A 62-Year-Old Man Comes to the Emergency Department Due to Sudden-Onset

question 106

Multiple Choice

A 62-year-old man comes to the emergency department due to sudden-onset chest pain.  The patient is diagnosed with unstable angina.  He undergoes cardiac catheterization and receives a drug-eluting stent to the left circumflex artery.  Medical issues include hypertension, hypercholesterolemia, osteoarthritis, and chronic kidney disease.  The patient was hospitalized 6 months earlier for upper gastrointestinal bleeding related to ibuprofen use.  He is treated with aspirin, prasugrel, lisinopril, atorvastatin, and metoprolol.
Laboratory results are as follows:
Echocardiogram shows a left ventricular ejection fraction of 55%.  Which of the following additional therapies is indicated in this patient?

• A)Angiotensin II receptor blocker
• B)Niacin
• C)Proton pump inhibitor
• D)Ranolazine
• E)Spironolactone

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Definitions:

Nursery

A place specifically designed for the care and growth of young plants, trees, or children, providing appropriate conditions for development.

Sea

A large body of saltwater that is often connected to an ocean and may be partially or completely surrounded by land.

Estuary

A partially enclosed coastal body of water with one or more rivers or streams flowing into it, and with a free connection to the open sea.

Epilimnion

The upper layer of water in a stratified lake, which is warm and well-oxygenated during the summer.