A 55-year-old man with a past medical history of obesity and hyperlipidemia suddenly develops left-sided chest pain and shortness of breath while at work. He relays to coworkers that the pain is intense and has spread to his upper left arm over the past 10 minutes. He reports it feels a lot like the “heart attack” he had a year ago. He suddenly collapses and is unresponsive. Coworkers perform cardiopulmonary resuscitation for 18 minutes until emergency medical services arrives. Paramedics pronounce him dead at the scene. Which of the following is the most likely cause of death in this man?
APericarditis
BAortic dissection
CAtrial fibrillation
DVentricular tachycardia
EFree wall rupture
A 16-year-old boy presents to the emergency department with abdominal pain and tenderness. The pain began approximately 2 days ago in the area just above his umbilicus and was crampy in nature. Earlier this morning, the pain moved laterally to his right lower abdomen. At that time, the pain in the right lower quadrant became severe and constant and woke him up from sleep. He decided to come to the hospital. The patient is nauseous and had a low-grade fever of 37.8°C (100.1°F). Other vitals are normal. Upon physical examination, the patient has rebound tenderness but a negative psoas sign while the remaining areas of his abdomen are non-tender. His rectal exam is normal. Laboratory tests show a white cell count of 15,000/mm3. Urinalysis and other laboratory findings were negative. What conclusion can be drawn about the nerves involved in the transmission of this patient’s pain during the physical exam?
AHis pain is transmitted bilaterally by somatic afferent nerve fibers of the abdomen.
BHis pain is transmitted by somatic afferent nerve fibers located in the right flank.
CHis pain is transmitted by the pelvic nerves.
DHis pain is transmitted by right somatic nerve fibers.
EHis pain is mainly transmitted by the right splanchnic nerve.
A 72-year-old woman comes to the emergency department 1 hour after the sudden onset of a diffuse, dull, throbbing headache. She also reports blurred vision, nausea, and one episode of vomiting. She has a history of poorly controlled hypertension. A photograph of her fundoscopic examination is shown. Which of the following is the most likely underlying cause of this patient's symptoms?
AHemorrhagic lacunar stroke
BTransient ischemic attack
CGiant cell arteritis
DHypertensive emergency
EEpidural hematoma
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