Tricky question - 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


View Poll Results: What is the most likely cause?
Right coronary infarction 1
Left ventricular failure 1
Cardiac tamponade 2
Pericarditis 1
Pulmonary embolism 1
Voters: 6. You have to register to vote in this poll.

This is a dynamic poll. Disregard the original thread starting date, members are still casting votes on this poll.
The poll still reflects the current popularity of the options.

 
 
Thread Tools
 
Old 01-07-2017
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 6
Threads: 2
Thanked 0 Times in 0 Posts
Reputation: 10
Default Tricky question

50M presents to emergency with chest pain, elevated JVP, S3 gallop, and hypotension. His chest is clear to auscultation. His ECG shows STE in leads V1-V4 and a right-sided ECG shows STE in V4-V6. What is the most likely cause of this presentation?

A. Right coronary infarction
B. Left ventricular failure
C. Cardiac tamponade
D. Pericarditis
E. PE
Quick reply to this message



 
Old 01-08-2017
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 6
Threads: 2
Thanked 0 Times in 0 Posts
Reputation: 10
Default

I think the answer is A, but can't really exclude pericarditis causing a pericardial effusion giving the same presentation.
Quick reply to this message
 
Old 01-11-2017
USMLE Forums Scout
 
Steps History: 1 + CK
Posts: 10
Threads: 4
Thanked 8 Times in 4 Posts
Reputation: 18
Default

Quote:
Originally Posted by benji View Post
I think the answer is A, but can't really exclude pericarditis causing a pericardial effusion giving the same presentation.
This vignette sounds like a massive PE causing RV dysfunction. If it was a straight out RCA infarction it should typically show inferior wall pattern on ECG (II, III, aVF).
Quick reply to this message
 
 
Old 01-16-2017
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 6
Threads: 2
Thanked 0 Times in 0 Posts
Reputation: 10
Default

Quote:
Originally Posted by janmr View Post
This vignette sounds like a massive PE causing RV dysfunction. If it was a straight out RCA infarction it should typically show inferior wall pattern on ECG (II, III, aVF).
Thanks, janmr. The question doesn't say that there isn't STE in II,III, or aVF, so can we assume there isn't? I think there would be given that the right sided ECG has STE, especially in V4R which is most specific for right ventricular ischaemia. Massive pulmonary embolism is definitely possible with the anteriolateral ischaemia, and perhaps this best explains the picture as a whole.
Quick reply to this message



 

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

Thread Tools


Similar Threads
Thread Thread Starter Forum Replies Last Post
Tricky but nice question... one_destiny USMLE Step 1 Forum 13 05-07-2015 05:36 PM
tricky question please help dr mumble USMLE Step 1 Forum 3 01-16-2015 07:54 PM
Blot Procedures Tricky Question Hope2Pass USMLE Step 1 Forum 12 12-22-2011 09:24 AM
Renal physiology - tricky question bebix USMLE Step 1 Forum 14 07-26-2011 04:51 AM
A little tricky question to solve.. dr.Hanief USMLE Step 1 Forum 7 07-02-2011 11:51 AM

Find Us on Facebook
Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2019, vBulletin Solutions, Inc.
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2019 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2019)