Gyrus Daily Questions; Internal Medicine #61 - 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 10-31-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 720
Threads: 217
Thanked 552 Times in 309 Posts
Reputation: 562
Arrow Gyrus Daily Questions; Internal Medicine #61

A 35-year-old woman comes to the emergency department complaining of shortness of breath since awakening this morning. She denies any cough,cheat pain. or fever, and denies ever feeling this way before. She has a significant past medical history of a deep venous thrombosis 2 years ago. She takes oral contraceptives. She states that she smokes one pack of cigarettes per day. Her vital signs include a pulse of 110/min, respiratory rate of 24/min, blood pressure of 110/60 mmHg. Oxygen saturation of 95% and temperature of 36.7 C(98.0 F).A ventilation - perfusion scan is reported as "high probability' of a pulmonary embolism. Which of the following is the most likely electrocardiograph finding ?

A Atrial fibrillation
B. Nonspecific ST-T wave changes
C. Right axis deviation
D. Right bundle branch block
E. s wave in lead 1, Q wave in lead II, inverted T wave in lead III
Reply With Quote Quick reply to this message
The above post was thanked by:
Novobiocin (10-31-2012)



  #2  
Old 10-31-2012
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,327 Times in 711 Posts
Reputation: 1342
Default

Quote:
Originally Posted by cingulate.gyrus View Post
A 35-year-old woman comes to the emergency department complaining of shortness of breath since awakening this morning. She denies any cough,cheat pain. or fever, and denies ever feeling this way before. She has a significant past medical history of a deep venous thrombosis 2 years ago. She takes oral contraceptives. She states that she smokes one pack of cigarettes per day. Her vital signs include a pulse of 110/min, respiratory rate of 24/min, blood pressure of 110/60 mmHg. Oxygen saturation of 95% and temperature of 36.7 C(98.0 F).A ventilation - perfusion scan is reported as "high probability' of a pulmonary embolism. Which of the following is the most likely electrocardiograph finding ?

A Atrial fibrillation
B. Nonspecific ST-T wave changes
C. Right axis deviation
D. Right bundle branch block
E. s wave in lead 1, Q wave in lead II, inverted T wave in lead III
And according to uworld and Medscape the MOST common EKG chance is actually sinus tachycardia without any other change whatsoever.
Reply With Quote Quick reply to this message
The above post was thanked by:
cingulate.gyrus (10-31-2012)
  #3  
Old 10-31-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,867
Threads: 149
Thanked 2,107 Times in 1,049 Posts
Reputation: 2127
Default

B. Nonspecific ST-T wave changes

Quote:
The most common ECG abnormalities in the setting of pulmonary embolism are tachycardia and nonspecific ST-T wave abnormalities. The finding of S1 Q3 T3 is nonspecific and insensitive in the absence of clinical suspicion for pulmonary embolism. The classic findings of right heart strain and acute cor pulmonale are tall, peaked P waves in lead II (P pulmonale); right axis deviation; right bundle-branch block; an S1 Q3 T3 pattern; or atrial fibrillation. Unfortunately, only 20% of patients with proven pulmonary embolism have any of these classic electrocardiographic abnormalities. If electrocardiographic abnormalities are present, they may be suggestive of pulmonary embolism, but the absence of such abnormalities has no significant predictive value.
__________________
A man doesn't know what he knows until he knows what he doesn't know.
“What is man? He's just a collection of chemicals with delusions of grandeur.”
Reply With Quote Quick reply to this message
 
  #4  
Old 11-01-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 720
Threads: 217
Thanked 552 Times in 309 Posts
Reputation: 562
Default

The correct answer is B Nonspecific ST- T wave changes.

Approximately 70% of patients with pulmonary embolus have ECG abnormalities.the most common of which is nonspecific ST segment - T wave abnormalities and sinus tachycardia.Aside from this nonspecific pattern.any ECG abnormality as likely as aother. The classic abnormalities are related to right heart strain. Thsoe include right axis deviation atrial fibrillation right bundle branch block and the S1 Q3 T3 pattern
Reply With Quote Quick reply to this message
The above post was thanked by:
fadi551 (11-10-2012)



Reply

Tags
Internal-Medicine-, Pulmonology-, 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
Gyrus Daily Questions; Internal Medicine #43 cingulate.gyrus USMLE Step 2 CK Forum 4 04-10-2013 02:32 AM
Gyrus Daily Questions; Internal Medicine #44 cingulate.gyrus USMLE Step 2 CK Forum 9 10-04-2012 03:15 AM
Gyrus Daily Questions; Internal Medicine #41 cingulate.gyrus USMLE Step 2 CK Forum 4 09-30-2012 07:51 AM
Gyrus Daily Questions; Internal Medicine #31 cingulate.gyrus USMLE Step 2 CK Forum 4 09-26-2012 11:00 PM
Gyrus Daily Questions; Internal Medicine #30 cingulate.gyrus USMLE Step 2 CK Forum 4 09-26-2012 08:13 AM

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)