Clinical Case Dyspnea

 Q1. A 40 yo female from Vietnam presents with a 2-month history of anorexia, palpitations, cough and dyspnea. She is unable to lie down at night without getting short of breath. She has no history of allergies and does not use any drugs. She came to the USA 20 years ago and does not remember if she had a throat infection as a child. She is afebrile with stable vitals. On exam, her JVP is elevated and she has rales. The patient has brought over an x-ray done 12 months ago- see below. You want to rule out?

A. Pericardial disease

B. Syphilis

C. Aortic aneurysm

D. Valve disorder

E. Lymphoma

f. Sarcoidosis

https://youtu.be/_5yeSyyoUlY

Clinical Case MCQs: Dyspnea

 Q13. While being worked up, the patient’s cardiac monitor reveals the following (See below). What is the next step in his management?

a. Consult with cardiology

b. Observe

c. Administer atropine 0.5 mg IV

d. Use a temporary pacemaker

e. Order troponin levels

https://youtu.be/q8AFrihE7GY

Clinical Case MCQs: Dyspnea

 Q12. What one common disorder is known to be associated with a ‘decrease’ in the rate in the below test?

a. Hemophilia

b. Lupus

c. Multiple myeloma

d. CO poisoning

e. Sickle cell anemia

f. Lymphoma

g. Pernicious anemia

https://youtu.be/q8AFrihE7GY

Clinical Case MCQs: Dyspnea

 Q11. The patient in Q1 undergoes the blood test shown below. What ‘prosedimentation’ factor in the blood governs this reaction?

a. Albumin

b. Thrombin

c. Fibrinogen

d. Prostaglandins

e. Bradykinin

f. Complement factor 3

https://youtu.be/q8AFrihE7GY

Clinical Case MCQs: Dyspnea

 Q10. The patient with mitral stenosis is worked up and his pathology is depicted below in the drawing. What is a common symptom in these patients with the anatomical pathology shown below?

a. Dizziness and syncope

b. Cyanosis

c. Hoarseness

d. Hematemesis

e. Stridor

https://youtu.be/q8AFrihE7GY