doc649
Forum Junior
Topics: 18
Posts: 61
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12. A 77-year-old man, complaining of abdominal
pain, anorexia, and nausea and vomiting over
the past 24 hours, presents to the clinic with
his son. The son reveals that his father has also
complained of blurred vision. On physical examination,
the patient’s vital signs are stable
and his abdomen is soft, but he appears to be
somewhat confused. He is currently maintained
on metoprolol, digoxin, and hydrochlorothiazide
for ischemic congestive
heart failure. His son says that sometimes his
father confuses his medications. The patient
also has renal insufficiency with a baseline
serum creatinine of 2.6 mg/dL. The ECG reveals
a widened QRS complex and a new firstdegree
heart block. Which of the following is
the most likely cause of this patient’s symptoms?
(A) Digoxin toxicity
(B) Gastroenteritis
(C) Hypocalcemia
(D) Hypovolemia secondary to thiazide diuretic
overuse
(E) Myocardial infarction
I chose AA..
13. An 89-year-old man presents to the ED with 2
days of painful lower extremity swelling and
shortness of breath. His blood pressure is
176/88 mm Hg with significant peripheral
edema, elevated jugular venous pulsations,
and rales on pulmonary examination. Laboratory
values are:
Na+ 34 mEq/L
K+ 5.3 mEq/L
Cl− 101 mEq/L
Blood urea nitrogen 54 mg/dL
Creatinine 1.7 mg/dL
Glucose 189 mg/dL
WBC count 6400/mm3
Hematocrit 37%
Platelet count 226,000/mm3
Troponin I 0.09 ng/dL
Creatine kinase, 6 ng/mL
myocardial bound
The physician suggests x-ray of the chest and
echocardiography to investigate further. The
patient’s ejection fraction is 70%. Which of the
following features is most consistent with the
diagnosis of diastolic dysfunction?
(A) Decreased end-diastolic pressure
(B) Decreased end-diastolic volume
(C) Decreased ejection fraction
(D) Decreased ratio of ventricular wall thickness
to ventricular cavity size
(E) Normal exercise capacity
(F) Normal x-ray of the chest
My ans:???B
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| drshvetasm
Forum Elite
Topics: 22
Posts: 278
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yeah i would pick the same
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| Ivonne
Forum Guru
Topics: 53
Posts: 1,402
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A
B
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| liliaeliz
Forum Elite
Topics: 31
Posts: 304
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