A65-Year-Old Man Is Brought to the ER Due to Recent

question 59

Multiple Choice

A65-year-old man is brought to the ER due to recent dyspnea on exertion and generalized fatigue. He has a history of recurrent heart failure exacerbations last year. He has hypertension, myocardial infarction and hypercholesteromia. he has a 30-pack-yaer smoking history in addition to 15-year history of alcohol abuse. Physical examination reveals tachycardia, distended neck veins, bilateral crackles on lung auscultation, a third heart sound on cardiac auscultation, and pedal edema.  The appropriate therapy is initiated. On the third day of hospitalization, his hematocrit level increases to 50%, up from 44% on admission. An arterial blood gas analysis shows an arterial O₂ partial pressure (PaO₂) of 70 mm Hg. A 51Cr-tagged red blood cell infusion indicates normal red blood cell mass. Which of the following is the most likely cause of this patient's polycythemia?

• A)Polycythemia vera
• B)Hypoxic erythrocytosis
• C)Renal disease
• D)Occult neoplasia
• E)Relative erythrocytosis

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Definitions:

Treatment Orders

Directives given by healthcare providers outlining specific treatments or procedures to be administered to patients.

Objective Data

Information that can be observed by others; free of feelings, perceptions, prejudices.

Respirations

The process of inhaling and exhaling air; breathing.

Critical Thinking Skills

The ability to actively and skillfully conceptualize, apply, analyze, synthesize, and/or evaluate information gathered from observation, experience, reflection, reasoning, or communication.