This is a question from NBME form3

This is a question from NBME form3. For those who is going to take the test please do not read it.

A 57-year-old man has had a. Development of which of the following sequelae of the infarction is associated with decreased surviral?
a) avoidant personality disorder
b) decrease platelet count
c) decreased serum catecholamine concentration
d) major depressive episode
e) sexual dysfunction
I could exclude b) and c).
Then for the answer, I could only guess: e)
But is there any relationship between myocardial infarction and avoidant personality disorder or major depressive episode?
Thanks!

Sorry for some mistake above.
The question stem should be
A 57-year-old man has had a myocardilal infarction. Development of ........

I choose A.

No friends, family, associates to push him to be compliant with doctor's recommendations.

Also may have a diminished self-preservation instinct.

The reason I chose "sexual dysfunction" is that the patient may take sidenafil.
But your answer is reasonable. Did you get your answer based on some book?

[lyuda_m@yahoo.com]

I think than correct answer is C (decrease perfusion visceral organs with devepment failure many organs and adrenal glands and brain). But at first make infusions dopamine, dobutamine and sometimes catecholamines and prednisolon. Cases depression and anxiety are treating later.

Clinical complications of myocardial infarction will depend upon the size and location of the infarction, as well as pre-existing myocardial damage. Complications can include:

• Arrhythmias and conduction defects, with possible "sudden death"
• Extension of infarction, or re-infarction
• Congestive heart failure (pulmonary edema)
• Cardiogenic shock
• Pericarditis
• Mural thrombosis, with possible embolization
• Myocardial wall rupture, with possible tamponade
• Papillary muscle rupture, with possible valvular insufficiency
• Ventricular aneurysm formation

Sudden death is defined as death occurring within an hour of onset of symptoms. Such an occurrence often complicates ischemic heart disease. Such patients tend to have severe coronary atherosclerosis (>75% lumenal narrowing). Often, a complication such as coronary thrombosis or plaque hemorrhage or rupture has occurred. The mechanism of death is usually an arrhythmia.