Progressive obtundation over the past 2 days

Discussion in 'Step 3' started by samuel, Nov 27, 2013.

  1. samuel

    samuel New Member

    A 70-year-old nursing home resident is admitted to the hospital because of progressive obtundation over the past 2 days. He has tachycardia, tachypnea, and hypotension. Bilateral basilar crackles and an S3 gallop are heard on auscultation. Examination shows jugular venous distention and peripheral edema. Swan-Ganz
    catheterization shows a cardiac index of 1.8 L/min/m2 (N=2.5–4.2), a mean Pulmonary capillary wedge pressure of 23 mm Hg (N=1–10), and markedly Increased systemic vascular resistance. Which of the following is the most likely diagnosis?

    A) Cardiogenic shock

    B) Hypovolemic shock

    C) Neurogenic shock

    D) Septic shock

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