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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor= {{Rim}} (Reviewed by  {{YD}})
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Physiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|MainCategory=Physiology
|MainCategory=Pathophysiology
|SubCategory=Cardiology
|SubCategory=Cardiology
|Prompt=Cardiovascular parameters are collected from the charts of hospitalized patients with different medical conditions for a retrospective study.  One of the patients have the following parameters:<br>
|Prompt=Hemodynamic parameters are collected from the medical records of hospitalized patients with different medical conditions for a retrospective study.  One of the patients has the following parameters:<br>
Systolic blood pressure: 160 mmHg<br>
Systolic blood pressure: 160 mmHg<br>
Diastolic blood pressure: 60 mmHg<br>
Diastolic blood pressure: 60 mmHg<br>
Pulse: 90 beats per minute<br>
Pulse: 102 beats per minute<br>


Which of the following medical conditions is possibly present in this patient?
Which of the following diseases is associated with the patient's hemodynamic parameters?
|Explanation=The [[pulse pressure]] of this patient is:
|Explanation=The [[pulse pressure]] of this patient is: Pulse pressure = systolic blood pressure - diastolic blood pressure = 160 - 60 = 100 mmHg<br>
 
Widened pulse pressure is associated with [[hyperthyroidism]], [[aortic regurgitation]], and [[obstructive sleep apnea]]. In contrast, narrowed pulse pressure is associated with [[aortic stenosis]], [[cardiac tamponade]], advanced [[heart failure]], and [[cardiogenic shock]].
[[Pulse pressure]]= [[systolic blood pressure]] - [[diastolic blood pressure]]= 160 - 60= 100 mmHg<br>
The patient has an elevated pulse pressure which can be found in [[hyperthyroidism]], [[aortic regurgitation]] and [[obstructive sleep apnea]]. [[Aortic stenosis]], [[cardiac tamponade]], progressed [[heart failure]] and [[cardiogenic shock]] are characterized by a low [[pulse pressure]].
 
'''Educational objective:'''
Pulse pressure is elevated can be elevated in [[hyperthyroidism]], [[aortic regurgitation]] and [[obstructive sleep apnea]]; while it can be low in [[aortic stenosis]], [[cardiac tamponade]], progressed [[heart failure]] and [[cardiogenic shock]].
 
'''Reference:'''
First aid for USMLE step 1, 2014.  Page 266.
|AnswerA=Aortic stenosis
|AnswerA=Aortic stenosis
|AnswerAExp=[[Aortic stenosis]] is characterized by a decreased pulse pressure.
|AnswerAExp=[[Aortic stenosis]] is associated with a narrowing in pulse pressure.
|AnswerB=Cardiac tamponade
|AnswerB=Cardiac tamponade
|AnswerBExp=[[Cardiac tamponade]] is characterized by a decreased pulse pressure.
|AnswerBExp=[[Cardiac tamponade]] is associated with a narrowing in pulse pressure.
|AnswerC=Heart failure
|AnswerC=Advanced heart failure
|AnswerCExp=Progressed [[heart failure]] is characterized by a decreased pulse pressure.
|AnswerCExp=Advanced heart failure is generally associated with low blood pressure. Pulse pressure may also be narrowed.
|AnswerD=Cardiogenic shock
|AnswerD=Cardiogenic shock
|AnswerDExp=[[Cardiogenic shock]] is characterized by a decreased pulse pressure.
|AnswerDExp=[[Cardiogenic shock]] is generally associated with low blood pressure. Pulse pressure may also be narrowed.
|AnswerE=Hyperthyroidism
|AnswerE=Hyperthyroidism
|AnswerEExp=[[Hyperthyroidism]] is characterized by an elevated pulse pressure.
|AnswerEExp=[[Hyperthyroidism]] elevates systolic blood pressure and is associated with tachycardia and a widened pulse pressure. In contrast, hypothyroidism may be accompanied by elevation in diastolic blood pressure and is associated with a narrowed pulse pressure.
|EducationalObjectives=Widened pulse pressure is associated with [[hyperthyroidism]], [[aortic regurgitation]], and [[obstructive sleep apnea]]. In contrast, narrowed pulse pressure is associated with [[aortic stenosis]], [[cardiac tamponade]], advanced [[heart failure]], and [[cardiogenic shock]].
|References=First Aid 2015 page 272
|RightAnswer=E
|RightAnswer=E
|WBRKeyword=Pulse pressure, hyperthyroidism
|WBRKeyword=Pulse pressure, Hyperthyroidism, Cardiology, Heart, Vascular, Pulse, Blood pressure
|Approved=No
|Approved=Yes
}}
}}

Latest revision as of 02:22, 28 October 2020
Author [[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pathophysiology
Sub Category SubCategory::Cardiology
Prompt [[Prompt::Hemodynamic parameters are collected from the medical records of hospitalized patients with different medical conditions for a retrospective study. One of the patients has the following parameters:

Systolic blood pressure: 160 mmHg
Diastolic blood pressure: 60 mmHg
Pulse: 102 beats per minute

Which of the following diseases is associated with the patient's hemodynamic parameters?]]

Answer A AnswerA::Aortic stenosis
Answer A Explanation [[AnswerAExp::Aortic stenosis is associated with a narrowing in pulse pressure.]]
Answer B AnswerB::Cardiac tamponade
Answer B Explanation [[AnswerBExp::Cardiac tamponade is associated with a narrowing in pulse pressure.]]
Answer C AnswerC::Advanced heart failure
Answer C Explanation AnswerCExp::Advanced heart failure is generally associated with low blood pressure. Pulse pressure may also be narrowed.
Answer D AnswerD::Cardiogenic shock
Answer D Explanation [[AnswerDExp::Cardiogenic shock is generally associated with low blood pressure. Pulse pressure may also be narrowed.]]
Answer E AnswerE::Hyperthyroidism
Answer E Explanation [[AnswerEExp::Hyperthyroidism elevates systolic blood pressure and is associated with tachycardia and a widened pulse pressure. In contrast, hypothyroidism may be accompanied by elevation in diastolic blood pressure and is associated with a narrowed pulse pressure.]]
Right Answer RightAnswer::E
Explanation [[Explanation::The pulse pressure of this patient is: Pulse pressure = systolic blood pressure - diastolic blood pressure = 160 - 60 = 100 mmHg

Widened pulse pressure is associated with hyperthyroidism, aortic regurgitation, and obstructive sleep apnea. In contrast, narrowed pulse pressure is associated with aortic stenosis, cardiac tamponade, advanced heart failure, and cardiogenic shock.
Educational Objective: Widened pulse pressure is associated with hyperthyroidism, aortic regurgitation, and obstructive sleep apnea. In contrast, narrowed pulse pressure is associated with aortic stenosis, cardiac tamponade, advanced heart failure, and cardiogenic shock.
References: First Aid 2015 page 272]]

Approved Approved::Yes
Keyword WBRKeyword::Pulse pressure, WBRKeyword::Hyperthyroidism, WBRKeyword::Cardiology, WBRKeyword::Heart, WBRKeyword::Vascular, WBRKeyword::Pulse, WBRKeyword::Blood pressure
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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