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OSH STATE UNIVERSITY

INTERNATIONAL MEDICAL FACULTY

SELF WORK

NAME-MOHAMMEDKHUZAIMA TALATI
SUBJECT - CHILD DISEASE
TEACHER - MAHABAT MITALIPOVNA BUGUBAEVA
GROUP-4 ENG 6 B

1.A 7 year old BOY presents with a 35 minute history of severe


chest pain radiating down his left arm, associated with
shortness of breath. He denies a prior history of chest pain. His
serum troponin levels and EKG are compatible with an acute
anterior wall myocardial infarction. The patient actually did
well initially, but collapsed outside his hospital room suddenly
6 days later. A new loud murmur indicating mitral insufficiency
was heard, but he died within 10 minutes. Of the following,
which is the most likely cause of death based on this history
A. Pulmonary embolism originating in left ventricular mural
thrombus
B. Ruptured ventricular papillary muscle
C. ruptured left ventricular papillary muscle
D. Acute bacterial endocarditis of mitral valve
E. Mitral valve prolapsed

Answer
C. ruptured left ventricular
papillary muscle
Ruptures can lead to papillary muscle
damage with acute mitral
insufficiency, which can lead to acute
hemodynamic changes on the left
side

2. A 10 year old GIRL with a history of rheumatic fever in


childhood had had episodes of congestive heart
failure for several years. During the last of her
hospital admissions, she developed massive
pulmonary thrombo-embolism and died. Autopsy
examination showed that her lungs were firm and
brown, and microscopically had widened, edematous
and fibrosed alveolar septa, aggregates of heart
failure cells in the alveoli, thickened small muscular
arteries, and atherosclerosis in the larger pulmonary
arteries. An acquired valvular disease was found in
the heart. Which one of the following was it most
likely to be
A. MITRAL STENOSIS.
B. TRICUSPID STENOSIS.
C. AORTIC STENOSIS.
D. AORTIC REGURGITATION.
E. MITRAL REGURGITATION

Correct answer is A
rheumatic heart disease (isolated mitral stenosis in
25% of all cases of rheumatic h.d., mixed mitral
stenosis and regurgitation in 40 % of all cases of
rheumatic h.d.,( two third of patients – women(
IN ABOUT 50% OF PATIENTS WITH MITRAL STENOSIS
THE RHEUMATIC FEVER MAY BE UNRECOGNISED
VIRAL CARDITIS - VERY RARE CAUSE OF MITRAL
STENOSIS
TWO THIRDS OF CASES OCCUR IN WOMEN

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