American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

The MKSAP Challenge

From the January-February ACP Observer, copyright 2005 by the American College of Physicians.

A 29-year-old woman in the 28th week of pregnancy has a 2-hour history of sudden onset, severe anterior chest pain radiating to her back. She has a 10-year history of mitral valve prolapse. Her family history is unremarkable.

On physical examination, blood pressure is 105/78 mm Hg, heart rate is 110/min, and respiration rate is 18/min. She has a high arched palate, diminished S1, a soft, early diastolic murmur best heard along the left sternal border, and a midsystolic click and a late systolic murmur. Abdominal examination shows a gravid uterus. The remainder of the physical examination is normal.

An electrocardiogram shows only mild T-wave flattening.

Which of the following is the most appropriate diagnostic test?

A. Serum troponin measurement
B. Transthoracic echocardiogram
C. Magnetic resonance angiography
D. Transesophageal echocardiography
E. Helical computed tomography scan

Answer

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Share

 
 

Internist Archives Quick Links

ACP Clinical Shorts

Expert Education on Your Schedule

Short videos deliver highly focused answers to challenging clinical situations seen in practice and are a terrific way to earn CME credit on-the-goShort videos deliver highly focused answers to challenging clinical situations seen in practice and are a terrific way to earn CME credit on-the-go. See more.

New: Free Modules from ACP Practice Advisor!

New: Free Modules from ACP Practice Advisor!

Keep your practice moving in the right direction. ACP Practice Advisor is offering four modules that you and your staff can try for free. Get to know the premier online practice management tool at no risk. Explore the modules.