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 Best of Five 221

 

   

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BOF: 221

An 18-year-old male presents with a history of dyspnoea on exertion and orthopnoea, fatigue and anorexia. On examination he has peripheral oedema, a rapid low volume pulse, no paradox, elevated JVP with a rapid y descent, no inspiratory increase in JVP, a quiet praecordium and characteristic auscultatory features of his condition. He also has hepatomegaly and ascites.

His chest X-ray demonstrates a small heart with no pericardial calcification.

ECG shows a widened QRS complex with diffuse non-specific repolarisation changes.

In this patient the characteristic auscultatory feature mentioned above is:

a)      Third heart sound

b)      Diastolic knock

c)      Fourth heart sound

d)      Pericardial rub

e)      Pericardial crunch

 

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