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Use the following patient vignette to answer questions 32 –…

Use the following patient vignette to answer questions 32 – 33. A 23-year-old student at CWRU is taken to Student Health by his friend after passing out on a run. The student says he has been experiencing trouble breathing while he runs and has been feeling very tired most of the time. He denies smoking or drinking alcohol in excess. Past medical history is significant for 2 episodes of angina upon exertion. At the physical examination his vitals are HR 80 bpm with a loud P2 (pulmonic) heart sound, BP 120/75 mmHg, RR 18 bpm. He appears to have a slightly lifted sternum but the rest of his physical exam is normal.  CXR shows normal lung fields, with a slightly increased umbra of the pulmonary artery. Cardiac silhouette appears slightly enlarged in the CXR image. 32. What is the most likely diagnosis for this patient?

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Use the following patient vignette to answer questions 30 –…

Use the following patient vignette to answer questions 30 – 31. Sophia, a 67-year-old woman, is brought into the ED by her son. He is concerned his mother has shown difficulty breathing every day of this past week. He is especially concerned because his mom had a STEMI about 3 months ago. Sophia states she has been sleeping with two extra pillows at night and keeps waking up in the middle of the night trying to catch her breath. Physical examination shows an ill-looking woman with peripheral edema (2+), jugular venous distension, and ascites. She is afebrile, HR 105 bpm, BP 100/75 mmHg, and RR is 26 bpm. Laboratory findings are within normal limits, and bacterial and viral serology are negative. There are decreased breath sounds and dullness to percussion on the right side, but no wheezing. 30. What is this patient’s most likely diagnosis?

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