An 80-Year-Old Woman Comes to the Office Due to Progressive

question 1335

Multiple Choice

An 80-year-old woman comes to the office due to progressive lower extremity edema over the last 2 months.  Her mobility is impaired due to knee osteoarthritis, but recently she has become somewhat tired and short of breath with daily activities.  Her stomach feels full and her appetite has been decreased.  The patient has had no forgetfulness or mood problems.  Blood pressure is 136/75 mm Hg and pulse is 70/min and regular.  Jugular veins are distended with the patient in the seated position.  There are no heart murmurs.  Breath sounds are decreased at the bases bilaterally.  The abdomen is distended with flank dullness on percussion.  There is 3+ peripheral edema.  Laboratory results are as follows: Urine albumin excretion is 1 g/24 hr.  Echocardiogram reveals left atrial enlargement, marked concentric left ventricular hypertrophy, and left ventricular ejection fraction of 70%.  Which of the following is the most likely cause of this patient's symptoms?

• A)Hypertrophic obstructive cardiomyopathy
• B)Inferior vena cava thrombosis
• C)Ischemic cardiomyopathy
• D)Protein malnutrition
• E)Renal disease
• F)Restrictive cardiomyopathy
• G)Thiamine deficiency

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Definitions:

Customer Cost Analysis

The process of evaluating all costs involved in acquiring and maintaining customers against the revenue they generate.

Time-Driven Activity-Based Costing

A cost accounting method that assigns costs based on the time resources are used by activities, using time as the driving factor.

Customer Support Department

A specialized division within a company dedicated to addressing customer inquiries, concerns, and issues, ensuring customer satisfaction.

Customer Cost Analysis

An evaluation of the total cost incurred by a business to serve a customer, including product, service, and indirect costs.