USMLE Forum Archives - USMLE Step 3 - Chest pain
Chest pain
zkadhem - 08-03-09 16:58
A 55-year-old Hispanic woman comes to the emergency department with symptoms of
intermittent substernal chest discomfort for the past 18 hours. Her other medical problems include hyperlipidemia, hypertension, diabetes mellitus- type 2, obesity, and hypothyroidism. She denies any history of smoking or alcohol abuse. Her medications include metformin, lisinopril, metoprolol, amlodipine, simvastatin, and levothyroxine. She is allergic to penicillin and sulfonamides. Her temperature is 37.2 C (99 F), blood pressure is 140/90 mmHg, pulse is 92/min, and respirations are 18/min. Her pulse oximetry reading is 99% on 2-liters oxygen. Examination shows normal jugular venous pressure, clear lung fields bilaterally, normal first and second heart sounds, and a grade 2/6 ejection systolic murmur in the right second intercostal area. All of her lab studies are normal, except an elevated blood glucose of 215 mg/dL, CK-MB and troponin-T. The electrocardiogram demonstrates deeply inverted T waves in the lateral leads. She is admitted to the hospital and started on standard therapy. Which of the following medications should be discontinued during her current hospitalization?
zkadhem - 08-03-09 16:58
A 55-year-old Hispanic woman comes to the emergency department with symptoms of
intermittent substernal chest discomfort for the past 18 hours. Her other medical problems include hyperlipidemia, hypertension, diabetes mellitus- type 2, obesity, and hypothyroidism. She denies any history of smoking or alcohol abuse. Her medications include metformin, lisinopril, metoprolol, amlodipine, simvastatin, and levothyroxine. She is allergic to penicillin and sulfonamides. Her temperature is 37.2 C (99 F), blood pressure is 140/90 mmHg, pulse is 92/min, and respirations are 18/min. Her pulse oximetry reading is 99% on 2-liters oxygen. Examination shows normal jugular venous pressure, clear lung fields bilaterally, normal first and second heart sounds, and a grade 2/6 ejection systolic murmur in the right second intercostal area. All of her lab studies are normal, except an elevated blood glucose of 215 mg/dL, CK-MB and troponin-T. The electrocardiogram demonstrates deeply inverted T waves in the lateral leads. She is admitted to the hospital and started on standard therapy. Which of the following medications should be discontinued during her current hospitalization?
The correct answer and explanation will be available after you answer.
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#22
Re: Chest pain babbu5508 - 07-28-10 05:37 My answer is: d.
except an elevated blood glucose of 215 mg/dL, CK-MB and troponin-T. The electrocardiogram demonstrates deeply inverted T waves in the lateral leads....MI
#25
Re: Chest pain babbu5508 - 08-30-10 02:32 in an analysis of patients with LVD, CCB use was associated with significantly increased risk of fatal or nonfatal MI.
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