A 39-Year-Old Man Comes to the Emergency Department with Anterior

question 670

Multiple Choice

A 39-year-old man comes to the emergency department with anterior chest pain.  He had felt well until the pain developed 4 days ago.  The patient says the pain is sharp and makes it difficult to take a deep breath.  Since yesterday, he has also felt out of breath.  Medical history is unremarkable.  The patient's father died of a heart attack at age 52, and his mother suffers from rheumatoid arthritis.  He does not use alcohol or tobacco.  Temperature is 37.4 C (99.3 F) , blood pressure is 112/65 mm Hg, and pulse is 103/min and regular.  Bedside ultrasound examination demonstrates a moderate pericardial effusion.  Which of the following is the most likely cause of this patient's current condition?

• A)Autoimmune disease
• B)Coronary artery disease
• C)Gram-positive cocci
• D)Malignancy
• E)Viral infection

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Definitions:

Wishful Thinking

The formation of beliefs or making decisions based on what is pleasing to imagine rather than on evidence, rationality, or reality.

Action System

A structured set of activities designed to achieve specific goals or outcomes.

Planned Change Process

A deliberate effort to improve a current situation by implementing new strategies or procedures.

Representing

The act of serving as an agent or delegate for another person or a group, particularly in legal, political, or advocacy contexts.