A 72-Year-Old Woman with Diet-Controlled Type 2 Diabetes Mellitus Is

question 86

Multiple Choice

A 72-year-old woman with diet-controlled type 2 diabetes mellitus is brought to the emergency department for chest pain and shortness of breath.  Her initial blood pressure is 132/72 mm Hg and pulse is 102/min.  ECG shows sinus tachycardia and a 2 mm horizontal ST segment depression in the anterior precordial leads.  A chest x-ray shows bilateral patchy opacities most consistent with congestive heart failure.
She is treated with aspirin, clopidogrel, furosemide, nitroglycerin infusion, and heparin infusion.  Non-invasive positive pressure ventilation is initiated.  She is taken to the cardiac catheterization lab, and coronary angiography is performed which shows extensive triple vessel coronary artery disease.  Pulmonary artery catheter is placed and no coronary artery intervention is performed.
The patient is transferred to the cardiac care unit.  Four hours later, her blood pressure is 84/46 mm Hg and pulse is 116/min.  Hemodynamic readings from the pulmonary artery catheter are shown below.

Which of the following is the most likely cause of this patient's hypotension?

• A)Cardiogenic Shock
• B)Early sepsis
• C)Pericardial tamponade
• D)Pulmonary embolism
• E)Volume depletion

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Definitions:

Variable

Any characteristic, number, or quantity that can be measured or counted.

Normally Distributed

This symmetric distribution about the mean suggests that events are more likely to happen closer to the mean than farther from it.

Standard Deviation

An index that evaluates the extent of variation or scatter of data points from the dataset's average.

Performance Management Systems

Frameworks used by organizations to monitor, manage, and improve the performance of employees through goal clarity, continuous feedback, and performance appraisals.