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* what problem he has? Diagnosis ?
 #139201  
  gradmd - 11/16/06 22:30
 
  An 18-year-old man comes to the physician 1 week after he had a blood pressure of 140/110 mm Hg during a routine precollege examination. His temperature is 37.1 C (98.7 F), blood pressure is 140/100 mm Hg, pulse is 92/min, and respirations are 12/min. The upper extremities appear to be more muscular than the lower extremities. Radial pulses are normal; femoral, posterior tibial, and dorsalis pedis pulses are decreased. A grade 2/6 systolic murmur is heard over the precordium, anterior chest, and back. An ECG shows left ventricular hypertrophy. Which of the following is the most appropriate next step in management?

A
) Limiting physical activity

B
) Repeat blood pressure measurement in 1 month

C
) Initiate a low-sodium diet and exercise program

D
) Pharmacologic management

E
) Operative treatment
 
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* Re:what problem he has? Diagnosis ?
#561715
  internalmed - 11/16/06 22:38
 
  D--- PHARMACOLOGICAL,B BLOCKERS,
BUT NO CHOICE GIVEN FOR ECHO TO RULE OUT OTHER VAVLE DISORDER.SYS MURMUR DUE TO LVH
 
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* Re:what problem he has? Diagnosis ?
#561727
  gradmd - 11/16/06 22:43
 
  why the following symtoms happening?

The upper extremities appear to be more muscular than the lower extremities. Radial pulses are normal; femoral, posterior tibial, and dorsalis pedis pulses are decreased.

Any definitive Diagnosis?
 
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* Re:what problem he has? Diagnosis ?
#561756
  srik - 11/16/06 23:10
 
  e,coarctation of aorta.  
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* Re:what problem he has? Diagnosis ?
#561886
  xwxf - 11/17/06 04:28
 
  E
) Operative treatment
 
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* Re:what problem he has? Diagnosis ?
#561961
  malak - 11/17/06 08:03
 
  Pharmacologic management--control Bp first then operate  
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* Re:what problem he has? Diagnosis ?
#562014
  docfoofoo - 11/17/06 08:49
 
  i go for E as well.......distal coarctation.....need to do surgery  
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