02-26-2012, 12:14 PM
A 75 y/o female presents to you with two day symptoms of burning pain in the retrosternal area that increases on lying down. She also has hoarseness. Her medications include calcium carbonate and alendronate for osteoporosis that was started 1 week ago, enalapril for hypertension and glipizide for her diabetes. She does not report weightloss of hemetemesis. Physical exam is unremarkable except for mild livedo reticularis on her extremities. An EKG, Cardiac enzymes are negative and CBC does not reveal Anemia. Her pastmedical history is significant for smoking 1ppd x 30 years. Most appropriate statement about this patients condition is:
A) Avoiding smoking would have prevented this condition
B) Life style changes like reducing the aggravating foods and lying with head end elevated would have prevented her symptoms
C) She most likely has a cancer in view of her smoking history
D) She could have prevented this by drinking at least 4 ounces of fluid with alendronate and avoiding supine position post alendronate ingestion
E) She has scleroderma
A) Avoiding smoking would have prevented this condition
B) Life style changes like reducing the aggravating foods and lying with head end elevated would have prevented her symptoms
C) She most likely has a cancer in view of her smoking history
D) She could have prevented this by drinking at least 4 ounces of fluid with alendronate and avoiding supine position post alendronate ingestion
E) She has scleroderma