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Discussion Starter #1
A 45 year old female presented with months of dyspnea and fatigue. Recently she noticed blood in her sputum which brought her to your office. On examination you've seen the patient is wasted and has hoarsness of voice. Liver enlarged 3 centimeters.

What is the most likely diagnosis?
A- Hypothyroidism
B- Mitral stenosis
C- Chronic Iron deficiency anemia
D- Hepatic tumor
E- Tuberculosis
 

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Discussion Starter #6
MS Pathophysiology

May you explain the pathophysiology???
The hemoptysis is due to congested pulmonary vasculature due to increased left atrial pressure backing up to the lungs.
Liver enlarged because she developed heart failure which can explain her wasting also.
Hoarseness of voice is due to impingement of the enlarged left atrium on the recurrent laryngeal nerve.
 

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A 45 year old female presented with months of dyspnea and fatigue. Recently she noticed blood in her sputum which brought her to your office. On examination you've seen the patient is wasted and has hoarsness of voice. Liver enlarged 3 centimeters.

What is the most likely diagnosis?
A- Hypothyroidism
B- Mitral stenosis
C- Chronic Iron deficiency anemia
D- Hepatic tumor
E- Tuberculosis
correct ans is B and it is called : Ortner's syndrome
 
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