#june2020mccqe1
A 52-year-old man with a 30-pack-year history of cigarette smoking presents to a physician after moving to a new city. He was told that he had “high cholesterol” about 2 years ago, and he has a history of mild hypertension for which he has never been treated. He had a myocardial infarction (MI) 6 months ago. His post-MI course has been uncomplicated, his exercise stress test was satisfactory, and he has experienced no subsequent chest pain. His medications include one aspirin tablet every other day. Physical examination is normal except for a fourth heart sound. Which of the following is the most appropriate next step in management to prevent significant morbidity and mortality?
(A) Add a beta blocker
(B) Add enalapril
(C) Add nifedipine
(D) Increase the aspirin to one tablet three times daily
(E) Prescribe nitroglycerin for angina
A 52-year-old man with a 30-pack-year history of cigarette smoking presents to a physician after moving to a new city. He was told that he had “high cholesterol” about 2 years ago, and he has a history of mild hypertension for which he has never been treated. He had a myocardial infarction (MI) 6 months ago. His post-MI course has been uncomplicated, his exercise stress test was satisfactory, and he has experienced no subsequent chest pain. His medications include one aspirin tablet every other day. Physical examination is normal except for a fourth heart sound. Which of the following is the most appropriate next step in management to prevent significant morbidity and mortality?
(A) Add a beta blocker
(B) Add enalapril
(C) Add nifedipine
(D) Increase the aspirin to one tablet three times daily
(E) Prescribe nitroglycerin for angina
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