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Questions 116-118: Cardiovascular pathology

Question 116

A 65-year-old male with a past medical history of hypertension, hyperlipidemia, and a 30 pack-year smoking history sustains an episode of chest pain while golfing with friends. He tells his friends that it feels like someone is standing on his chest and he clenches his fist in front of his chest when he does so. In addition to the pain, he is nauseous and sweating. They try to convince him to call an ambulance, but he refuses. The pain stops about 4 hours after it began. Three days later, his wife finds him dead in bed when she awakes. He had no complaints the night before. Of the following, which is most likely to be found at autopsy?

A. A ruptured ventricular aneurysm
B. A ruptured ventricular free wall
C. A ruptured interventricular septum
D. A ruptured papillary muscle
E. A ruptured coronary artery

Question 117

A 61-year-old male comes to the emergency room complaining of abdominal pain. He says that over the past 3 months, he has had abdominal pain which occurs 1-2 hours after eating, and then dissipates. Because of this pain, he has not wanted to eat, and has lost 20 lbs in that time frame. He has a 40 pack-year smoking history and hypertension. Of the following, what is the most likely diagnosis?

A. Acute mesenteric ischemia
B. Chronic mesenteric ischemia
C. Abdominal aortic aneurysm
D. Atypical acute myocardial infarct
E. Vasculitis

Question 118

A 41-year-old male who has been diagnosed with hypertension for 2 years presents to his physician complaining of weakness, which he says comes and goes. Physical examination reveals a blood pressure of 152/81 mmHg, but is normal otherwise, including normal heart and lung sounds. Laboratory testing reveals an elevated concentration of sodium and a decreased concentration of potassium in the blood. A CT scan of the abdomen reveals a nodule in the right adrenal gland Additional laboratory testing would most likely reveal an elevated concentration of which of the following?

A. Aldosterone
B. ACTH
C. Epinephrine
D. Renin
E. Beta natriuretic peptide (BNP)