Explanation The correct answer is B This patient seems to be describing

Explanation the correct answer is b this patient

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Explanation: The correct answer is B. This patient seems to be describing intermittent claudication, which is a sign of peripheral vascular disease. Patients often complain of pain during exertion that is relieved by rest. The physical findings in this case are very consistent with this diagnosis. Noninvasive evaluation is usually recommended initially and consists of determining the ratio of ankle to brachial arterial
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pressures. The ankle/brachial artery ratio is determined by measuring and comparing the 2 blood pressures. If the ratio is less than 1 (greater than or equal to 1 is considered normal), peripheral artery disease is present. After it is determined that peripheral artery disease is present, it is appropriate to advise him to quit smoking and maintain meticulous foot care (choice A). Additional treatment includes a gradual exercise program and possible aspirin or other antiplatelet drugs. Surgical r evascularization is usually considered for severe, disabling disease. It may be appropriate to recommend daily aspirin therapy (choice C) after you have determined that peripheral artery disease is present to reduce the risk of cardiovascular events. It is inappropriate to refer him to a surgeon for evaluation for surgical revascularization (choice D) at this time. You should first perform a noninvasive evaluation before this is even considered. It is inappropriate to schedule angiography of the left leg (choice E) at this time. You should first perform a noninvasive evaluation before this is even considered. An angiography is not used as a routine diagnostic study for the initial evaluation of claudication. It should only be performed if surgical revascularization is being considered. A 40-year-old man comes to the office complaining of a 3-day history of midsternal chest pain, non-radiating that is worse with inspiration and relieved by sitting forward. He has no past medical history, is on no medications, does not smoke, and has no known drug allergies. He leads an active lifestyle, and had been running about 10 miles a week without problem until a week ago when he developed a “ viral syndrome.” His temperature is 38.4 C ( 100 F), blood pressure is 130/70 mm Hg, pulse is 100/min and regular, and respiratory rate is 20/min. He has a high pitched, grating sound that can be auscultated throughout the cardiac cycle over his precordium. An
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electrocardiogram shows diffuse ST elevation, diffuse PR depression with PR elevation in lead aVR. The most likely diagnosis is A. angina B. myocardial infarction C. pericarditis D. pneumonia E. pulmonary embolism Explanation: The correct is answer is C. A chest pain that is pleuritic and improves with sitting up and leaning forward is a classic description of the chest pain associated with pericarditis, as is the precordial rub auscultated on physical exam. Diffuse ST elevations with diffuse PR depressions and PR elevation in lead aVR is also the classic description of the EKG findings associated with pericarditis.
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