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14338 Medicine

A 46-year-old woman presents for her annual examination. Her main complaint is frequent sweating episodes with a sensation of intense heat starting at her upper chest and spreading up to her head. These have been intermittent for the past 6 to 9 months but are gradually worsening. She has three to four flushing/sweating episodes during the day and two to three at night. She occasionally feels her heart race for about a second, but when she checks her pulse it is normal. She reports feeling more tired and has difficulty with sleep due to sweating. She denies major life stressors. She also denies weight loss, weight gain, or change in bowel habit. Her last menstrual cycle was 3 months ago. Physical examination is normal. Which treatment is most appropriate in alleviating this woman’s symptoms?

ALevothyroxine
BEstrogen
CEstrogen plus progesterone
DCitalopram
Medicine
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14343 Medicine

True about ASD :

AForamen ovale is patent
BLeft parasternal heeve is due to increased pulmonary aery flow
CS2 is wide and variable
DSystolic murmur is due to rapid flow of blood across the shunt.
Medicine
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