Agency for Toxic Substances and Disease Registry
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Instructions |
This Initial Check will help you assess your current knowledge about taking an exposure history. To take the Initial Check, read the case below, and then answer the questions that follow. |
Case Study |
On Tuesday afternoon, a 52-year-old man with previously diagnosed coronary artery disease controlled by nitroglycerin describes episodes of recurring headache for the past three weeks. Mild nausea often accompanies the headache; there is no vomiting. He describes a dull frontal ache that is not relieved by aspirin. The patient states that the headaches are sometimes severe; at other times they are a nagging annoyance. The durations range from half an hour to a full day. His visit was also prompted by a mild angina attack that he suffered this past weekend shortly after he awoke on Sunday morning. He has experienced no further cardiac symptoms since that episode. History of previous illness indicates that the patient was diagnosed with angina pectoris three years ago. He has been taking 0.4 milligrams (mg) nitroglycerin sublingually prophylactically before vigorous exercise. He also takes one aspirin every other day. He has been symptom-free for the past 2½ years. Sublingual nitroglycerin relieved the pain of the Sunday morning angina attack within several minutes. The patient does not smoke and rarely drinks alcohol. He is a trim man with a slightly ruddy complexion. At present, he is afebrile, and his vital signs are as follows
Physical exam is normal. The results of an electrocardiogram (ECG) with a rhythm strip performed in your office are unremarkable. Subsequent laboratory testing reveals normal blood lipids, cardiac enzymes, complete blood cell count (CBC), sedimentation rate, glucose, creatinine, and thyroid function. |
Initial Check Questions |
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Initial Check Answers |
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