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DrPak
Forum Elite  Topics: 48 Posts: 335 |
A 36-year-old female presents to the emergency room complaining of chest pain that started suddenly while she was shopping at the mall. She also reports shortness of breath, palpitations and diaphoresis. The pain is retrosternal and radiates to the left arm. There are no aggravating or relieving factors. On review of systems, the patient reports having had a runny nose, sore throat and dry cough for the past 3 days. Her past medical history is significant for panic attacks, for which she takes paroxetine, and dysfunctional uterine bleeding, for which she takes estrogen. Her family history is significant for the sudden death of her father at age 44 from a heart attack. Social history reveals that she has smoked one pack of cigarettes per day for the past 15 years. Which of the following is the most appropriate initial therapy for this patient? A) Lorazepam B) Heparin C) Aspirin D) Ibuprofen E) Acetaminophen F) Oxycodone
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robin082006
| Forum Hero  Topics: 468 Posts: 5028
A panic episode?
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Aashi
| Forum Moderator  Topics: 15 Posts: 805
Even though the hx clearly states that the pt has hx of panic episodes,and s/s does support panic attack, but with s/s like that one shld always rule out cardiac part FIRST,and a dose of ASA wont hurt..morever ALPRAZOLAM is the DOC of panic attacks and not lorazapam...so I go for C-------->Aspirin
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DrPak
| Forum Elite Topics: 48 Posts: 335
aashi, how would aspirin help in an acute coronary event? Wouldn't heparin or tPA be the choice there?
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DR PAK Take this as aRULE ACUTE CORONARY SYNDROME = ASPIRIN 1ST I faced more than 10 qs till now in kaplan q bank regarding this issue to give aspirin 1st before any other meds and she has many risk facors
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young_doc
| Forum Guru  Topics: 59 Posts: 718
Remember MONA: Morphine, Oxygen, Nitro, and ASPIRIN!!!
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DrPak
| Forum Elite Topics: 48 Posts: 335
Ok, thanks. The answer is indeed aspirin. The lesson for me today is aspirin with acute coronary events.
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