A 38-year-old male comes to the emergency room complaining of shortness of breath on exertion for a few weeks. His medical history is significant for malignant melanoma. Physical examination is significant for dyspnea, jugular venous distention, pericardial friction rub,muffled cardiac tones, and hypotension. ECG shows low-voltage electrical waves. You suspected pericardial tamponade in this patient and wanted to do a bed-side maneuver to establish the diagnosis. Of the following, the measurement of which would help you in reaching the correct diagnosis in this patient?

A 43 year-old man presents to the emergency department complaining of weakness, feeling bad, and difficulty breathing for the last 4 days. His temperature is normal, heart rate is 160 beats per minute, blood pressure is 60/40 mm Hg, and oxygen saturation is 91% on 80% FiO2 by face mask.On physical examination, his trachea is not deviated. His lung sounds are normal. But his heart sounds are muffled, distant and faint. You noted swollen veins in the neck with pressure not changing with breathing. There is an abnormal drop in systolic blood pressure when he inhales and the disappearance of radial pulse on inspiration. ECG revealed a QRS complex height that varies from one heart beat to the next. On chest x-ray, the cardiac silhouette is rounded in its lower portion and ­tapers at the base of the heart resembling a plastic bag filled with water sitting on a table. Jugular venous pressure waveform is remarkable for prominent x descent and absent y descent. Laboratory tests revealed normal troponin levels. Echocardiogram revealed a small right ventricle and confirmed the suspected diagnosis. Which of the following is most likely to be diagnosed in this patient?

A 64-year-old man presents to your primary care office because his ‘pre-surgery clearance form’ needs to be filled by a doctor. Next month he is scheduled to undergo pancreatectomy for a malignant tumor of the pancreatic head. His medical history is significant for ischemic heart disease and diabetes mellitus requiring insulin. His most recent serum creatinine level was 2.1 mg/dL. Of the following which medication is considered the first-line therapy to reduce perioperative morbidity and mortality in this patient?

A 58 year-old woman comes to your office with a pre-surgery clearance form. She is going to have cataract surgery next month and her eye doctor wanted her to get a physical examination before the surgery. She reports no medical complaints. Her past medical history is significant for occasional acid reflux disorder. Her serum creatinine level was 1.2 mg/dL two weeks ago. She works as a teller in a local bank and exercises one hour a day in the local gym. Her temperature is 99 °F (37.2 °C), heart rate is 78 beats/min, blood pressure is 125/80 mm Hg, respirations are 19 breaths/min, and oxygen saturation is 98% on room air. Her physical examination is significant for cataracts in both eyes. Of the following, the next step in her management is