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Thread: Case 1 (Inaugurating this amazing section)

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    Talking Case 1 (Inaugurating this amazing section)

    A 12-year-old male presented with a sore throat and fever. Throat culture was positive for /J-hemolytic Strepto-
    coccus. Three weeks later, the sore throat had resolved, but the patient developed a reddish rash. On examination, the pediatrician noticed a murmur of mitral regurgitation and rales over both of the lungs. The patient was admitted to the hospital. During the hospital stay, he had several episodes of atrial fibrillation, and he developed signs of acute left ventricular failure and died of pulmonary edema 2 days after admission. Which of the following changes is least likely to be seen in the heart?


    O (A) Fibrinous pericarditis
    O (B) Aschoff nodules in the myocardium
    O (C) Fibrosis of mitral valve with fusion of commissures
    O (D) Foci of fibrinoid necrosis in mitral valve
    O (E) Dilatation of the left ventricle


    [hide]
    (C) This patient developed acute left ventricular fail-
    ure, an uncommon complication of acute rheumatic fever.
    During the acute phase patients develop pancarditis, and
    hence pericarditis, valvulitis, myocarditis, and ventricular
    dilatation are all likely. Fibrosis and fusion of the mitral
    valve leaflets take several weeks to months to develop.
    [/hide]
    Last edited by Amal; 01-15-2008 at 11:51 PM.

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    Aschoff nodules in the myocardium

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    Quote Originally Posted by quemerde View Post
    Aschoff nodules in the myocardium
    Wrong answer !!! Read the question properly !!!

    It asks for the "the least likely change" !!!

    Be careful my friend.....

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    dialation of left ventricle

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    Quote Originally Posted by rupu View Post
    dialation of left ventricle
    Wrong answer!!! Dilation of left ventricle is a likely change in complication of infective endocarditis !!!!

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    The least one is (c) for sure..there is not enough time for fibrosis to develop this is an Acute rheumatic fever


    Wafa

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