05-01-2012, 04:19 PM
NBME F1B1
Q-37
For each patient with loss of consciousness, select the most likely diagnosis.
A) Aortic stenosis
B) Carotid sinus hypersensitivity
C) Conversion reaction
D) Hypertrophic obstructive cardiomyopathy
E) Hypoglycemia
F) Mitral valve prolapse
G) Orthostatic hypotension
H) Pulmonary embolus
I) Seizure
J) Vasovagal syncope
K) Vertebrobasilar insufficiency
37. A 62-year-old woman is brought to the emergency department 1 hour after a 1-minute episode of loss of consciousness; her symptoms began when she stood up after she passed a dark, watery stool. She has had diarrhea and dark stools for 2 days. She has been receiving warfarin therapy for deep venous thrombosis for 2 weeks. On arrival, her blood pressure is 82/60 mm Hg, and pulse is 150/min and regular. She is unable to stand. The lungs are clear to auscultation. A grade 2/6 systolic murmur is heard at the second right intercostal space with no radiation. Examination shows a soft, nontender abdomen. There is 1+ edema of the right lower extremity with no tenderness. Test of the stool for occult blood is positive.
Q-37
For each patient with loss of consciousness, select the most likely diagnosis.
A) Aortic stenosis
B) Carotid sinus hypersensitivity
C) Conversion reaction
D) Hypertrophic obstructive cardiomyopathy
E) Hypoglycemia
F) Mitral valve prolapse
G) Orthostatic hypotension
H) Pulmonary embolus
I) Seizure
J) Vasovagal syncope
K) Vertebrobasilar insufficiency
37. A 62-year-old woman is brought to the emergency department 1 hour after a 1-minute episode of loss of consciousness; her symptoms began when she stood up after she passed a dark, watery stool. She has had diarrhea and dark stools for 2 days. She has been receiving warfarin therapy for deep venous thrombosis for 2 weeks. On arrival, her blood pressure is 82/60 mm Hg, and pulse is 150/min and regular. She is unable to stand. The lungs are clear to auscultation. A grade 2/6 systolic murmur is heard at the second right intercostal space with no radiation. Examination shows a soft, nontender abdomen. There is 1+ edema of the right lower extremity with no tenderness. Test of the stool for occult blood is positive.