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A 42-year-old man comes to the emergency department because of chest pain that is very focal, just adjacent to the sternum at approximately the junction of the left 4th rib. It does not hurt to take a deep breath, but the pain is exacerbated with certain twisting movements. He denies fever, cough, sputum production, nausea, vomiting, diaphoresis, or shortness of breath. He tells you that he thinks that "it is most likely nothing," but he is very concerned since his father died of a myocardial infarction at age 45 and he has not seen a physician since he was 14 years old. He has no significant past medical history and is on no medications. He is afebrile with normal vital signs. Oxygen saturation is 100% on room air. He has point tenderness to light palpation over the left 4th costochondral junction. Heart is regular with no murmurs, rubs, or gallops. Lungs are clear and his abdomen is benign. Extremities are normal. Laboratory studies show a leukocyte count of 8,100 mm3, hematocrit of 34%, creatinine of 0.7 mg/dL, blood urea nitrogen of 18 mg/dL, and cardiac enzymes and troponin are normal. Electrocardiogram is normal. Chest x-ray is normal. You explain that he most likely has costochondritis and œprescribe as needed nonsteroidal antiinflammatory medications. He tells you that he would like to follow up with you in the clinic because he is concerned about his cardiovascular risk. You should tell him that when he comes to the clinic you plan to order A. no laboratory tests since his pain will most likely have resolved
B. a periodic fasting cholesterol profile and yearly blood pressure checks
C. a periodic fasting cholesterol profile, yearly blood pressure checks, and an annual chest x-ray
D. a periodic fasting cholesterol profile, yearly blood pressure checks, and a coronary angiogram
E. a periodic fasting cholesterol profile, yearly blood pressure checks, and sigmoidoscopy

B. Chleosterol+ BP checks.

where is A i believe thats b fasting choletrol for screening and bp periodically

A is after the word order no laboratory tests since his pain will most likely have resolved


ans b

hey guys tell me when sigmoidosscopy is indicated colonoscopy is indicated usually at the age of 50
is there ny indicationfor siigmoidoscopy?please

at 50, colono every 10 yrs, sigmoido every 3-5 yrs


Guys~ u R all good!!
Ans Is indeeed B

BP shud be checked at least every 2 yrs
Cholesterol chud be checked coz he has risk factor (FHx of CVD

sigmoido every 3 to 5 years starting when colonoscopy ismore indicated or sigmoidscopy
help me guyes thanx

what's ur q exactly

It's either or

U can either do sig or colono

u said sigmo every 2 to 3 years eight
i read somewhere now colonoscopy is more indicated
i am confused
and normally in hospitals i have heard of more colonoscopy rathern than sigmo