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* nbme 2-9
 #427777  
  tranquilizer - 07/13/09 20:57
 
  An 18‐year‐old woman gave birth to a healthy neonate 72 hours ago. The woman now has the acute onset of tachypnea. Vital signs are normal. Diffuse wheezing is noted on auscultation of the chest. Chest x‐ray film is normal. Electrocardiogram shows evidence of right heart strain. Which of the following is the most likely diagnosis?
A ) Adult respiratory distress syndrome
B ) Aspiration pneumonia
C ) Bronchopneumonia
D ) Congestive heart failure
E) Pulmonary embolism
 
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* Re:nbme 2-9
#1812201
  northeast - 07/13/09 21:02
 
  e. fits the best  
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* Re:nbme 2-9
#1812202
  tranquilizer - 07/13/09 21:03
 
  e........cxr is normal and chf is unlikely in this acute situation in young pt  
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* Re:nbme 2-9
#1812267
  caferogo - 07/13/09 23:31
 
  PE with wheezing..no make sense...  
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* Re:nbme 2-9
#1812318
  docholiday - 07/14/09 00:44
 
  Another one I struggled with.
None of them really make sense, but to me E appears best. But yeah, wheezing and PE?

Its certainly not ARDS.
I thought about peripartum cardiomyopathy, but unlikely with normal CXR.

Its possible that aspiration pneumonitis to cause wheezing and a normal CXR, but certainly not right heart strain. Besides, its not a choice.

Bronchopneumonia is not acute and would show changes on CXR.

Its likely just a bad question.
 
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