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USLME Step 2 Review
A
82 year old male
with a history of hypertension and osteoarthritis
presents to the emergency room with an episode of syncope while
watching TV. He has felt generally weak for the past 5 days. He denies
any chest pains, shortness of breath, or fevers. His medications
include metoprolol and celecoxib. His blood pressure is 115/65, heart
rate 40, respirations
12, and he is afebrile. His physical examination reveals normal lung
sounds, a regular, bradycardic rhythm with verying intensities of the
S1 heart sound, and intermittent large cannon A waves in the jugular
venous pulsations. His
laboratory studies are normal. His ECG is below. What is the
appropriate treatment?
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