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A32-year-old woman presents for a routine gynecological exam. she has been married for 5 years and plans to start a family with her husband in the near future. her first menstrual period was at the age of 11. she is in a 28/4 cycle with no irregularities or discomfort. at age 18, she had an induced abortion and has used oral contraceptives since then. in the recto-vaginal exam, you palpate a mass on the left side. an ultrasound confirms a complex cystic tumor 6cm in diameter on the left ovary. there is no free fluid in the pelvis. there is no family history of any malignant tumors. what is your therapeutic approach?
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Health, 23.06.2019 05:00
A62-year-old man is being treated for an acute myocardial infarction. he originally came to the ed with substernal chest pain and diaphoresis. given his risk factors of hypertension, diabetes, tobacco use, and family history, he is considered high risk. an ecg in the ed reveals a left-bundle branch pattern, and cardiac enzymes are elevated slightly. after a focused evaluation in the ed, the patient receives iv thrombolytics. although his bundle branch pattern never resolves, the patient is chest pain-free and haemodynamically stable after thrombolysis. two days later, however, the patient reports episodes of recurrent chest discomfort and shortness of breath overnight. in evaluating for potential myocardial reinfarction, which of the following is the most appropriate diagnostic test? - creatinine kinase- dynamic ecg changes- lactate dehydrogenase- myoglobin levels- troponin i level
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