A 63-year-old male patient with history of hyperlipidemia and hypertension present with 8 months history of chest pain on moderate exertion which get relived by rest. His current medications include atorvastatin (statin) and lisinopril (ACEI). His physical exam and baseline ECG are normal. Stress ECG showed 2mm ST depression. What will be your next step in management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Start the patient on Aspirin, Beta blocker and refer to cardiology
Exertional chest pain relieved by rest with a positive stress ECG = stable angina/CAD. All CAD patients need aspirin (reduces MI risk), and a beta-blocker is first-line antianginal therapy that also reduces coronary events; a positive stress test is an indication for cardiology referral/catheterization. SL nitrates alone (D) only relieve symptoms with unknown effect on prognosis, and clopidogrel is reserved for aspirin intolerance or post-stent DAPT.
ليش كل خيار صح أو غلط
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A
ليش غلط
Referral alone omits medical therapy: aspirin is indicated in all patients with CAD and a beta-blocker lowers coronary events.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 7 -
B
ليش غلط
Clopidogrel is used in patients with contraindications to aspirin; he is not described as aspirin-intolerant.
✓ CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 5 -
C
ليش صح
Aspirin is indicated in all CAD patients (reduces MI risk) and beta-blockers reduce coronary events, so both are started with cardiology referral.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 7 -
D
ليش غلط
Nitrates give symptomatic relief only; their effect on prognosis is unknown, and this option omits aspirin and a beta-blocker.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 7 -
E
ليش غلط
Dual antiplatelet therapy is used in special situations such as after stent placement; he has none, and this leaves out a beta-blocker.
✓ CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 5
- المصدر
- Step-Up To Medicine 6th (IHD & ACS).pdf · p. 7
CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 5
Step-Up To Medicine 6th (IHD & ACS).pdf · p. 5 - المحاضرة
- Ischemic Heart Disease · Cardiology · Module B
- ظهر في
- Cardio bank