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1. The term Angina (angina pectoris) is used to refer to which of the following?

31. A 62-year-old man with a history of coronary artery disease is diagnosed with atrial fibrillation. Which of the following ECG findings would most likely be observed? Rate Rhythm A. No change Regular B. No change Irregular C. Decrease Regular D Decrease Irregular E. Increase Regular F. Increase Irregular

A 70-year-old woman presents with heavy, crushing chest pain of 3-hour duration.  The pain is exacerbated with exertion and resolves with rest.  Past medical history is significant for type 2 diabetes.  She has a 40-year history of smoking (2 packs per week).  Current medications are metformin and canaglifozin (SGLT2 inhibitor) for management of her diabetes. Physical examination reveals an overweight individual with blood pressure 145/92 mm/Hg.  The remainder of the examination is within normal limits.  Laboratory studies are significant for severely depressed circulating HDL, increased total cholesterol and LDL, and mildly elevated triglycerides. ECG reveals T wave inversion, and serum Troponin is within the reference range.  A full workup confirms a diagnosis of acute coronary syndrome. 11. Which of the following is the strongest risk factor for this patient’s illness?

Calcium phosphate Ca3(PO4)2 is a mineral found in human bones and teeth.  Calcium phosphate has __________ oxygen atom(s) in every formula unit.

In the following reaction, how many grams of H2O are produced if 7.25 g of H2S react?  2 H2S  +  3 O2  —–>  2 H2O  +  2 SO2

A 55-year old man is being evaluated by a cardiologist for exertional angina and dyspnea.  Past medical history is significant for poorly-controlled hypertension. Current medications are hydrochlorothiazide and Lisinopril (an ACE inhibitor). On physical examination, he is afebrile, blood pressure is 150/95 mm Hg, pulse is 90/min, and respiration rate is 16/min.  Auscultation of the chest demonstrates a late-peaking systolic murmur at the upper sternal border and delayed carotid pulses.  The lungs are clear.  Laboratory studies are within normal limits, including troponin. The ECG reveals mild left ventricular hypertrophy, which is confirmed by echocardiography. 13. Which of the following is the most likely diagnosis?

15. In a patient with aortic valve stenosis, which of the following would most likely be increased?

Use the following patient vignette to answer questions 4 – 8. A 55-year-old man reaches the ED with a chief complaint of chest pain.  He describes it as crushing, heavy pain in the left substernal area, present for the last 95 min at rest.  He reports another episode of chest pain about 1 year before. In that case, pain was more ‘stabbing’ and felt primarily in the back. Clinical records of that event indicated that he complained of being mildly diaphoretic, mostly at night, and not necessarily in association with the stabbing pain symptoms. An ECG recorded in the ED showed slightly accelerated rhythm but no sign of ischemic sufferance. A chest X-ray determined it to be pneumonia. Aside from that episode, past medical history is notable for hypertension (160/100 mmHg) and dyslipidemia (hypertriglyceridemia and elevated total cholesterol and LDL, with slightly decreased HDL). The patient reports smoking 1 pack of cigarettes every 2-3 days, and to have 4-5 drinks per week. Currently, he is taking aspirin, hydrochlorothiazide (thiazide diuretic) and atorvastatin (statin).  On physical examination, the patient is afebrile, blood pressure is 100/70 mm Hg, pulse is 100/min, and respiration rate is 20/min.  There is no jugular venous distention and no cardiac murmurs or rales.  Lungs are clear to auscultation.  A blood sample is run to the laboratory for troponin I and CK-MB. An initial ECG is performed and the results are shown below. 6. Which of the following enzymatic results would you expect to see in this patient at the time of admission? 

30. In a hemodynamically unstable patient with atrial fibrillation, which of the following therapeutic interventions should you order?

Use the following patient vignette to answer questions 4 – 8. A 55-year-old man reaches the ED with a chief complaint of chest pain.  He describes it as crushing, heavy pain in the left substernal area, present for the last 95 min at rest.  He reports another episode of chest pain about 1 year before. In that case, pain was more ‘stabbing’ and felt primarily in the back. Clinical records of that event indicated that he complained of being mildly diaphoretic, mostly at night, and not necessarily in association with the stabbing pain symptoms. An ECG recorded in the ED showed slightly accelerated rhythm but no sign of ischemic sufferance. A chest X-ray determined it to be pneumonia. Aside from that episode, past medical history is notable for hypertension (160/100 mmHg) and dyslipidemia (hypertriglyceridemia and elevated total cholesterol and LDL, with slightly decreased HDL). The patient reports smoking 1 pack of cigarettes every 2-3 days, and to have 4-5 drinks per week. Currently, he is taking aspirin, hydrochlorothiazide (thiazide diuretic) and atorvastatin (statin).  On physical examination, the patient is afebrile, blood pressure is 100/70 mm Hg, pulse is 100/min, and respiration rate is 20/min.  There is no jugular venous distention and no cardiac murmurs or rales.  Lungs are clear to auscultation.  A blood sample is run to the laboratory for troponin I and CK-MB. An initial ECG is performed and the results are shown below. 7. Which of the following is the best next step for managing this patient?