Lectus

A 68-year-old man with intermittent claudication due to peripheral arterial disease is prescribed cilostazol. He experiences significant improvement in his walking distance after 8 weeks of treatment. The mechanism by which this medication improves symptoms in peripheral arterial disease involves inhibition of which of the following enzymes?Deselect Answer

A 68-year-old man with chronic obstructive pulmonary disease is admitted to the hospital with an acute exacerbation. His ECG shows an irregular rhythm with at least three different P-wave morphologies and a ventricular rate of 140 beats per minute, consistent with multifocal atrial tachycardia. His blood pressure is 110/70 mmHg and oxygen saturation is 88% on room air. Which of the following medications would be most appropriate for rate control in this patient?Deselect Answer

A 21-year-old man presents to his provider for a routine checkup. He says that he has not been ill over the past year, except for one episode of the flu two months ago. He has been training consistently for his college football tournament. His blood pressure is 110/70 mm Hg, pulse is 69/min, and respiratory rate is 17/min. He has a heart sound coinciding with the rapid filling of the ventricles and no murmurs. He does not have any other significant physical findings. Which of the following best describes the heart sound heard in this man?Deselect Answer

A 28-year-old psychiatry resident is treating a 35-year-old patient diagnosed with narcissistic personality disorder. During therapy sessions, the patient frequently makes grandiose statements about his superior intelligence and dismisses the resident's interventions as "beneath his intellectual level." The resident finds himself becoming increasingly frustrated and begins to feel inadequate and incompetent. He starts arriving late to sessions and finds himself being more confrontational with the patient. What is the most appropriate initial step for the resident to take in managing this situation?Deselect Answer