A 61-Year-Old Man Comes to the Emergency Department Complaining of Nausea

question 83

Multiple Choice

A 61-year-old man comes to the emergency department complaining of nausea and right upper-quadrant abdominal discomfort for 3 days.  His other medical problems include hypertension, type 2 diabetes, hypercholesterolemia, and hypothyroidism.  His medications include low-dose aspirin, metformin, glipizide, hydrochlorothiazide, lisinopril, atorvastatin, and levothyroxine.  He is an active smoker with a 60-pack-year history and drinks 1-2 glasses of wine daily.
His blood pressure is 155/90 mm Hg and pulse is 80/min.  Examination shows no abnormalities.
Laboratory results are as follows:

Ultrasound examination shows several small gallstones without cholecystitis and a 3.8-cm abdominal aortic aneurysm.
Which of the following is associated with the highest rate of aneurysm expansion and rupture in this patient?

• A)Active smoking
• B)Chronic kidney disease
• C)Daily alcohol consumption
• D)LDL cholesterol > 130 mg/dL
• E)Uncontrolled diabetes mellitus

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Definitions:

Personality Disorder

A type of mental disorder characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture.

Trust

The firm belief in the reliability, truth, ability, or strength of someone or something.

Suspicious

Characterized by or inclined to suspect, especially inclined to suspect in a malign manner; distrustful.

Jealous Rage

describes a very intense emotional state involving anger and jealousy, often in interpersonal relationships.