A 70-Year-Old Man Comes to the Office Due to Palpitations

question 254

Multiple Choice

A 70-year-old man comes to the office due to palpitations.  He has felt an irregular and fast heartbeat on multiple occasions over the last month.  The patient has not had chest pain, dyspnea, dizziness, or weakness.  His medical history includes hypertension and type 2 diabetes mellitus.  Temperature is 36.7 C (98.1 F) , pulse is 102/min and irregular, blood pressure is 140/82 mm Hg, and respirations are 16/min.  Cardiopulmonary auscultation reveals clear lungs and no heart murmurs.  ECG shows an irregularly irregular rhythm with absent P waves.  The patient is started on metoprolol and apixaban.  Which of the following is likely to be directly affected as the result of this therapy?

• A)Conversion of factor X to Xa
• B)Conversion of fibrinogen to fibrin
• C)Conversion of plasminogen to plasmin
• D)Conversion of prothrombin to thrombin
• E)Gamma-carboxylation of coagulation factors

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Definitions:

Attachment Styles

Patterns of emotional bonding and interpersonal relationships, often categorized into secure, anxious, and avoidant types.

Unresponsive Mothers

Caregivers who fail to respond adequately to their child's needs, which can lead to issues with attachment and emotional development in the child.

Insensitive

Lacking awareness or concern for the feelings of others, often resulting in actions or comments that can be hurtful.

Strange Situation

A procedure developed by Mary Ainsworth to measure attachment styles in infants by observing their reactions to separations and reunions with their caregiver.