12-26-2013, 09:37 AM
A 70-year-old man is found unresponsive at home. The emergency medical
technicians note his blood pressure to be 70 mm Hg by palpation. His pulse
is 120/min. He is brought to the emergency department, where his
temperature is 39.5 C (103 F), and respirations are 30/min. He has rales
halfway up his chest. Heart sounds are inaudible. His urine output is 10
mL/hr. A chest x-ray film reveals Kerley B lines, and an ECG shows sinus
tachycardia. He is given antibiotics and is taken to the intensive care unit,
where a right-sided catheterization shows an elevated wedge pressure and
diminished cardiac output. His right atrial pressure is not elevated. Which of
the following is the most likely cause of this man's hypotension?
A. Gastrointestinal bleeding
B. Gram-negative sepsis
C. Left ventricular dysfunction
D. Pericardial tamponade
E. Pulmonary embolus
technicians note his blood pressure to be 70 mm Hg by palpation. His pulse
is 120/min. He is brought to the emergency department, where his
temperature is 39.5 C (103 F), and respirations are 30/min. He has rales
halfway up his chest. Heart sounds are inaudible. His urine output is 10
mL/hr. A chest x-ray film reveals Kerley B lines, and an ECG shows sinus
tachycardia. He is given antibiotics and is taken to the intensive care unit,
where a right-sided catheterization shows an elevated wedge pressure and
diminished cardiac output. His right atrial pressure is not elevated. Which of
the following is the most likely cause of this man's hypotension?
A. Gastrointestinal bleeding
B. Gram-negative sepsis
C. Left ventricular dysfunction
D. Pericardial tamponade
E. Pulmonary embolus