WBR1013

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Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Physiology
Sub Category SubCategory::Cardiology
Prompt [[Prompt::Cardiovascular parameters are collected from the charts 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: 90 beats per minute

Which of the following medical conditions is most likely present in this patient?]]

Answer A AnswerA::Aortic stenosis
Answer A Explanation [[AnswerAExp::Aortic stenosis is characterized by a decreased pulse pressure.]]
Answer B AnswerB::Cardiac tamponade
Answer B Explanation [[AnswerBExp::Cardiac tamponade is characterized by a decreased pulse pressure.]]
Answer C AnswerC::Heart failure
Answer C Explanation [[AnswerCExp::Progressed heart failure is characterized by a decreased pulse pressure.]]
Answer D AnswerD::Cardiogenic shock
Answer D Explanation [[AnswerDExp::Cardiogenic shock is characterized by a decreased pulse pressure.]]
Answer E AnswerE::Hyperthyroidism
Answer E Explanation [[AnswerEExp::Hyperthyroidism is characterized by an elevated 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
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.
References: First Aid 2015 page 272]]

Approved Approved::No
Keyword WBRKeyword::Pulse pressure, WBRKeyword::hyperthyroidism, WBRKeyword::Cardiology, WBRKeyword::Heart, WBRKeyword::Vascular, WBRKeyword::Pulse
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