Threads: 0
Thanked 0 Times in 0 Posts
Reputation: 10
Default

MUGA scan definitely
Reply With Quote Quick reply to this message
 
  #4  
Old 06-19-2011
b.abid's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS+3
Posts: 167
Threads: 56
Thanked 90 Times in 43 Posts
Reputation: 100
Default

Quote:
Originally Posted by IsabelCris View Post
MUGA scan definitely
How come? Isn't HF defined by ejection fraction? and the way to measure this is Echo. right?
Reply With Quote Quick reply to this message
  #5  
Old 06-19-2011
USMLE Forums Scout
 
Steps History: Not yet
Posts: 12
Threads: 2
Thanked 5 Times in 5 Posts
Reputation: 15
Default

Quote:
Originally Posted by alaahoda2001 View Post
A 61-year-old woman presents to the outpatient department complaining of shortness of breath. Over the previous 3 months, the patient has felt progressively dyspneic. She used to be able to climb the stairs of her house with little problem, but now finds it increasingly difficult and occasionally has to stop halfway up the stairs to catch her breath. She now has trouble playing with her grandchildren. She complains of extreme fatigue following 5 minutes of interacting with her grandchildren. She also describes waking up in the middle of the night with shortness of breath. She finds these episodes distressing and has to rush to a nearby open window to catch her breath. She denies chest pain. Her vital signs are temperature 37.1 C (98.8 F), pulse 74/min, blood pressure 150/94 mmHg. On physical examination the patient becomes mildly dyspneic on transferring from the chair to the examination table. There is evidence of jugulovenous distension and pedal edema. There is no chest wall tenderness, although there are scattered, fine crackles throughout the chest. Cardiovascular examination reveals heart sounds that are regular in rate and rhythm, with absence of murmurs or rubs. What is the most accurate test to confirm the diagnosis?

A) Coronary angiography
B) Echocardiography
C) Electrocardiogram
D) MUGA scan
E) Stress test
Echocardiography
Reply With Quote Quick reply to this message
  #6  
Old 06-19-2011
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 5
Threads: 2
Thanked 0 Times in 0 Posts
Reputation: 10
Default

Echocardiography
Reply With Quote Quick reply to this message
  #7  
Old 06-19-2011
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 2
Threads: 0
Thanked 0 Times in 0 Posts
Reputation: 10
Default

Quote:
Originally Posted by b.abid View Post
How come? Isn't HF defined by ejection fraction? and the way to measure this is Echo. right?
It asked for the most accurate
Reply With Quote Quick reply to this message
  #8  
Old 06-19-2011
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 244
Threads: 16
Thanked 200 Times in 86 Posts
Reputation: 210
Default

muga scan most sensitive
btw isnt bnp most specific ??
Reply With Quote Quick reply to this message
  #9  
Old 06-19-2011
b.abid's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS+3
Posts: 167
Threads: 56
Thanked 90 Times in 43 Posts
Reputation: 100
Default

Quote:
Originally Posted by IsabelCris View Post
It asked for the most accurate
Can you please elaborate more?
Reply With Quote Quick reply to this message
  #10  
Old 06-19-2011
USMLE-Syndrome's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,203
Threads: 180
Thanked 1,251 Times in 441 Posts
Reputation: 1265
Default

according to MTB page 78
initial test is transthoracic echo
most accurate test is MUGA or nuclear ventriculogrphy
Reply With Quote Quick reply to this message
The above post was thanked by:
bebix (06-19-2011)
  #11  
Old 06-19-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
Default

Answer D. Most accurate test would be MUGA
Reply With Quote Quick reply to this message
  #12  
Old 06-19-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 51
Threads: 7
Thanked 79 Times in 32 Posts
Reputation: 89
Correct Answer correct answer

MUGA scan is the correct answer (becuase the question: THE MOST ACCURATE)
Echocardiographic EF is a useful tool to monitor HF but is niether specific nor sensitive for diagnosing HF
For Example:
some patients may have EF>50% and Have Severe HF symptoms
others May Have EF of as low as 25% but either have mild sympoms or not at all
Echocardiography can be used as an initial tool in HF to collect heamodynamic information and aslo to guide different therapies But is not the most accurate
Reply With Quote Quick reply to this message
The above post was thanked by:
Ace3 (06-20-2011)



Reply

Tags
Cardiology-, Internal-Medicine-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
What would you do to confirm diagnosis? (micro) drahmednawaz USMLE Step 1 Forum 5 06-17-2012 04:44 PM
Most accurate test for Charcot - Marie - Tooth Disease kemoo USMLE Step 2 CK Forum 2 06-17-2011 10:37 AM
Do we need to call/email Prometric to confirm test date? usmledee General Topics Forum 2 02-11-2011 12:52 PM
How to confirm the diagnosis? Hohepa USMLE Step 2 CK Forum 5 04-30-2010 06:50 AM
Heart Failure + Cough Farazdaq USMLE Step 2 CK Forum 3 03-02-2010 05:49 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)