|
|---|
|
|
|
|
|
|
l******g
发帖数: 278 | 1 A 72-year-old man comes to the emergency department because he has
vomited blood three times during the past 12 hours. He has had dizziness
during this period. He has a 5-year history of arthritis treated with daily
ibuprofen. Over the past 4 weeks, he has increased his daily dose of
ibuprofen because of worsening joint pain but is not sure how many pills he
has been taking. He has been unable to take his daily walks because of the
joint pain. He has not had chest pain. He had an uncomplicated myocardial
infarction 10 years ago. He appears pale. His temperature is 37.5°C (99.5°
F), pulse is 110/min, respirations are 24/min, and blood pressure is 90/60
mm Hg. Examination shows dried blood near the mouth. The lungs are clear to
auscultation. Heart sounds are normal. The stool is black, and test for
occult blood is positive. His hematocrit is 22%, and platelet count is 215,
000/mm3. Upper endoscopy shows hemorrhagic gastritis with no active site of
bleeding. Thirty minutes after fluid resuscitation with crystalloid solution
and transfusion of 4 units of crossmatched packed red blood cells, the
patient has shortness of breath. Diffuse rhonchi and crackles are heard
bilaterally. Which of the following is the most likely cause of the dyspnea?
A
) ABO incompatibility
B
) Acute respiratory distress syndrome
C
) Aspiration of gastric contents
D
) Fluid overload
E
) Pulmonary embolism | z**********4
发帖数: 467 | | l******g
发帖数: 278 | | l*******d
发帖数: 449 | 4 B often happens in 72 hours after the trigger | l******g
发帖数: 278 | 5 you guys are great....
【在 l*******d 的大作中提到】
: B often happens in 72 hours after the trigger
| h*******r
发帖数: 182 | 6 Largebird got Goljan's pearl:
Day 1: sepsis
Day 2: DIC
Day 3: ARDS
Day 4: autopsy
【在 l******g 的大作中提到】
: you guys are great....
|
|
|
|
|
|
|
|
