A 63-Year-Old Man Comes to the Emergency Department Due to Increasing

question 324

Multiple Choice

A 63-year-old man comes to the emergency department due to increasing dyspnea.  He was unable to mow his lawn the previous day due to shortness of breath.  The patient has a history of hypertension and a 20-pack-year smoking history.  He is retired and traveled to Hawaii 2 months ago.  Blood pressure is 160/86 mm Hg, pulse is 94/min, and respirations are 24/min; oxygen saturation is 94% on room air.  Physical examination reveals bilateral lung crackles and occasional wheezes.  Laboratory testing reveals elevated brain natriuretic peptide levels.  Which of the following is the primary trigger for the release of this substance in this patient?

• A)Activation of alveolar juxtacapillary receptors
• B)Decrease in renal perfusion pressure
• C)Decrease in vena cava blood return
• D)Focal myocardial necrosis
• E)Increase in ventricular wall stress
• F)Stretching of aortic baroreceptors

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Definitions:

Gastroesophageal Reflux

A digestive disorder where stomach acid or bile irritates the food pipelining, often leading to heartburn or regurgitation.

Trendelenburg Position

A position where the patient's legs are elevated higher than their head, often used in surgical settings to improve venous return to the heart.

Thicken Formula

The practice of adding certain substances to infant formula to increase its consistency, often used for babies with swallowing difficulties or reflux.

Acute Diarrhea

A sudden onset of frequent, watery bowel movements that can result from infection, allergy, or other causes, often resolving within a few days.