A 55-year-old male is brought to the ED, by ambulance, because of crushing chest pain radiating to his left shoulder and arm that started 1 hour ago. He has a history of hypertension, high cholesterol, and has smoked a pack of cigarettes a day for 30 years. He has never had symptoms like this before. The patient's rhythm converts to asystole. What is the most appropriate first action to take?
Answer(s): E
The clinical scenario described is classic for an acute MI. The patient has multiple risk factors, including smoking, hypertension, and elevated cholesterol. His symptoms of crushing chest pain radiating to the left arm is commonly seen in this setting. Often the first electrocardiographic sign of acute ischemia is the development of hyperacute T waves. The ECG will usually show S-T segment elevations in the area of the involved occluded vessel, with reciprocal S-T segment depressions in uninvolved areas. This can be followed by the eventual resolution of S-T segment abnormalities and the development of T wave inversions and Q waves. Diffuse P-R depressions are often the initial manifestation of pericarditis, a less common cause of acute chest pain. This often progresses to diffuse S-T segment elevations, the presence of which helps to distinguish pericarditis from the focal S-T elevations more classically associated with a thrombosed coronary artery. Q waves would be unlikely to occur within 1 hour of the onset of symptoms. In this clinical setting, a normal ECG, while possible, would be less likely to occur.Ventricular arrhythmias, both tachycardia and fibrillation, are recognized complications of acute MI. The presence of ventricular fibrillation or pulseless ventricular tachycardia should lead to the primary "ABCD" survey, as outlined in the American Heart Association's ACLS protocols. The mnemonic stands for airway, breathing, circulation, and defibrillation. Epinephrine, lidocaine, or amiodarone are reserved for the setting where defibrillation is ineffective. Synchronized cardioversion would be used in efforts to convert a patient's rhythm in the setting of a stable tachycardia.
A 55-year-old male is brought to the ED, by ambulance, because of crushing chest pain radiating to his left shoulder and arm that started 1 hour ago. He has a history of hypertension, high cholesterol, and has smoked a pack of cigarettes a day for 30 years. He has never had symptoms like this before. Fortunately, the patient survives this episode. As part of his long-term treatment, which of the following would be an appropriate therapeutic intervention to initiate due to its proven effect on survival rate?
Answer(s): B
An 18-year-old female presents for follow-up of a rash. She states that she has been using OTC antifungal preparations without success. She used OTC cortisone cream with mild improvement, but the lesions never disappeared. Her condition also recurred with full severity once the cortisone cream was discontinued. Her family history reveals a first degree relative with similar rash. The rash is over the elbows, trunk, and scalp .Which other physical finding would be consistent with your presumptive diagnosis?
Psoriasis is a benign chronic, inflammatory skin disorder with a genetic basis that affects approximately 2% of the population in the United States. The condition varies in its presentation from person to person, with some having only local involvement and others having a severe generalized involvement. The incidence occurs in a bimodal distribution, with peaks persons in their 20s and 50s. Those with earlier onset generally will have a more severe disease over the course of their lifetime. Psoriasis has several variants, or subtypes, including plaque type (most common), eruptive (guttate), generalized pustular, and erythrodermic psoriasis. Some patients may be asymptomatic or may have only minor itching. Others may have involvement of most of their body, with severe disfigurement and poor quality of life. Psoriasis may involve any skin area; however, areas such as the scalp, extensor surfaces, palms, soles, and nails should always be examined. The typical lesions are described as erythematous, well-demarcated plaques with overlying scales. Fine stippling (pitting) of the nails is highly suggestive of psoriasis. In addition to the skin findings, patients may also have arthritis. The lesions can be reactivated with local injury or irritation of normal skin (Koebner phenomenon). The diagnosis is predominantly clinical, based on the history and examination. There are no laboratory measures that will diagnose psoriasis. Skin biopsy, although not pathognomonic, would show features consistent with psoriasis and would help to rule out other similar appearing conditions.
An 18-year-old female presents for follow-up of a rash. She states that she has been using OTC antifungal preparations without success. She used OTC cortisone cream with mild improvement, but the lesions never disappeared. Her condition also recurred with full severity once the cortisone cream was discontinued. Her family history reveals a first degree relative with similar rash. The rash is over the elbows, trunk, and scalp .Which of the following tests is most likely to confirm your clinical suspicion?
Answer(s): C
An 18-year-old female presents for follow-up of a rash. She states that she has been using OTC antifungal preparations without success. She used OTC cortisone cream with mild improvement, but the lesions never disappeared. Her condition also recurred with full severity once the cortisone cream was discontinued. Her family history reveals a first degree relative with similar rash. The rash is over the elbows, trunk, and scalp.Which of the following would be the appropriate initial treatment?
Answer(s): D
Share your comments for USMLE STEP3 exam with other users:
manged to pass the exam with this exam dumps.
good questions
can we please have the latest exam questions?
please help with jn0-649 latest dumps
please i need this dump. thanks
i have to take the aws certified developer - associate dva-c02 in the next few weeks and i wanted to know if the questions on your website are the same as the official exam.
all questions are more important
ques 4 answer should be c ie automatically recover from failure
very very useful page
the exams are giving me an eye opener
3rd so far, need to cover more
aligns with the pecd notes
question 4: b securityadmin is the correct answer. https://docs.snowflake.com/en/user-guide/security-access-control-overview#access-control-framework
kindly please share dumps
it is very useful, thank you
need safe rte dumps
can you upload the cis - cpg dumps
q6 = 1. download odt application 2. create a configuration file (xml) 3. setup.exe /download to download the installation files 4. setup.exe /configure to deploy the application
great material
could you please upload sap c_arsor_2302 questions? it will be very much helpful.
vraag 20c: rsa veilig voor symmtrische cryptografie? antwoord c is toch fout. rsa is voor asymmetrische cryptogafie??
so far good
question 31 has obviously wrong answers. tls and ssl are used to encrypt data at transit, not at rest.
pls provide dump for 1z0-1080-23 planning exams
could you please upload the exam?
please upload this
good material
lets see if this is good stuff...
useful information
intéressant
thank you for making the interactive questions
questions are accurate
i need questions/dumps for this exam.
i need this exam, when will it be uploaded