Originally Posted by Muezzin
there were no takers =( but the answer is B which is TB
you have to cut through the fillers with these q's, and I know many people myself included by the way who often get distracted by the fillers. Medicine is alot of detective work, that is what is really appealing about it...
I mean in the above Q the only pertinent portions are the Kussmaul's sign which basically tells you, there is something wrong with the heart, it is telling you that the heart isn't filling properly, either there is fluid accumulating in the sac around the heart or you have a poorly compliant heart, interpreting JVP findings in and of itself is very challenging, can literally be anything from, right heart failure, to constrictive pericarditis, restrictive cardiomyopathy, to pericardial effusion.. You really have to work by process of elimination because a thousand condition can present the same way, but of the choices they have given you, which is most likely to cause these symptoms, would be eliminated down to TB.. in this case it is very much a process of elimination... I think the best clue is the patient's background, perhaps it is the give away? since psittacosis is caused by bird dropping, people who breed parrots or work at petland's discount lol, pneumoconiosis happens when someone inhales dust or silica, I mean for a living, they do this for yrs to present with this condition, and the man here is a "Mexican farmer", doesn't work in a mine or the glass industry.. I can see how one might pick Cor pulmonale which describes a failure of the right side of the heart. It is caused by prolonged high blood pressure in the right ventricle of the heart, and I can see how one would pick that, but the key thing is prolonged, you'll notice the patient has had these symptoms for only two months, and a viral infection of the heart wouldn't really present with these conditions, although certain viruses can give you cardiomyopathies but wouldn't present with these symptoms ... so basically you have to reason through this Q... and that is why when I posted it, I said you can look some of the things up on line to arrive to an answer... The only thing that is left, that is pertinent would be Tuberculosis...
it is a difficult one, I agree =)
thanks so much for participating this was delightful.. a change from the norm and the heaviness of the other sections of this board!