A 54-Year-Old Man Comes to the Emergency Department Due to Severe

question 425

Multiple Choice

A 54-year-old man comes to the emergency department due to severe fatigue and dyspnea.  He has a long history of progressively worsening heart failure that has been resistant to treatment with medications, including diuretics.  He was treated with chest radiation 10 years ago for non-Hodgkin lymphoma and has been in remission since then.  The patient is admitted to the hospital, but his condition continues to deteriorate despite aggressive therapy.  He dies 3 days later, and an autopsy is performed.  Gross inspection of the heart shows dense, thick, fibrous tissue in the pericardial space between the visceral and parietal pericardium.  Which of the following signs would most likely have been detected during a physical examination of this patient just prior to his death?

• A)Kussmaul sign
• B)Loud P2
• C)Paradoxical splitting of S2
• D)S3 gallop
• E)Sustained left parasternal lift

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Definitions:

Natural Progression

refers to a gradual and continuous development or change in conditions, capacities, or phenomena following a sequence or a specific inherent course.

Business Begins

This term implies the initial stage or inception of a commercial enterprise or venture.

Financing

The process of providing funds for business activities, making purchases, or investing.

Management Consultant

is a professional advisor who helps organizations improve their performance, primarily through the analysis of existing organizational problems and the development of plans for improvement.