A 39-year-old female with poorly controlled systemic lupus erythematosus (SLE) presents to the emergency room with a cough and pleuritic chest pain. She states that she developed these symptoms 2 days prior. The pain appears to improve when the patient leans forward. She currently takes hydroxychloroquine for her systemic lupus erythematosus but has missed several doses recently. Her temperature is 99°F (37.2°C), blood pressure is 135/80 mmHg, pulse is 115/min, and respirations are 22/min. Physical examination reveals a rise in jugular venous pressure during inspiration. In addition to tachycardia, which of the following EKG patterns is most likely to be seen in this patient?
APeaked T waves with flattened P waves
BIrregularly irregular QRS complexes with no P waves
CPR depressions and diffuse ST elevations
DST segment depressions in leads II, III, and aVF
EProlonged PR interval with normal QRS complexes
A researcher measures action potential propagation velocity in various regions of the heart in a 42-year-old Caucasian female. Which of the following set of measurements corresponds to the velocities found in the atrial muscle, AV Node, Purkinje system, and ventricular muscle, respectively?
A0.05 m/s, 1.1 m/s, 2.2 m/s, 3.3 m/s
B2.2 m/s, 0.3 m/s, 0.05 m/s, 1.1 m/s
C0.3 m/s, 2.2 m/s, 0.05 m/s, 1.1 m/s
D0.5 m/s, 1.1 m/s, 2.2 m/s, 3 m/s
E1.1 m/s, 0.05 m/s, 2.2 m/s, 0.3 m/s
A 77-year-old man presents to his primary care physician with lightheadedness and a feeling that he is going to "pass out". He has a history of hypertension that is treated with captopril. In the office, his temperature is 38.3°C (100.9°F), the pulse is 65/min, and the respiratory rate is 19/min. His sitting blood pressure is 133/91 mm Hg. Additionally, his supine blood pressure is 134/92 mm Hg and standing blood pressure is 127/88 mm Hg. These are similar to his baseline blood pressure measured during previous visits. An ECG rhythm strip is obtained in the office. Of the following, what is the likely cause of his presyncope?
ALeft bundle branch block
BHypertension
CCaptopril
DRight bundle branch block
EOrthostatic hypotension
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