A 45-Year-Old Man Is Evaluated in the Emergency Department for Acute

question 18

Multiple Choice

A 45-year-old man is evaluated in the emergency department for acute shortness of breath with right-sided chest pain. He also has a dry cough with scanty blood streaking of his phlegm. He is a nonsmoker and has no other past medical illnesses; he has just returned by airplane from Japan.
On physical examination, his temperature is 37.4°C (99.4°F) , blood pressure is 102/76 mm Hg, pulse rate is 98 beats per minute, and respiration is 32 breaths per minute. D-dimer is elevated. Creatinine is 0.5. Breath sounds are clear bilaterally. There are no rhonchi auscultated. He feels soreness in the left calf and has trace left ankle edema. All peripheral pulses are intact. Anticoagulation has been started and lower extremity venous Doppler studies are positive for bilateral deep vein thromboses. What is the next step?

• A) 12-lead EKG
• B) Placement of an inferior vena cava filter
• C) Consult to an orthopedic surgeon
• D) None of these is correct.

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Definitions:

Adenine And Thymine

Adenine and Thymine are complementary nitrogenous bases in DNA, where Adenine (A) pairs with Thymine (T) through hydrogen bonding.

Nucleotide Excision Repair

A DNA repair mechanism that removes and correctly replaces a damaged segment of DNA using the undamaged strand as a template.

Nuclease

An enzyme that helps in breaking down nucleic acids by cleaving the phosphodiester bonds between nucleotides.

Origins Of Replication

Specific sequences in the genome where DNA replication begins, necessary for the duplication of chromosomes.