A 50-year-old male is admitted an acute myocardial
infarction. His ejection fraction is noted to be 30%. He
develops shortness of breath and his physical exam reveals
crackles bilaterally. The bedside CXR indicates pulmonary
edema. Which of the following best describes the
pathological cause of the edema?
A. Increased hydrostatic pressure
B. Decreased plasma osmotic pressure
C. Increased cardiac output
D. Decreased central venous pressure -
..ANSWER...Increased hydrostatic pressure
The direction of blood flow and the clinical severity of
symptoms in Tetralogy of Fallot is determined primarily by
the:
A. Presence of an atrial septal defect
B. Diameter of the tricuspid valve
C. Size of the left ventricle
D. Degree of pulmonary stenosis - ..ANSWER...Degree of
Pulmonary stenosis
A 36-year-old female presents to the ED with the chief
complaint of acute SOB and anxiety that started suddenly 2
to 3 hours ago while she was working around the house. She
denies chest pain. Her PMH is unremarkable. She takes oral
contraceptives, but no other medications. Vital signs are
temperature=99.1, RR=34, BP=148/90, pulse=100. Oxygen
saturation is 94% on room air. Laboratory tests reveal
WBC=7.1, Hgb=12.2, Hct=37.3, Na+=138, K+=4.7,
Cl=109, HCO3=25, BUN=14, Cr=0.9, glucose=106. ABGs
are obtained and reveal pH=7.52, HCO3=20, PaCO2=26,
PaO2=70. CXR and ECG are normal. What type of acid
base disorder does the patient suffer from?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis - ..ANSWER...Respiratory alkalosis
A 65-year-old male is brought for care by his wife because
of headache, nausea, and fatigue. PMH is significant for
small cell carcinoma of the lung diagnosed approximately 2
years ago. He also has a history of TIA (6 years ago) and
mild CHF. Vital signs are as follow: temperature=99.8F,
RR=18, BP=140/88, pulse=76. On examination, he is awake
but somewhat lethargic. Physical examination is
unremarkable. Laboratory tests reveal the following:
WBC=8.3, Hgb/Hct=10.2/30.7, glucose=106, serum
Na+=121 mEq/L, K+=4.3, BUN/Cr= 7.0/0.4. What is the
most likely diagnosis?
A. Syndrome of Inappropriate Anti-diuretic Hormone
(SIADH)
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