USMLE Question of the Day- 8

A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves.

What is the appropriate treatment to improve his symptoms in this current situation?

A- Metoprolol

B- Aspirin

C- Heparin

D- Cardioversion

E- Refer to cardiologist


This is most probably a case of atrial fibrillation. The next appropriate step of action is to improve the rate in order to improve the symptoms as the question specifies it. The drug of choice to improve the rate is metoprolol. The patient may need cardioversion later in the process but it is not the appropriate first step and the patient condition needs to be stable before taking any further action.

The correct answer is A

37 thoughts on “USMLE Question of the Day- 8”

  1. Patient has AF but hemodynamically stable. He needs rate control with b blockers(metoprolol).

  2. To control the rate of heartbeat, metoprolol should be given. Maybe she’s suffering atrial fibrillation.

  3. DC-Cardiovertion..
    he is present with less than 48hrs ..first episode..less than 65 yrs of age..

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