PANCE Exam Practice Questions: Quiz 856

A 50-year-old woman presents with fatigue for 2 months. She has recently started having shortness of breath, dizziness, and nausea while walking up the stairs at work. She feels normal after resting at the top of the stairs for a moment. She denies chest pain, orthopnea, paroxysmal nocturnal dyspnea, or recent respiratory infection. Past medical history is significant for hypertension for 10 years and hyperlipidemia for 5 years. She denies tobacco use and exercises regularly. Family history is positive for heart attacks and strokes in her mother’s family, but she cannot give details. On physical examination, her waist circumference is 38 in, lungs are clear, and cardiovascular examination is unremarkable and without murmurs. ECG reveals poor R wave progression in V1 through V2 and nonspecific ST-T wave changes in the anterolateral leads. Chest x-ray is normal. Pulse oximetry is 99%. Laboratory evaluation shows a normal complete blood count, cholesterol 250, HDL 29 mg/dL, LDL 160 mg/dL, and a random glucose of 250 mg/dL. Which medication(s) should you recommend?
- a. Aspirin and statin
- b. Warfarin
- c. Selective serotonin reuptake inhibitor
- d. Proton pump inhibitor and over-the-counter antacid

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