What is the functional status of this heart disease patient? - 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 05-31-2011
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 200
Threads: 101
Thanked 195 Times in 65 Posts
Reputation: 218
Heart What is the functional status of this heart disease patient?

A 70 years old man with heart disease has dyspnea in his normal ordinary daily activity but is symptom free at rest.
In what functional class this patient is?
A. I
B. II
C. III
D. IV


Reply With Quote Quick reply to this message



  #2  
Old 05-31-2011
USMLE-Syndrome's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,203
Threads: 180
Thanked 1,251 Times in 441 Posts
Reputation: 1265
Default

C- 111 comfortable only by rest with mark limitation of activity
Reply With Quote Quick reply to this message
  #3  
Old 05-31-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 353 Times in 169 Posts
Reputation: 376
Default

Yes. Class 3 indeed. See below.


The Stages of Heart Failure – NYHA Classification
In order to determine the best course of of therapy, physicians often assess the stage of heart failure according to the New York Heart Association (NYHA) functional classification system. This system relates symptoms to everyday activities and the patient's quality of life.
Class
Patient Symptoms
Class I (Mild)
No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea (shortness of breath).
Class II (Mild)
Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, or dyspnea.
Class III (Moderate)
Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes fatigue, palpitation, or dyspnea.
Class IV (Severe)
Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased.
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
The above post was thanked by:
Taiwan_Guy (06-03-2011)
 
  #4  
Old 05-31-2011
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 132
Threads: 11
Thanked 185 Times in 70 Posts
Reputation: 195
Default

Isn't this Class II?
Reply With Quote Quick reply to this message
  #5  
Old 05-31-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 353 Times in 169 Posts
Reputation: 376
Default

Quote:
Originally Posted by healer2b View Post
Isn't this Class II?
You're right. Info given is not too accurate. May well be class 2.

I felt that this patient's normal daily activity was limited by breathlessness.
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #6  
Old 05-31-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,261 Times in 881 Posts
Reputation: 3271
Default

For me "dyspnea in his normal ordinary daily activity" is less than 5 METS, so I think is Class III
Reply With Quote Quick reply to this message
  #7  
Old 05-31-2011
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 132
Threads: 11
Thanked 185 Times in 70 Posts
Reputation: 195
Default

Quote:
Originally Posted by bebix View Post
For me "dyspnea in his normal ordinary daily activity" is less than 5 METS, so I think is Class III
What do you mean by "5 METS"?

To me, dyspnea during "normal ordinary daily activity" does not equal dyspnea during "less than ordinary activity" as defined by Class III, but clearly these definitions are up for interpretation....
Reply With Quote Quick reply to this message
  #8  
Old 05-31-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,261 Times in 881 Posts
Reputation: 3271
Default

Quote:
Originally Posted by healer2b View Post
What do you mean by "5 METS"?

To me, dyspnea during "normal ordinary daily activity" does not equal dyspnea during "less than ordinary activity" as defined by Class III, but clearly these definitions are up for interpretation....
Goldman specific activity scale corresponds to NYHA Class

NYHA Class I : > 7 METS
NYHA Class II : 5-7 METS
NYHA Class III: 2-5 METS
NYHA Class IV : < 2 METS
Reply With Quote Quick reply to this message
  #9  
Old 05-31-2011
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 132
Threads: 11
Thanked 185 Times in 70 Posts
Reputation: 195
Default

[QUOTE=healer2b;43392]What do you mean by "5 METS"?

I had never heard of the term "METS" before.

Courtesy of Wiki:

The metabolic equivalent of task (MET), or simply metabolic equivalent, is a physiological concept expressing the energy cost of physical activities[1] as multiples of resting metabolic rate (RMR) and is defined as the ratio of metabolic rate (and therefore the rate of energy consumption) during a specific physical activity to a reference rate of metabolic rate at rest, set by convention to 3.5 ml O2·kg-1·min-1 or equivalently 1 kcal·kg-1· h-1 or 4.184 kJ·kg-1· h-1. By convention 1 MET is considered as the resting metabolic rate obtained during quiet sitting.[2][3] MET values of physical activities range from 0.9 (sleeping) to 18 (running at 17.5 km/h or a 5:31 mile pace).
Reply With Quote Quick reply to this message
  #10  
Old 05-31-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,261 Times in 881 Posts
Reputation: 3271
Default

[QUOTE=healer2b;43398]
Quote:
Originally Posted by healer2b View Post
What do you mean by "5 METS"?

I had never heard of the term "METS" before.

Courtesy of Wiki:

The metabolic equivalent of task (MET), or simply metabolic equivalent, is a physiological concept expressing the energy cost of physical activities[1] as multiples of resting metabolic rate (RMR) and is defined as the ratio of metabolic rate (and therefore the rate of energy consumption) during a specific physical activity to a reference rate of metabolic rate at rest, set by convention to 3.5 ml O2·kg-1·min-1 or equivalently 1 kcal·kg-1· h-1 or 4.184 kJ·kg-1· h-1. By convention 1 MET is considered as the resting metabolic rate obtained during quiet sitting.[2][3] MET values of physical activities range from 0.9 (sleeping) to 18 (running at 17.5 km/h or a 5:31 mile pace).
if somebody ask...In anesthesia/surgery, the magical number is 4
"Perioperative cardiac and long-term risk is increased in patients unable to meet a 4-MET demand during most normal daily activities."
Reply With Quote Quick reply to this message
The above post was thanked by:
healer2b (05-31-2011)



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
Congenital Heart Disease Question harlesmd USMLE Step 1 Forum 28 11-10-2011 09:33 PM
Diagnose this valvular heart disease! aghammoud85 USMLE Step 2 CK Forum 2 05-31-2011 02:09 PM
Physiologic Status in this patient Rawalian USMLE Step 1 Forum 7 05-25-2011 07:21 AM
Valvular Rheumatic Heart Disease Seetal USMLE Step 1 Forum 10 02-12-2011 11:32 AM
Viral Heart Disease Yallah USMLE Step 1 Forum 4 05-22-2010 06:27 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)