A 78-Year-Old Man with Severe Dementia Is Brought to the Emergency

question 509

Multiple Choice

A 78-year-old man with severe dementia is brought to the emergency department due to a daylong history of lethargy, fever, and vomiting.  The patient lives in a nursing home, and his caregivers report that he has had poor oral intake over the last week.  Medical history is significant for emphysema, heart failure with reduced ejection fraction, hypertension, and diabetes mellitus type 2.  On physical examination, the patient is lethargic but arousable.  Blood pressure is 60/30 mm Hg and pulse is 120/min and regular.  The extremities are warm.  Coarse rhonchi are heard over the right lower lung.  After receiving several intravenous fluid boluses, the patient is given an intravenous infusion of an agent that increases peripheral vascular resistance, increases blood pressure, and decreases heart rate.  Which of the following agents is most likely being described?

• A)Dobutamine
• B)High-dose dopamine
• C)Low-dose epinephrine
• D)Milrinone
• E)Phenylephrine

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Definitions:

Myocardial Infarction

A medical condition commonly known as a heart attack, resulting from the blockage of blood flow to the heart muscle.

Atherosclerosis

A condition characterized by the hardening and narrowing of the arteries due to the buildup of plaque, leading to potential heart disease and stroke.

Myocardial Ischemia

A condition characterized by reduced blood flow to the heart muscle, leading to chest pain and potential heart damage.

Type B Personality

Type B Personality is characterized by lower stress levels, a relaxed attitude, patience, and a laid-back approach to life, contrasting with the high-strung Type A personality.