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

---

Definitions:

Principal Square Root

The principal square root is the non-negative root of a given number, represented as sqrt(x) for a non-negative number x.

Real Roots

The solutions of an equation that are real numbers.

Calculator

A calculator is a device or software used for performing mathematical calculations, ranging from basic arithmetic to complex mathematical operations.

Principal Square Root

The non-negative square root of a number, denoted as √x for a non-negative number x.