A 53-Year-Old Man Comes to the Office Due to Difficulty

question 183

Multiple Choice

A 53-year-old man comes to the office due to difficulty breathing and increasing fatigue.  He has shortness of breath at night and has been sleeping in a recliner to help relieve his dyspnea.  Medical history is significant for hypertension and hyperlipidemia.  Two months ago, the patient suffered a myocardial infarction that was not revascularized due to a delay in seeking treatment.  He quit smoking afterward, but had previously smoked a pack of cigarettes daily for 25 years.  On cardiac auscultation, a low-frequency diastolic heart sound is heard shortly after the second heart sound when the patient lies in the left lateral decubitus position.  Cardiac imaging shows hypokinesis of the left ventricular free wall.  Which of the following is most likely to accentuate this patient's abnormal auscultation finding?

• A)Amyl nitrite inhalation
• B)Furosemide injection
• C)Having the patient stand up
• D)Listening at end expiration
• E)Valsalva strain phase

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Definitions:

Net Cash Flows

The difference between a company's cash inflows and outflows in a given period.

Financing Activities

Transactions related to raising capital and repaying investors, including issuing stocks or bonds and paying dividends.

Treasury Stock

Shares that were previously issued and outstanding but have been repurchased by the issuing company, reducing shareholders' equity.

Noncash Activities

Transactions that do not involve direct cash flow, such as depreciation or stock-based compensation.