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USMLE · Question #543
USMLE Question #543: Real Exam Question with Answer & Explanation
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Question
A 54-year-old man comes to the physician because of episodes of fainting for 3 months. He also has had difficulty performing daily tasks because he is easily fatigued. He had a myocardial infarction 12 years ago. His pulse is 40/min, respirations are 18/min, and blood pressure is 138/85 mmHg. Physical examination shows evidence of cannon a waves. An ECG shows a P- wave rate of 90/min, and an R-wave rate of 40/min, with no apparent relation between the two. Which of the following is the most likely diagnosis?
Options
- AFirst-degree atrioventricular block
- BRight bundle branch block
- CSecond-degree atrioventricular block, type I
- DSecond-degree atrioventricular block, type II
- EThird-degree atrioventricular block
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