Print
E-mail
Reprint

#7

ANSWER D.

Unlike myocardial infarction or pulmonary edema, the diagnosis of acute heart failure syndrome can be elusive. History and physical exam are not always accurate when attempting to establish the diagnosis. However,the best physical exam finding suggestive of an elevated pulmonary capillary wedge pressure is the S3 heart sound, with a specificity of 99%.

Dyspnea (A) has a sensitivity and specificity 50%. Jugular venous distension (B) has a specificity of 94% and a sensitivity of 39%. Orthopnea (C) has a specificity of 88%.

Ref
Peacock WF: Congestive Heart Failure and Acute Pulmonary Edema, in Tintinalli JE, Kelen GD, Stapczynski JS (eds): Emergency Medicine, A Comprehensive Study Guide, ed 7. New York, McGraw-Hill, 2011, (Ch) 57:p 405-414.

 

>>GO TO QUESTION 8 

 

Comments   

# Mini Board Review: March 2013 EditionDiane Gilliland 2013-03-07 20:37
Thank you for putting together the questions for the mini board review. I find them very helpful!
Reply
# Mini Board reviewDr Zahn 2013-03-10 09:37
Good review....but alot of medical info, very specific...not known when you are out for years in practice.
Reply
# MDSam Morale 2013-03-11 17:06
Thanks for your effort. Nice to review uncommon diseases to keep us up to speed. It is amazing how many diseases, pathogens etc... have had their names changed : Granulomatosis with Polyangiitis (GPA) (formerly referred to as Wegener’s granulomatosis) .
Reply
# Robert Ditrolio 2013-03-12 17:10
Excellent review questions. Please keep them coming in future issues!
Reply

Add comment

Security code
Refresh

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM