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6 A 72-year-old male presents to the ER with the chief complaint of shortness of breath that awakens him at night and also night cough. Further questioning confirms recent dyspnea on exertion. As you pursue the diagnosis of congestive heart failure using the Framingham criteria, you note the physical exam findings below. Which of the findings is considered among the less specific minor criteria?
A) Neck vein distention
B) Rales
C) S3 gallop
D) Positive hepatojugular reflux
E) Extremity edema
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eeee
The major criteria are the following:
Paroxysmal nocturnal dyspnea
Neck vein distention
Rales
Radiographic cardiomegaly
Acute pulmonary edema
S3 gallop
Central venous pressure greater than 16 cm water
Circulation time of 25 seconds
Hepatojugular reflux
Pulmonary edema, visceral congestion, or cardiomegaly at autopsy
Weight loss of 4.5 kg in 5 days in response to treatment
Minor criteria include the following:
Bilateral ankle edema
Nocturnal cough
Dyspnea on ordinary exertion
Hepatomegaly
Pleural effusion
Decrease in vital capacity by one third from maximal value recorded
Tachycardia (rate of 120 bpm)
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dubu nice ans
The answer is e. Use of the Framingham criteria (eight major and seven minor) is one method by which to organize the signs and symptoms for the diagnosis of congestive heart failure. Major criteria include paroxysmal nocturnal dyspnea, neck vein distension, rales, cardiomegaly, acute pulmonary edema, S3 gallop, increased venous pressure, and hepatojugular reflux. Minor criteria include extremity edema, night cough, dyspnea on exertion, hepatomegaly, pleural effusion, vital capacity reduced by one-third from normal, and tachycardia of 120 or more beats per minute. In addition, weight loss of 4.5 kg or more over 5 days of treatment may be considered as a major or minor criterion. To establish a clinical diagnosis of congestive heart failure, at least one major and two minor criteria are required
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do we need to know this for step 2
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Dr. future, you just made me laugh...
I was wondering the same thing
