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:

Learning And Performance

The relationship between acquiring new knowledge or skills and the ability to apply them effectively in specific contexts.

Diversity

The inclusion of individuals with a range of characteristics, such as age, gender, ethnicity, religion, disability, sexual orientation, education, and national origin, contributing to a rich variety of experiences and perspectives.

Experimentation With Failure

The process of actively engaging in trials that may not succeed in order to learn, innovate, or solve problems.

Group Size

refers to the number of individuals forming a group, affecting dynamics such as participation, cohesion, and effectiveness.