A 22-year-old African American male presents to the emergency department with shortness of breath, which started 2 hours prior to arrival. He does not have a history of pulmonary disease that he is aware of, and he states that in the past at random events he has had similar episodes. He does nothing to get the episodes to stop, and he also states that he feels his chest pounding at the same time of the shortness of breath. He has no medical history that he is aware of, and he takes no medications or any illicit drugs. On examination he is alert, awake, and oriented. His vital signs show T 99.0, P 142, R 18, and BP 132/82. His chest x-ray is negative for any acute cardiopulmonary disease, and his electrocardiogram has an irregularly irregular rate of 142 with visible delta waves.
Given the clinical situation above, what is the best medication for managing this patient's condition with a long-term approach?
A 43-year-old male farmer is seen in the oncology clinic for his next round of chemotherapy for acute myelogenous leukemia. He complains of a persistent cough over the last three weeks, but has not run a fever at home. Today, his temperature is 37.4°C, HR is 67, RR is 18, and BP is 120/72. Lung examination is clear to auscultation bilaterally, no lymphadenopathy is noted, color is pale, there is good capillary refill, and the rest of the examination is negative. A CT is obtained, and a RUL wedge-shaped infiltrate at the periphery and a 1 cm cavitary lesion is noted. The best course of treatment would include which of the following?
A 66-year-old male with a history of hypertension, diabetes mellitus, and hypercholesterolemia presents by emergency medical services (EMS) to the emergency department complaining of severe chest pain with radiation into his back. The patient states that he was feeling well in the morning, but while performing some light activity he felt a "ripping" sensation in his back, which he initially thought was a pulled muscle. The pain continued and the patient started to have chest pain, shortness of breath, and lightheadedness. On initial examination the patient is still in pain, pale, diaphoretic, and has a blood pressure of 85/40. His chest is clear to auscultation, and he has a 3/6 diastolic murmur best appreciated at the base of the heart. Given this clinical scenario, what is the best test to definitively diagnose this medical problem?