Timothy, a 72-year-old man, presents to the emergency department complaining of palpitations, shortness of breath, and fatigue. His medical history includes hypertension and coronary artery disease. An electrocardiogram (ECG) reveals an irregular rhythm with a rapid ventricular rate, consistent with atrial fibrillation. Q.Of the following what are the mechanisms for rate control in patients with atrial fibrillation A.Cardioversion B.Medications C.Both Correct answer is C. In patients with atrial fibrillation, rate control can be achieved with cardioversion, medication, or both. The decision is based on the clinical picture, time in atrial fibrillation, and shared decision-making.Of the following, atrial fibrillation is associated with increased risk of which illnesses?
Timothy, a 72-year-old man, presents to the emergency department complaining of palpitations, shortness of breath, and fatigue. His medical history includes hypertension and coronary artery disease. An electrocardiogram (ECG) reveals an irregular rhythm with a rapid ventricular rate, consistent with atrial fibrillation. Q.Of the following what are the mechanisms for rate control in patients with atrial fibrillation A.Cardioversion B.Medications C.Both Correct answer is C. In patients with atrial fibrillation, rate control can be achieved with cardioversion, medication, or both. The decision is based on the clinical picture, time in atrial fibrillation, and shared decision-making.Of the following what are the mechanisms for rate control in patients with atrial fibrillation?
A 68-year-old male with a history of hypertension and type 2 diabetes presents to the clinic with complaints of intermittent palpitations, fatigue, and shortness of breath for the past week. He reports occasional episodes of dizziness but denies chest pain or syncope. The symptoms are more noticeable after mild exertion, such as climbing stairs. ECG Findings are significant for absence of P waves, irregular R-R intervals, and fibrillatory waves consistent with atrial fibrillation. You wanted to use CHA2DS2-VASc score as part of your management of this patient. What is the CHA2DS2-VASc score used to assess?
A 34 year-old woman comes to the emergency room because she has been having shortness of breath, palpitations, and sweating for the last 3 weeks. Four weeks ago she had a mild fever for a whole week. Her travel history is significant for yearly trips to Colombia. Her most recent trip to Colombia was 4 months ago with her church group on a medical mission trip. She slept many nights in primitive living quarters in areas without protection from reduviid insects. In Colombia, she was treated for ‘some eye infection with swelling around the eyes’. Physical examination is significant for tachycardia and pericardial friction rub. You also notice bilateral pitting edema and enlarged abdomen. ECG reveals diffuse ST segment elevation with low QRS voltages. Echocardiogram shows dilated ventricles with systolic and diastolic dysfunction, and wall motion abnormalities. Laboratory tests in this patient would most likely show serologic evidence of antibodies to which of the following?
A 32 year-old male comes to your office inquiring about antibiotic prophylaxis for endocarditis before a dental procedure. He reports a history of repaired congenital cyanosis heart disease when he was 5 years-old. He has been asymptomatic since his surgery. He is allergic to penicillins. Physical examination is unremarkable. What would be the best advice to this patient concerning antibiotic prophylaxis?
Of the following, which is the most common predisposing condition for infective endocarditis in developing nations?
A 34 year-old female comes to the emergency room with fever, chills, productive cough and dizziness. She is a known intravenous drug user with multiple visits to the emergency room in previous months. Her echocardiogram shows multiple vegetations over the tricuspid valve. One medical student who examined her told you that she felt Osler nodes in the physical examination of this patient. Of the following, which is the correct description of the Osler nodes?
A 24 year-old male comes to the emergency room with fever, chills, weakness, chest pain with deep inspiration, persistent, productive cough with greenish sputum mixed with blood, and shortness of breath. On examination, his temperature is 103.5 °F, heart rate is 122 beats per minute (bpm), blood pressure is 100/71 mm Hg, and respiratory rate is 26 breaths per minute. He is alert and awake. Oral examination shows black staining on the teeth. Fundoscopic examination shows round, flame-shaped hemorrhages with a pale center in the posterior pole of the retina. Auscultation of lungs reveals inspiratory rales bilaterally. Cardiac examination shows tachycardia with a regular rhythm with a high pitched holosystolic murmur loudest in the fourth intercostal space at the left lower sternal border. There are splinter hemorrhages under the nails in both hands. He has bilateral axillary lymphadenopathy, hyperpigmentation and scarring over both forearms. When you ask him in a non-judgmental way, the patient reveals that he is a regular intravenous drug user. His laboratory tests are remarkable for leukocytosis, anemia, hematuria, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and elevated rheumatoid factor. Blood cultures were drawn and sent to the lab. Of the following, which is the next best step in the management of this patient?
