prasannakumar
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A 53-year-old woman presents to the physician's office with a 3-week history of burning, substernal chest pain that usually comes on with exertion and is relieved with rest. The pain does not radiate to the arms or jaw. Her past medical history is significant for bronchial asthma, type 2 diabetes, hypercholesterolemia, and hypertension. A diagnosis of stable angina is suspected, and the patient is scheduled for an exercise EKG stress test. Which of her medications should be withheld 24 hours before the test?
A) Atenolol
B) Hydrochlorothiazide
C) Simvastatin
D) Ramipril
E) Metformin
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| young_doc
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A.
Being on a B-blocker during a stress test defeats the purpose of a stress-test!
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| cirus
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agree, BBs decrease rate so it may cause a false -ve test..
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| Justice
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A) Atenolol
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| doyoudig
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A) Atenolol
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| ssrpk
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also pain meds shuld be discontinued
agree with A
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| dr in trouble
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yes A
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| virgola82
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A, atenolol would prevent the increase in HR necessary for a valid stress test
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| prathapdoctor
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yes, I am confused between A and E. but we should not give metformin whereever the patient gets hypoxia, so we must not give metformin too.
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| ssrpk
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and why do you think there would be hypoxia?? he does'nt have a COPD and angina per se don't reduce ventilation, on the contrary due to anxiety associated with an impending attack of angina patient may even hyperventilate
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| prathapdoctor
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dont we get hypoxia while we do stress ekg test? we need not have any lung disease whilie we do severe exercise to get hypoxia.
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| young_doc
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Physical exertion should not make you "hypoxic" unless you have an underlying cardiovascular or pulmonary disease.
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| ssrpk
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hypoxia is decrease in PO2, and that should stay normal even during excercise,[as long as the ventilation is adequate] in the absence of any major cardiorespiratory illness.
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| prathapdoctor
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yes guys, i am wrong. i was considering getting dyspnea as having hypoxia, which was wrong. thanks.
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| ssrpk
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no problem, after this discussion now, u won't forget
good luck
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