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* heart 8
 #136118  
  kashmala - 11/06/06 22:50
 
  Physical examination reveals jugular venous disten-
tion in the neck of a 50-year-old male, even when he is
sitting up. He also has an enlarged and tender liver that
can be felt 10 cm below the right costal margin. Pitting
edema is observed on his lower extremities. A chest radio-
graph reveals large pleural effusions. Thoracentesis on the
right yields 500 mL of clear fluid with few cells. The most
likely cause of this clinical picture is
(D (A) Tricuspid valve stenosis
(D (B) Acute myocardial infarction
(D (C) Puhnonary valve stenosis
(D (D) Chronic obstructive lung disease
(D (E) Primary pulmonary hypertension
 
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* Re:heart 8
#546924
  jjliu - 11/07/06 01:20
 
  D.  
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* Re:heart 8
#546932
  rmansour - 11/07/06 01:29
 
  Probably has Cor Pulmonale, causing RIGHT-SIDED HEART FAILURE, SO D  
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* Re:heart 8
#546941
  niyati82 - 11/07/06 01:39
 
  i think AAAAAAA
jvp is quite high and tender enlargd liver may be due to rt side etilology.
plueral eefusion and pitting edema r also signs and symtoms of right side failure....
but dont know strong bases how to exclude copd
plz explain the answer.... thnks in advance
 
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* Re:heart 8
#546944
  rmansour - 11/07/06 01:42
 
  THE CHEST RADIOGRAPH SHOWS LARGE PLEURAL EFFUSIONS, SO THERE IS PROBABLY SOME TYPE OF INTRINSIC LUNG DISEASE CAUSING THE RIGHT HEART FAILURE. COPD LEADS TO PULMONARY HYPERTENSION AND BACK-UP OF BLOOD IN THE VENOUS SYSTEM.  
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* Re:heart 8
#546950
  neoplasia - 11/07/06 01:48
 
  but fluid from pleura effusion is clear with only few cells,i mean it may be transudate not exudate,somay be not primary lung disease.  
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* Re:heart 8
#546955
  student2000 - 11/07/06 01:52
 
  D..  
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* Re:heart 8
#546972
  kashmala - 11/07/06 02:36
 
  yes D  
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* Re:heart 8
#546973
  kashmala - 11/07/06 02:37
 
  D
His findings point to a pure fight-sided conges-
tive heart failure. This can be caused by right-sided valvu-
lar lesions such as tricuspid or pulmonic stenosis, but these
are rare. Much more common is pulmonary hypertension
resulting from obstructive lung diseases such as emphy-
sema. Primary pulmonary hypertension can also cause
right-sided heart failure, but it is a much less common
cause than are lung diseases. Because acute MI usually
affects the left ventricle, left-sided heart failure is more
common in these patients. Chronic left heart failure can
eventually lead to right-sided heart failure.
 
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