WhlCh of the following is associated with the highest rate of aneurysm expans,on and rupture in this patient?


#1

1magmg study detects an incidental 3.5-cm infrarenal abdominal aortic aneurysm in a 60-year-01d man. He has no associated symptoms His mechcal history Is significant for hypertension, type 2 diabetes, hypercholesterolemIa, and hypothyroidism. His medications include aspirin, metformin, glip1zide, hydrochlorothiaz1de, l1siriopril, low-dose atorvastat1n, and levothyroxine. He has smoked 1-2 packs of cigarettes daily for the past 4Dyears, and he dnnks 1 or 2 glasses of wme daily On phys1eal examination, his
blood pressure JS 160/90 mm Hg and pulse is 80/min. Heart sounds are normal and his lungs are clear
Laboratoryresutts are as follows

Serum creatirnne 17mg/dl

Low-density lipoprotem (LOL) 150 mg/dl

HbA1C 85%

Serum thyroid-stimulating hormone 3 0 μU/ml

WhlCh of the following is associated with the highest rate of aneurysm expans,on and rupture in this patient?

  • Q A Uncontrolled hypertension
  • QB LDL>130mgldl
  • QC Uncontrolled dIabetes mellitus
  • Q D Active smoking
  • Q E Daily alcohol consumptk>n

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2-hour-old boy has developed worsening cyanosis over the past few minutes The infant was delivered vaginally at term after an uncomplicated pregnancy Birth weight was 4.1 kg (9 lb) Apgar scores were 7 and 8 at 1 and 5 minutes, respectIve!y. Oxygen is administered by hood but does not relieve the cyanosis . Further exammat10n shows tachypnea, subcostal retractions, a normal first heart sound, a single and loud second heart sound, and no murmur Wtuc:h of the following is the most likely cause of the infant’s cyanos1s?

  • O A Atnal septal delect
  • Q B Coarctat10n of the aorta
  • QC Delctrocard1a
  • Q D Hypoplastic left heart syndrome
  • Q E Patent duclus artenosus
  • 0 F Tetralogy ofFallot
  • Q G TransposItIon of the great vessels
  • Q H Ventncular septaldefect

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