USMLE Forum Archives - USMLE Step 2 CK - cardio
cardio
bingousmle - 05-13-10 14:19
You are seeing a 68-year-old woman for the first time in your office. She has just moved her care to you
after her primary care physician retired. She has a history of chronic atrial fibrillation, diabetes,
gastritis, and osteoarthritis and she takes glyburide and ranitidine. She has no known drug allergies.
During your interview you find out that she is very active and walks 3 miles a day. Her blood pressure is
128/76 mm Hg and heart rate is 80/min and irregular. Her lungs are clear to auscultation bilaterally and
her cardiac examination is significant for an irregularly irregular rhythm. A finger stick blood glucose is
87 mg/dL. Based on your history and physical examination, the most appropriate pharmacologic agent
to add to her regimen is
A. digoxin
B. ibuprofen
C. metoprolol
D. NPH insulin
E. warfarin
bingousmle - 05-13-10 14:19
You are seeing a 68-year-old woman for the first time in your office. She has just moved her care to you
after her primary care physician retired. She has a history of chronic atrial fibrillation, diabetes,
gastritis, and osteoarthritis and she takes glyburide and ranitidine. She has no known drug allergies.
During your interview you find out that she is very active and walks 3 miles a day. Her blood pressure is
128/76 mm Hg and heart rate is 80/min and irregular. Her lungs are clear to auscultation bilaterally and
her cardiac examination is significant for an irregularly irregular rhythm. A finger stick blood glucose is
87 mg/dL. Based on your history and physical examination, the most appropriate pharmacologic agent
to add to her regimen is
A. digoxin
B. ibuprofen
C. metoprolol
D. NPH insulin
E. warfarin
The correct answer and explanation will be available after you answer.
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#4
Re: cardio mtniharika - 05-18-10 15:02 My answer is: e.
Drugs are used to help reduce stroke risk in people with AF. Anticoagulant and antiplatelet medications thin the blood and make it less prone to clotting. Warfarin is the anticoagulant now used for this purpose, and aspirin is the antiplatelet drug most often used.
#5
Re: cardio babbu5508 - 05-19-10 14:19 My answer is: e.
warfarin as an anticoagulant is recommended to all elderly or high risk people with atrial fibrillation in order to prevent or decrease the chances of stroke.
#6
Re: cardio ammulufy - 05-19-10 19:41 My answer is: e.
I feel e is the answer because the patient's history is consistent with Chronic AF.....which if not corrected immediately with an antiarryhthmic agent it can be detrimental.....before even antiarrythmic agent,she is to be put on Warfarin,an anticoagulant in view of impending embolization.
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