Monday, March 23, 2009

identification data - shortness of breath,cough,frothy sputum

Soalan 3
a 63 year old lady presented with shortness of breath and cough with frothy sputum.

On examination she has displaced heart beat and bibasal crepitations. She was diagnosed as a hypertensive since 15 years ago but defaulted treatment.

You are shown her chest radiograph

sate 2 abnormalities seen in the radiograph

Loss of costophrenic angle
Increase cardio-thoracic ratio (cardiomegaly)
Increase pulmonary vascular markings

State the most likely diagnosis

Pulmonary oedema

Briefly explain how hypertension lead to this patient’s condition

Hypertension → increase systemic pressure → heart need to pump harder to overcome the resistance → left heart failure → congested flow → extravasation of pulmonary vessels → pulmonary oedema

State 2 complication to diagnosis above

End organ failure (sbb heart cannot pump out blood, tak cukup blood supply keorgan2, organ failure)
Cardiogenic shock

p/s: gmbar xray ni bukan 100% sama tp lebih kurang sama dgn id trial hr tu.
maaf sbb lambat post


si comei..hehe. said...

salam kak maaf nak tanya kita bleh letak pulmonary edema sbg diagnosis??


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