The following vignette applies to the next 2 items.
Item 1 of 2
A 38-year-old woman is brought to the emergency department due to an episode of syncope. The patient has felt weak and has not eaten well over the last 2 weeks. As a result, she believes she is “dehydrated.” Temperature is 38.2 C (100.8 F), blood pressure is 112/58 mm Hg, and pulse is 49/min and regular. The oral mucosa is dry and dentition is poor. An early diastolic murmur is heard at the left sternal border at full expiration. The lungs are clear1 3,000/mm3. The abdomen is soft and nontender 3,000/mm3. ECG reveals sinus rhythm with a 2:1 second-degree atrioventricular block. Laboratory results are as follows 3,000/mm3:
Leukocytes
13,000/mm3
Hemoglobin
10.8 g/dL
Platelets
410,000/mm3
Which of the following is the most likely diagnosis in this patient?
Correct
Incorrect
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