08-12-2016, 10:18 AM
NBME Q
A 72-year-old man comes to the office for medical clearance for scheduled cataract surgery. He reports that he moved to the area to live with his daughter 2 months ago after the death of his wife of 50 years. He states that he has been generally healthy. He stopped smoking cigarettes 20 years ago. He has been treated for bronchitis on two occasions in the past 5 years. He takes no medications. The patient is a talkative man who looks younger than his stated age. He reports that he has never had shortness of breath and can walk up stairs without difficulty. He has regular bowel movements and gets up twice nightly to urinate. Before examining him, you review his preoperative ECG, which is shown. ECG is unchanged from an ECG obtained 2 years ago by his previous physician. Prior to surgery, the referring ophthalmologist should be told which of the following?
(ECG shown)
A) Further workup of the patient's heart disease is indicated
B) The patient has an old myocardial infarction
C) The patient has chronic lung disease
D) The patient's preoperative evaluation is entirely normal
E) The surgery should be delayed for 6 months
A 72-year-old man comes to the office for medical clearance for scheduled cataract surgery. He reports that he moved to the area to live with his daughter 2 months ago after the death of his wife of 50 years. He states that he has been generally healthy. He stopped smoking cigarettes 20 years ago. He has been treated for bronchitis on two occasions in the past 5 years. He takes no medications. The patient is a talkative man who looks younger than his stated age. He reports that he has never had shortness of breath and can walk up stairs without difficulty. He has regular bowel movements and gets up twice nightly to urinate. Before examining him, you review his preoperative ECG, which is shown. ECG is unchanged from an ECG obtained 2 years ago by his previous physician. Prior to surgery, the referring ophthalmologist should be told which of the following?
(ECG shown)
A) Further workup of the patient's heart disease is indicated
B) The patient has an old myocardial infarction
C) The patient has chronic lung disease
D) The patient's preoperative evaluation is entirely normal
E) The surgery should be delayed for 6 months