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:

Hierarchy

A system or organization in which people or groups are ranked one above the other according to status or authority.

Maslow

Abraham Maslow, a psychologist known for creating Maslow's hierarchy of needs, which is a theory of psychological health predicated on fulfilling innate human needs in priority, culminating in self-actualization.

Unconscious Fixations

Deeply held impulses or patterns of thought rooted in one's subconscious mind, influencing behavior or attitudes.

Unresolved Conflicts

Issues or disagreements that have not been successfully addressed, leading to ongoing tension or distress.