06-24-2010, 02:31 PM
A 67 yo f, comes to physician with 2 month h/o mild intermitten burning sensation in her epigastrium, the sensation occurs after she walks one block or climbs one flight of stairs, and is occasionally associated with lighte headedness and profuse sweating. her epigastric discomfort is relieved with rest, and not respond to antacid. Current medication is daily multivitamin and calcium. She smoked one pack of cigarette for 40 yrs, and drinks once or twice weekly. Her temp 98.6, pulse 98/min, resp 15, BP 150/90, no other abnormaliy. Lab including cardiac enzymes are withing reference range. ECG shows not abnormality. What is the most appropriate next step in dx?
a. Ambulatory ECG monitoring
b. Abdominal usg
c. cardiac stress scintigraphy
d. 24 hour esophageal pH monitoring
e. Esophagogastroduodenoscopy
I think I chose C, thinking stable angina, and among the wrong answers I didnt find it, and in forum nbme form, people said its A. Did anyone took nbme with feedback answered it, or sure, what is the answer, because I think I chose C, but not 100% sure that I chose that.
a. Ambulatory ECG monitoring
b. Abdominal usg
c. cardiac stress scintigraphy
d. 24 hour esophageal pH monitoring
e. Esophagogastroduodenoscopy
I think I chose C, thinking stable angina, and among the wrong answers I didnt find it, and in forum nbme form, people said its A. Did anyone took nbme with feedback answered it, or sure, what is the answer, because I think I chose C, but not 100% sure that I chose that.