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  #1  
Old 03-24-2014
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Default NBME from6 block3 q19 (online version)

A 52-year-old man comes to the physician for a routine health maintenance examination. He has smoked one pack of cigarettes daily for 20 years and does not drink alcohol. He has a sedentary lifestyle and requests advice about beginning a regular exercise program. His father died of a MI at the age of 62 years. His 77-year-old mother and 51-year-old sister are healthy. He is 178cm tall and weight 80kg; BMI is 25kg/m2. His pulse is 80/min, respirations are 12/min, and blood pressure is 140/90 mmHg. Examination shows no other abnormalities. In addition to measurement of serum cholesterol concentration, which of the following is the most appropriate next step prior to starting this patient on an exercise program?


A, complete blood count
B, measurement of serum homocysteine concentration
C, exercise stress test
D, spirometry
E, cardiac catheterization

I thought he has a history of smoke, to see his PFT would be appropriate, so I chose D, which was wrong. Any suggestions?
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Old 03-24-2014
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I would go with c bec. He's a high risk for MI.
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Old 03-24-2014
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c

i guess
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