A 24-Year-Old Man Comes to the Physician with a 6-Month

question 893

Multiple Choice

A 24-year-old man comes to the physician with a 6-month history of intermittent palpitations.  He reports a sudden onset of fluttering in his chest that lasts 30-40 minutes and stops spontaneously or after deep breathing maneuvers.  The episodes occur about once a month and are not related to physical activity.  He has no chest pain, dizziness, dyspnea, or syncope.
Jugular venous pressure is estimated at 4 cm H₂O.  There are no cardiac murmurs or additional heart sounds.  Peripheral pulses are 2+ and symmetrical bilaterally.
ECG is shown in this exhibit.
The PR interval duration is 100 msec and the QRS complex duration is 140 msec.
Which of the following findings would most likely be seen during episodes of palpitations in this patient?

• A)Irregular narrow QRS complex tachycardia
• B)Irregular wide QRS complex tachycardia
• C)Junctional escape beats
• D)Regular narrow QRS complex tachycardia
• E)Regular wide QRS complex tachycardia

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Definitions:

Ejaculation

The release of semen from the male reproductive tract as a result of sexual climax.

Emission

The process of expelling substances, in physiology it often refers to the movement of semen into the urethra prior to ejaculation.

Erection

The physiological process resulting in an increased blood flow into the penis, leading to its enlargement and firmness.

Primary Oocytes

Immature female germ cells that are arrested in prophase I of meiosis, present in the ovaries from birth.