A 32-Year-Old Man Comes to the Office Due to Recurrent

question 303

Multiple Choice

A 32-year-old man comes to the office due to recurrent episodes of chest pain, dizziness, and numbness.  The patient says, "Suddenly, my heart starts pounding and I have trouble breathing.  Then my whole body shakes, I start to sweat, and I feel like I'm going to faint.  Many times I also notice numbness and tingling in both arms.  It only lasts for a few minutes, but it feels like hours."  The episodes occur 3 or 4 times a week.  He is very worried that similar episodes will occur at work and that he will pass out.  The patient has a history of occasional insomnia and hypertension treated with enalapril.  His mood is good, and he enjoys his work and spending time with family and friends.  The patient both smokes marijuana and drinks 2 or 3 glasses of wine daily.  Family history is significant for hypertension, coronary artery disease, and seizure disorder.  Physical examination is unremarkable, and laboratory results and ECG are normal.  Which of the following is the most appropriate pharmacotherapy for this patient?

• A)Alprazolam
• B)Buspirone
• C)Diazepam
• D)Propranolol
• E)Sertraline

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Definitions:

Mixed Methods Research

A research approach that combines both quantitative and qualitative methods to gain a more comprehensive understanding of a research problem.

Concurrent Mixed Methods Design

A research approach that involves collecting, analyzing, and integrating both quantitative and qualitative data within a single study phase to provide a comprehensive analysis of the research question.

Simultaneously Collected

Pertains to data or information gathered at the same time across multiple variables or groups, allowing for synchronized analysis.

Qualitative

Refers to research or data collection methods that focus on understanding phenomena through observation in natural settings and analyzing non-numerical data.