01-07-2012, 02:51 PM
33. A 45-year-old woman comes to the emergency department because of shortness of breath,chest pain, dizziness, and mild numbness and tingling around the lips for 2 hours. She says that shefeels like she is going to die. She had three similar episodes last week when she was vacationing atthe Grand Canyon; the first episode occurred while crossing a narrow bridge on a donkey. She takesa hypoglycemic drug for type 2 diabetes mellitus, verapamil for hypertension, and sumatriptan asneeded for migraine. She is mildly diaphoretic and appears pale. Her blood pressure is 130/90 mmHg, pulse is 120/min, and respirations are 28/min. Serum glucose level is 120 mg/dL. An ECGshows sinus tachycardia. Sublingual nitroglycerin therapy does not relieve her symptoms and givesher a headache. The most appropriate next step in management is administration of which of thefollowing?
A) Haloperidol
B) Lorazepam
C) Oxygen
D) Sumatriptan
E) Verapamil
A) Haloperidol
B) Lorazepam
C) Oxygen
D) Sumatriptan
E) Verapamil