A 23-Year-Old Man Is Evaluated for a Murmur Discovered at a Health

question 663

Multiple Choice

A 23-year-old man is evaluated for a murmur discovered at a health fair.  His past medical history is insignificant, and he feels well with no cardiac symptoms.  The patient plays soccer and jogs regularly.  His immediate family is healthy.  Blood pressure is 122/70 mm Hg and pulse is 72/min.  A 2/6 midsystolic murmur is heard at the left sternal border.  The femoral pulses are full, and there is no brachial-femoral pulse delay.  Echocardiography shows bicuspid aortic valve with a mildly increased gradient and no dilation of the aortic root.  Which of the following is the best next step in management of this patient?

• A)Angiography to rule out coronary artery anomaly
• B)Aortic valve replacement
• C)Balloon valvuloplasty
• D)Doppler ultrasound for renal artery stenosis
• E)First-degree relative screening with echocardiography

Understand the developmental stages and types of language and thought, including telegraphic speech and imaginal thought.

Recognize strategies for problem-solving and decision-making, including subgoal analysis and means-ends analysis.

Identify biases and heuristics that influence thinking and decision-making processes.

Comprehend the neurological basis and lateralization of language and thought processes.

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Definitions:

National Guard

A reserve military force composed of state National Guard militia members or units under federally recognized active or inactive armed force service.

Livestock

Domesticated animals raised in an agricultural setting to produce commodities such as food, fiber, and labor.

Warehouser's Lien

A legal right granted to warehouse operators to hold onto a customer's goods until payment has been made for warehouse services.