A 68-Year-Old Man Comes to the Emergency Department Due to Severe

question 1255

Multiple Choice

A 68-year-old man comes to the emergency department due to severe dizziness while playing tennis an hour ago.  He says that he had a spinning sensation accompanied by nausea and vomiting; the symptoms have now subsided.  The patient has had brief episodes of dizziness in the past, especially when performing vigorous work with his arms.  He has also experienced heaviness and fatigue of the left arm with exertion.  The patient has a history of hypertension, hyperlipidemia, and type 2 diabetes mellitus.  Blood pressure is 140/90 mm Hg on the right arm and 100/74 mm Hg on the left, and pulse is 82/min and regular.  A systolic bruit is present at the base of the neck just above the clavicle on the left side.  Cardiac auscultation discloses a fourth heart sound.  There is no extremity weakness or sensory loss.  Which of the following is the most likely cause of this patient's symptoms?

• A)Coronary artery atherosclerosis
• B)Internal carotid artery stenosis
• C)Segmental narrowing of the aortic arch
• D)Subclavian artery occlusion
• E)Vertebral artery atherosclerosis

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Definitions:

SML

The Security Market Line (SML) is a graphical representation of the Capital Asset Pricing Model (CAPM), showing the relationship between the expected return of investments and their risk as measured by beta.

Stable Equilibrium

A condition in which a system tends to return to its original state after a disturbance, indicating stability and balance.

Probabilities Of Loss

Probabilities of loss indicate the likelihood or risk of an investment resulting in a financial loss rather than a gain or profit.

Higher Returns

Earning more income on an investment relative to its cost, indicative of successful investments or strategies.