Review Questions

1. A 48-year-old man comes to the emergency department 2 hours after experiencing severe chest pain while he was shoveling snow from his driveway. He describes the pain as an "elephant standing on his chest" and says that it radiates to his jaw. He experienced several episodes of vomiting in the car and in the waiting room. An electrocardiogram shows ST elevation. Which of the following changes would be seen if a cardiac biopsy was taken on his arrival to the hospital?

A. Central pallor with a red border

B. Coagulative necrosis

C. Neutrophilic infiltrate

D. No gross changes

E. Yellow pallor

2. A 27-year-old man comes to the emergency department because of fever, chills, and pleuritic chest pain for the past 2 days. His temperature is 39°C (102.2°F). Physical examination shows pinpoint lesions in between his toes and a medium-pitched, midsystolic heart murmur that is best heard at the lower left sternal border. He has multiple hyperpigmented lesions and scars on his inner thighs and upper arms. A chest x-ray shows patchy infiltrates. Which of the following is the most likely cause of this patient's condition?

A. Aortic valve prosthesis

B. Calcific aortic stenosis

C. Injection drug use

D. Rheumatic valvular disease

E. Ventricular septal defect

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