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New cases in Pous 2064, HIV = 175, AIDS = 26, Death = 2. HIV rate is very high in Housewives than sex workers in Nepal ! ! ! HIV status in Nepal till 2005: Total Adult=70000, Adult Prevalence (15-49)=0.55%, Number of Women (15-49) LWHA=15,310 (22%), HIV Prevalence rate in IDUs=32.7%, HIV prevalence rate in sex worker=3.8%, HIV prevalence rate in client of SW=2.1%. The latest U.N. report shows that 65 million people have been infected with HIV since it was first identified 25 years ago. Twenty five million people have died of AIDS.

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Clinical Vignette A clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.

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Clinical MCQs 4 - 06-06-2006, 06:27 AM

Here is the next scenario:

A 50-year-old man is brought to the emergency room with substernal chest pain. An electrocardiogram is performed, which demonstrates ST segment elevation and T wave inversion. Several hours later the patient develops an arrhythmia. The electrocardiogram shows random electrical activity without recognizable QRS complexes. Which of the following descriptions best describes this arrhythmia?
A. Accelerated idioventricular rhythm
B. Accelerated junctional rhythm
C. Premature ventricular contraction
D. Ventricular fibrillation
E. Ventricular tachycardia

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Re: Clinical MCQs - 06-06-2006, 07:21 AM

well is not Subacute sclerosing panencephalitis a late complication of mesals infection ? well does it occur so soon withg in the weeks ? plz. cleraify me. thanks
well this was for another question regarding mesals?

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Re: Clinical MCQs - 06-06-2006, 07:26 AM

Ventricular fibrillation in this AMI patient.
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Re: Clinical MCQs - 06-06-2006, 07:35 AM

dear Oak
Had this scenario been provided with an ECG, it would have been of great help for us to distinguish the kind of Arrhythemia.
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Re: Clinical MCQs - 06-06-2006, 07:33 PM

The correct answer is D. The rhythm described is that of ventricular fibrillation, which is a feared complication of myocardial infarction that must be corrected immediately (CPR, defibrillation, IV and intracardiac drugs including epinephrine, lidocaine, or procainamide) if the patient is to survive.

In an accelerated idioventricular rhythm (choice A), a normal latent pacemaker in the ventricles depolarizes at a regular, accelerated rate of 50 to 100/min, each time producing unusually shaped (but similar to each other) QRS complexes. P waves related to the complexes are not seen.

In an accelerated junctional rhythm (choice B), the P waves are typically inverted and may precede, follow, or be hidden within regular QRS complexes that occur at a rate of 60 to 150/min.

In a premature ventricular contraction (choice C), an ectopic ventricular pacemaker inserts an ectopic beat (typically with a wide and bizarre QRS complex) before the next sinus beat occurs.

In ventricular tachycardia (choice E), wide and bizarre, but recognizable, QRS complexes occur at an accelerated rate.



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Originally Posted by unseennude
dear Oak
Had this scenario been provided with an ECG, it would have been of great help for us to distinguish the kind of Arrhythemia.
Actually the scenario was to emphasize that VF is important in this case, I mean attending doctor must be aware of the fact but will try to do so.


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Originally Posted by bharat
well is not Subacute sclerosing panencephalitis a late complication of mesals infection ? well does it occur so soon withg in the weeks ? plz. cleraify me. thanks
well this was for another question regarding mesals?
You are right that wasn't SSP for those who want to go through Click Here
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