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MCQ 38

Q. Which of the following is not a major criteria for congestive heart failure?
A. Hepatojugular reflex
B. PND attacks
C. S3 gallop
D. Tachycardia (Heart rate more than 120/minute)

 Answer: D. Tachycardia (Heart rate more than 120/minute)

 Explanation: 
Framingham proposed the diagnostic criteria for congestive heart failure.
Either 2 major or one major and 2 minor criterias should be fulfilled for the diagnosis of CHF

 Major criterias are:
  1. Paroxysmal nocturnal dyspnea
  2. Weight loss of 4.5 kg in 5 days in response to treatment
  3. Neck vein distention
  4. Rales
  5. Acute pulmonary edema
  6. Hepatojugular reflux
  7. S 3 gallop
  8. Central venous pressure >16 cm water
  9. Circulation time of ≥25 seconds
  10. Radiographic cardiomegaly
  11. Pulmonary edema, visceral congestion, or cardiomegaly at autopsy
And minor criterias are:
  1. Nocturnal cough
  2. Dyspnea on ordinary exertion
  3. A decrease in vital capacity by one third the maximal value recorded
  4. Pleural effusion
  5. Tachycardia (rate of 120 bpm)
  6. Hepatomegaly
  7. Bilateral ankle edema
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