A 72-year-old man comes to the emergency room with chest pain. ECG demonstrates ST-segment elevation in leads II,III, and aVF on an electrocardiogram. Suspecting a myocardial infarction, you admit him in the hospital. After a few minutes, the patient reports worsening chest pain, shortness of breath and lightheadedness. On electrocardiogram, you notice independent atrial and ventricular activity with no relation between the P waves and the QRS complexes. Which of the following is the most likely location of the patient’s infarct?
A 54-year old man presents to the emergency room complaining of crushing, substernal chest pain associated with confusion, shortness of breath, dizziness and a feeling of doom. Laboratory tests revealed an elevated troponin level. ECG demonstrated ST segment elevation in anterior leads V1-V4. He is taken to cardiology cath lab for percutaneous coronary intervention. Which of the following best describes the pathophysiology of this disorder?
As you work in the emergency room of a hospital, you received a phone call from an emergency team from an ambulance, which is transferring a patient suffering with myocardial infarction from his home to the hospital. Both percutaneous coronary intervention and fibrinolysis are available in your hospital. As you prepare to receive this patient, what is the objective in definitive reperfusion therapy of this patient?
A 60-year-old woman reported chest pain for the last three hours which has been worsening progressively. She has a history of angina. However, this pain is longer and more intense than her usual angina and it is not responding to nitroglycerin. Her husband called 911 and the patient was transported to the local hospital. As she arrived in the hospital, her breathing became very rapid, heart rate rose to 135 beats/minute, blood pressure dropped to 75/55 mm Hg and oxygen saturation dropped to 92%. An ECG demonstrates regular rhythm, tachycardia and ST segment elevation in precordial leads. Laboratory tests reveal elevated troponin. Which of the following is the definitive treatment for this patient?
A 60-year-old woman presents to the hospital complaining of substernal chest pain. An ECG demonstrates evidence of ST segment elevation. Laboratory tests reveal elevated troponin. Which of the following statements is true about troponin in a patient with myocardial infarction?
A 54 year-old male is admitted to the hospital for an abdominal surgery. His current medications include digoxin, enalapril, ibuprofen and ketoconazole. He is on heparin for DVT prophylaxis. His laboratory tests reveal the following: random, non-fasting, serum glucose: 357 mg/dl (normal fasting glucose: 70 – 100 mg/dL; Random, non-fasting: <140 mg/dL) serum potassium 6.2 mEq/L (normal serum potassium: 3.5 - 5.0 mEq/L) You reviewed his medical records as you investigated the etiology of his hyperkalemia. Which of the following is a cause of hyperkalemia, because it inhibits potassium excretion from the body?
A 32 year-old female who has recently been diagnosed with hypertension came to your office to get started on antihypertensive therapy. She googled about different medications used for hypertension and would like to get started on lisinopril. Her future plans include having one more child and to start a career as a commercial truck driver. As part of patient education, which of the following information should be given to this patient?
A 58-year-old male has come to your primary care center for establishment of care. His medical problems include heart failure with preserved ejection fraction and hypertension. As you review his medications, you want to make sure he is on the right medications which would be beneficial in the long run. You initiated this patient on lisinopril. As part of patient education, you should inform this patient about which of the following adverse effects of angiotensin-converting enzyme inhibitor?
A 58-year-old male has come to your primary care center for establishment of care. His medical problems include chronic systolic heart failure and hypertension. As you review his medications, you want to make sure he is on the right medications which would be beneficial in the long run. Which of the following medications are known to decrease mortality in patients with chronic heart failure?
A 66-year-old female is brought to the emergency room who has been suffering from substernal chest pain. Her ECG showed ST segment elevation. Laboratory tests reveal elevated troponin. Echocardiogram showed an ejection fraction of 35%. She was treated with coronary angioplasty and transferred to the recovery room. Of the following, which medication should be initiated in this patient that has proved to reduce mortality in post-myocardial infarction patients?
