Shock and Resuscitation
Questions
190.A 79-year-old woman with a history of coronary artery disease who
underwent a coronary artery bypass graft (CABG) surgery in 2000 is
brought to the emergency department (ED) by her family for 2 days of
worsening shortness of breath. For the past 2 days, she has not gotten out
of bed and is confused. She does not have chest pain, fevers, or cough. Her
temperature is 98.1°F, blood pressure (BP) is 85/50 mm Hg, heart rate (HR)
is 125 beats per minute, and respiratory rate (RR) is 26 breaths per minute.
On examination, she is unable to follow commands and is oriented only to
name. The cardiovascular examination reveals tachycardia with no mur-
murs. Her lungs have rales bilaterally at the bases. The abdomen is soft,
nontender, and nondistended. Lower extremities have 2+ edema to the
knee bilaterally. Which of the following is the most likely diagnosis?
a. Hypovolemic shock
b. Neurogenic shock
c. Cardiogenic shock
d. Anaphylactic shock
e. Septic shock
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