Of the following, which patients should be considered for high-dose statin therapy?

A 63-year-old woman comes to your office for her annual physical examination. In the review of systems, she denies any chest pains, shortness of breath on exertion, cough, fatigue and reports ‘just some joint pains here and there’. She has an estimated 10-year cardiovascular disease risk of 12%. She lives with her husband and children in a neighborhood near your medical center. According to the United States Preventive Services Task Force (USPSTF), of the following, what is recommended to this patient?

Of the following, which is a cause of acquired platelet dysfunction?

A 58-year-old woman presented to the emergency room complaining of severe, crushing, substernal chest pain that began while she was cooking a meal at a friend’s house this morning. She tells you that she experiences this type of pain when she walks fast or does something strenuous. An electrocardiogram demonstrates some signs of ischemia. Serial cardiac enzymes reveal elevated troponin. The cardiac catheterization reveals significant stenosis of the left anterior descending coronary artery and the patient has a bare-metal coronary stent placed. What is the primary recommendation for anticoagulation in this patient?

Polymorphisms in which of the following genes might lead to decreased metabolism of clopidogrel to its active metabolite, leading to inadequate platelet inhibition?

A 58-year-old woman presented to the emergency room complaining of severe, crushing, substernal chest pain that began while she was cooking a meal at a friend’s house this morning. She tells you that she experiences this type of pain when she walks fast or does something strenuous. An electrocardiogram demonstrates some signs of ischemia. Serial cardiac enzymes reveal elevated troponin. The cardiac catheterization reveals significant stenosis of the left anterior descending coronary artery and the patient has a bare-metal coronary stent placed. After stent placement, she is placed on clopidogrel, a medication that acts to prevent thrombosis at the stent site. Of the following, which explains the mechanism of action of clopidogrel?

A 42 year-old woman comes to the emergency room with severe chest pain for the last 12 hours. She was soundly asleep when the pain woke her up early this morning. Physical examination is unremarkable. ECG showed ST segment elevation. After administration of sublingual nitroglycerin, ST segment is reversed and becomes depressed. She was rushed for a cardiac catheterization, which showed no obstruction in her coronary arteries, but showed coronary arteries in spasm. Laboratory tests revealed normal troponin level. Which of the following is the most effective strategy in the management of this patient?

A 42 year-old woman comes to the emergency room with severe chest pain for the last 12 hours. She was soundly asleep when the pain woke her up early this morning. Physical examination is unremarkable. ECG showed ST segment elevation. After administration of sublingual nitroglycerin, ST segment is reversed and becomes depressed. She was rushed for a cardiac catheterization, which showed no obstruction in her coronary arteries, but showed coronary arteries in spasm. Laboratory tests revealed normal troponin level. What is the most likely diagnosis in this patient?

A 64-year-old woman comes to the cardiology clinic complaining of chest pain on exertion. She has been getting these attacks in a regular fashion for over a few years. It occurs reliably with exertion and emotional stress. The pain develops rapidly and feels like tightness. It starts in the midsternal region and radiates to the left shoulder, arm, or neck. The pain has not changed in intensity and duration for the last few years. She can predict these attacks and she gets relief from chest pain if she stops doing what she is doing. As she reached the examination table, she reported some chest pain with her clenched fist keeping over the sternum. During your physical examination, she kept her clenched fist over the sternum. Which of the following medication regimens is appropriate to manage this patient ?

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?