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8 Multiple Choice Antworten
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Int. 1) A 52-year-old woman receiving orally iron formulations because of mild microcytic anaemia complains of abnormally heavy menorrhagia. The doctor ordered faecal guaiac occult blood test (FOBT) three times and the results were positive. Which strategy should be chosen first?
B. FOBT should be repeated after discontinuation of iron formulations.
C. coeliac disease should be excluded.
D. diet with elimination of high doses of vitamin C and repeat the test.
E. decision needs to be based on gastrointestinal symptoms.
Int. 2) Which of the following medications should be avoided in the patient with hypertrophic cardiomyopathy, with left ventricular outflow tract peak instantaneous pressure gradient 35 mmHg (measured with Doppler echocardiography), left ventricular ejection fraction 52%, symptoms of heart failure NYHA class II and chest pain:
Int. 4) A 62-year-old patient with arterial hypertension and type 2 diabetes presents at his family doctor office because of a retrosternal stubbing pain that occurs after going upstairs to the first floor. The symptoms started about 6 weeks ago. Medical examination shows no significant abnormalities. The ECG records regular sinus rhythm 70/min without changes within ST segment or T wave. Indicate the correct management of this patient:
A. referring the patient to the cardiology ward in order to exclude myocardial infarction and to perform urgent coronarography.
B. referring the patient to the cardiology outpatient clinic in order to schedule the planned coronarography.
C. referring the patient to the cardiology outpatient clinic in order to perform non- invasive stress echocardiography.
D. referring the patient to the cardiology outpatient clinic in order to perform stress test ECG.
E. patient does not need any further diagnostics.
A 70-year-old patient, treated for arterial hypertension for over 30 years, called his family doctor because of lower limb edemas worsening for a week. Physical examination showed increased blood pressure and edemas around ankles. Indicate the least probable cause of those symptoms:
A. hypertensive nephropathy
B. drug-induced lymphatic edemas.
C. congestive heart failure.
D. nephrotic syndrome in the course of primary amyloidosis.
E. nephrotic syndrome in the course of glomerulonephritis.
Int. 6) Non-cardiac conditions that predispose towards atrial fibrillation include: