Presentation

You are a final year medical student on a clinical placement at a local general practice. Mr. Connor Mason, a 68-year old man, has just arrived and he is clearly distressed. Dr. Demetriou asks the patient what brought him in today. 

Mr. Mason explains that he has been becoming increasingly breathless and tired, even when doing things that would normally not tire him out, like walking up the stairs. He also points to his ankles, which show clear signs of ankle edema. He is concerned that the 'old ticker' is getting worse, as these symptoms were similar to what he experienced before starting treatment for his heart failure.  

The GP asks you to take a short history and you establish that Mr. Mason has suffered from moderate heart failure, with left ventricular systolic dysfunction, for the past two years. His heart failure has been well-controlled on ramipril, bisoprolol and metolazone. He also notes that he is allergic to aspirin. 

Recently, he has been experiencing bouts of heartburn and epigastric pain, that occur at regular intervals daily. The pain has been partially relieved by food and magnesium hydroxide, which he has taken regularly over the past few days. 

What advice would you give Mr. Mason? 

If you use antacids, it is better to combine them with alginates
If you use antacids, it's better to use calcium carbonate
You should never use antacids
If you use antacids, it is better to take them at least two hours apart of taking any other medication
If you use antacids, it's better to use sodium bicarbonate

Map: Connor Mason_UNIC (1100)
Node: 20895
Score:

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