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Which of the following is not a common finding in a patient with cardiac tamponade and coexisting pericardial effusion?
An 88-year-old male suddenly faints while sitting on the sofa. The syncopal episode lasted approximately 10 seconds. There are no associated symptoms. He is brought to the emergency department where your exam reveals an alert, asymptomatic man with no significant physical examination findings. BP = 140/76 mmHg (right arm, supine), pulse = 78 bpm (irregular), respirations = 16 breaths/min (nonlabored); temp = 97.8° F (oral); SaO2 = 97% on room air. Which of the following tests should be performed first?
A 72-year-old patient is found pulseless, apneic, and unconscious in one of your hospital beds. The cardiac monitor demonstrates junctional bradycardia. You should immediately do which of the following?
A 68-year-old man who has known chronic bronchitis now has a 6-day history of increasing dyspnea and weight gain. Vital signs are: BP = 110/70 mmHg (left arm, supine), pulse = 120 beats/minute (regular), respirations = 34 breaths/minute. Physical exam reveals scleral icterus and cyanosis of the lips and nailbeds. Jugular veins are distended to the angle of the jaw with the patient at 30 degrees elevation. A grade II/VI holosystolic murmur is heard in the 4th intercostal space along the left sternal border. Peripheral edema is present in both lower extremities. Which of the following is the most likely diagnosis?
Which of the following presentations best describes someone suffering from acute pulmonary edema caused by congestive heart failure?
Prinzmetal’s variant angina is characterized by all of the following except:
A 67-year-old known hypertensive male with extensive smoking history, presents to the ED with “sharp” substernal chest pain. A plain-film chest x-ray reveals a widened mediastinum. CT scan without contrast shows an aortic intimal flap. Which of the following is the most likely diagnosis?
A 29 year-old female with history of IV drug abuse presents to the emergency room with ongoing fevers for three weeks. She complains of fatigue, worsening dyspnea on exertion and arthralgias. Physical examination reveals a BP of 130/60 mmHg, HR 90 bpm, regular, RR 18, unlabored. Petechiae are noted beneath her fingernails. Funduscopic examination reveals exudative lesions in the retina. Heart examination shows regular rate and rhythm, there is a grade II-III/VI systolic murmur noted, with no S3 or S4. Lungs are clear to auscultation bilaterally, and the extremities are without edema. Which of the following is the definitive diagnostic study of choice in this patient?
A 44-year-old woman has an acute ischemic cerebellar stroke. Blood pressure 146/92 mm Hg, pulse 102/min/regular, rectal temperature 102.4 degrees F, and respirations 22/min. Lungs are clear to auscultation. Cardiac examination shows a 2/6 left sternal border diastolic heart murmur. Which of the following is the most likely diagnosis?
A patient with a known dilated cardiomyopathy presents to the office in atrial fibrillation. The husband asks you why his wife when in atrial fibrillation and her history of heart problems is more likely to go into congestive heart failure than when she has a regular rhythm. What is your answer?
Which of the following medications is most likely to cause muscle aches and pains when initially started?
A patient is in a head on collision as an unrestrained driver, he has bruising across his chest, prominent JVD, hypotension and muffled heart sounds. What is the diagnostic test of choice for this patient?
Which one of the following valvular heart problems is most likely to cause a systemic emboli?
A 22-year-old woman has the acute onset of severe anterior chest pain that is eased by leaning forward but increased during deep inspiration. Acute pericarditis is diagnosed. Which of the following is the most likely electrocardiographic abnormality?
A 14-year-old girl has an atrial septal defect. Which of the following is the expected abnormality to be noted on chest radiography?
A contraindication to the use of verapamil is:
An antihypertensive drug that inhibits reabsorption of sodium and chloride is:
A common adverse effect of clonidine is:
A 69-year-old female presents to the emergency room with a complaint of acute shortness of breath. Based on her history, physical examination and chest x-ray it is difficult to discern if her symptoms are pulmonary or cardiac in nature. Which of the following blood tests would be the most useful in determining between the two?
What antianginal agent(s) is/are contraindicated for a patient with closed-angle glaucoma?
A class IV antiarrhythmic agent is:
An antiarrhythmic agent that prolongs repolarization and is used in atrial or ventricular arrhythmias is:
A 78-year-old woman is first seen with progressive dyspnea, orthopnea, and cough. Physical examination discloses jugular venous distention, an S3 gallop, bibasilar rales, and ankle edema. Which of the following studies would allow the practitioner to assess the patient’s heart wall and chamber size, ventricular wall motion, and estimated left ventricular ejection fraction?
A 49-year-old man arrives at the emergency department with complaint of intermittent severe substernal pressure sensation lasting 2 to 10 minutes, precipitated by minimal exertion that began 6 days ago. The pain has been occurring with increasing frequency over that time but does not occur with rest. What is the most appropriate diagnosis in this patient?
In pericarditis, the pain is often relieved or decreased by which of the following?
A 39-year-old man arrives at the emergency department with 2 weeks of fever, night sweats, and arthralgias. The physical examination discloses a heart murmur, lower extremity petechiae, splinter hemorrhages on his nail beds, and small nonpainful hemorrhagic patches on his palms and soles of his feet. What is the most likely diagnosis in this patient?
Which of the following is a common skin manifestation of lower extremity chronic venous insufficiency?
A 68-year-old woman in the hospital after a total hip replacement 4 days prior, reports unilateral leg edema and pain. The physical examination discloses unilateral lower leg edema and calf tenderness. Which of the following would be the most definitive study to diagnose this patient?
Which of the following is the most common side effect of the hydroxymethylglutaryl coenzyme A reductase inhibitor or statin drug class?
A 30-year-old male presents to his primary care clinician with what appears to be bilateral Raynaud phenomenon. On further questioning he reports that he has intermittent claudication symptoms that occur after walking approximately one-quarter of a mile. Review of his medical records reveals that he has been treated multiple times for superficial thrombophlebitis of the legs. He is a 2 pack per day smoker. Which of the following is the most likely underlying diagnosis?