EBCOG Part 1-Maternal Medicine-Day 5(EMQ)

a.Tuberculous cavity n.pericardial effusion
b.Pulmonary embolism o.costochondritis
c.Musculoskeletal pain p.none of the above
d.gastro-esophageal reflux
e.Pneumonia
f.Pneumothorax
g.Ischemic heart disease
h.Aortic stenosis
i.Cardiac tamponade
j.Myocarditis
k.Aortic dissection
l.Pleural effusion
m.anemia
n.pericardial effusion

1.45 year old conceived thru ovum donation presented at 34 weeks with sudden onset of central chest pain & breathlessness.She smokes about 15 cigarettes/day.On exam-pulse 98 bpm & BP-100/70 mmHg.SFH is appropriate for gestation & fetal heart is well heard.Chest X-Ray is normal.An ECG shows sinus rhythm with T wave inversion in leads III,aVL & aVF.

2. 26 years old woman in 2nd pregnancy at 27 weeks gestation with severe chest pain that radiates to her back.Her height is 170 cm & she has hypermobile joints.On exam she looks unwell with a pulse of 136 bpm & BP 76/46 mmHg.Chest Xray is normal & ECG shows sinus rhythm with rate of 128 bpm.

3. 32 year old Asian lady in 3rd pregnancy at 20 weeks with sevre left sided chest pain.She has recently moved to Uk.She gives a h/o easy fatiguability & lassitude & becoming breathless over past 4 weeks.On exam-pulse 88 bpm & BP-96/70 mmHg.Auscultation of chest reveal muffled heart sounds & ECG shows low voltage complexes.

4. 30 year old school teacher at 30 weeks gestation with right sided chest pain that is worse on coughing.She has a productive cough.On exam pulse is 110 bpm & BP-100/76 mmHg.Her temp is 38֯c.Heart sounds are normal & breath sounds are diminished on right side.Chest Xray shows ground glass appearance on right side.