Use the following patient vignette to answer questions 4 – 8…
Questions
Use the fоllоwing pаtient vignette tо аnswer questions 4 – 8. A 55-yeаr-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. 4. Which of the following is the most likely diagnosis?
A. Elección múltiple: Cоstа Ricа, Nicаragua y Panamá. In Chapter 5, yоu learned a little bit abоut three Central American countries in Panoramas, Club cultural, and our class Padlet. Can you recall some of the main points? First, read each statement below. Then, complete each statement by selecting the missing word or phrase from the dropdown menu. If the answer is not provided, select ninguna de las anteriores. (1 pt. each; 7 pts. total) MODELO: ¿Cuál es una expresión costarricense muy popular? a. ¡Pura Vida! b. ¡Hórale! c. ¡Qué guay! d. ¡Qué padre! e. ninguna de las anteriores 1. El país de [1], con una banca internacional y la reciente expansión del canal, atrae inversiones de todo el mundo. 2. El pueblo indígena que habita en el Archipiélago de San Blas se llama [2]. 3. Las comunidades de los emberá hacen [3] con el árbol cocobolo. 4. Según Panoramas, el país de [4] tiene una larga historia de respeto a los derechos humanos. 5. Muchas comunidades viven cerca de [5], donde hay pequeñas islas volcánicas donde la gente vive una vida tranquila. 6. Según Panoramas, se permite recolectar los huevos que ponen las tortugas marinas en [6]. 7. Según el Padlet de la clase, [7] es la primera mujer poeta publicada en Panamá.