Diabetes mellitus Quiz: Ace Your Exams

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A 60-year-old woman comes to the emergency department complaining of sudden onset nausea. She is employed as a city bus driver, and on the morning route a rider verbally assaulted the patient. Moments afterwards, the patient felt a persistent sensation of nausea associated with forehead sweat and chest tightness. Medical history includes hypertension, for which the patient takes amlodipine. The patient’s father died of a myocardial infarction at 50 years old. The patient has never smoked and does not drink. The patient’s temperature is 36.7°C (98.0°F), pulse is 100/min, respirations are 20/min, and blood pressure is 150/100 mmHg. BMI is 38 kg/m2. Physical examination reveals the patient to be visibly uncomfortable, with regular tachycardia and no murmurs or jugular venous distention. The lungs are clear to auscultation bilaterally.  Laboratory tests show an elevated troponin T level; a complete blood count and chemistry panel are normal. ECG shows the following:  


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Fluoroscopy reveals a 90% stenotic lesion of the left anterior descending artery, and a drug eluting stent is placed. In recovery, the patient's symptoms have resolved and she has no complaints. Which of the following laboratory tests should be ordered at this point in time to determine the underlying cause of her myocardial infarction?  

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