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Anutritional study should take all of the following into account except taste in music. family medical history. work and home responsibilities. lifestyle factors, such as smoking or alcohol consumption.

A35-year-old woman comes to the ed complaining of chest pressure. she has had such episodes intermittently over the last 5 years, usually when sleeping, but over the last year she has had more frequent severe symptoms that are occasionally associated with severe migraine headaches. the pain is midsternal and is described as pressure that extends as a band around her chest. the ed physician is initially dubious that the pain is cardiac in origin, because the woman has no coronary disease risk factors. an ecg, however, shows 2mm st-segment elevation and inverted t waves in leads v1 through v5 and 1mm st-segment depression in leads ii, iii, and avf. before the cardiologist arrives in the ed, the patient's ecg has returned to normal. this repeat normal ecg is obtained after the administration of aspirin, nitroglycerin, morphine, and oxygen. which of the following is most likely for these findings? - diffuse intimal thickening with focal areas of atherosclerotic narrowing - intermittent thrombus formation and lysis in the left anterior descending artery - intermittent thrombus formation and lysis in the right coronary artery - plaque rupture and thrombus formation in the left anterior descending artery - transiently increased coronary vascular tone in the right coronary artery

A46-year-old man with a history of hypertension and hypercholesterolemia visits the physician for a routine followup. the patient's job involves a lot of travelling, and he admits to occasionally forgetting to take his medications with him when he travels. he complains of several episodes of chest pain in the past few months. the pain is sharp in nature, mainly over his lower chest and epigastrium, and tends to come on when walking. he believes these episodes are due to indigestion and has been taking antacids. there is a family history of heart disease, and his father died of a heart attack at age 48. on physical examination, his blood pressure is 150/80 mmhg and heart rate is 86/min. his lungs are clear to auscultation. cardiac auscultation reveals normal rate and rhythm, without rubs, gallops, or murmurs. there is no pedal oedema. he is sent for an exercise stress test. five minutes into the test, he develops st depression of 3mm in leads v1-v5. the st segment depression is greater than 0.12 seconds in duration and the stress test is stopped. which of the following is the most appropriate next step in management? - coronary angiography- holter monitor- no further tests are required- repeat stress test with thallium- upper gastrointestinal endoscopy