Monday, November 26, 2007


Here's an easy one. As a gunner, you begin studying for Step 1 of the Boards in the fifth grade. A 65 year old male has a BNP of 500 pg/mL and a CXR that looks like this:

Challenge: What are some treatments for this?

Related Questions:
1. What does BNP measure?
2. What do you see on the CXR?
3. What is your diagnosis?

Image shown under fair use.


Alex said...

1. venous congestion
2. i only see cardiomegaly, but are u expecting kerley b lines?
3. CHF

Craig said...


BNP or brain natriuretic peptide is secreted by the ventricles of the heart in response to cardiac distention. It decreases PVR and CVP while increasing natriuresis, thus decreasing volume and cardiac output. It is used as a marker of congestive heart failure (500 pg/mL is elevated and positive). The CXR demonstrates cardiomegaly and also supports heart failure. Other signs on CXR include peribronchial cuffing, Kerley B lines, and pulmonary edema. (Congestive) heart failure is treated with ACE inhibitors, beta-blockers, aldosterone antagonists, diuretics, and vasodilators.

Sources: Wikipedia;

Alex said...

specifically carvedilol, which has alpha-antagonist activity. standard beta-blockers not helpful