Aashi wrote:
S4 + s/s of CHF-->can be Diastolic CHF--> A
good brief explanation Aashi!! ///// In addition B&C would probably get a doc sued or thrown out of a PGY1 program. D- making her urinate for 3 months does nothing. E doesnt treat.
Edited by mjl1717 on 02/07/07 - 06:15 AM
___________________
Smell the coffee! "Is That an Osler move??"
|
| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
|
A. This patient has new-onset
congestive heart failure. Her history is very clear for the
telltale signs of increasing left heart filling pressures:
paroxysmal nocturnal dyspnea, orthopnea, decreased
exercise tolerance, and pulmonary congestion. Given
her age and track record of never having been hospitalized,
the correct course of action is to obtain an
echocardiogram as an inpatient and then begin a medication
regimen while in the hospital.
Limiting her activity (choice B) and salt intake (choice
C) are not correct because we fail to acknowledge the
presence of a clear process occurring in this patient.
Simply prescribing a diuretic (choice D) assumes that
you understand that she has CHF, but given our lack of
diagnostic evidence for this, and with no way for us to
evaluate the efficacy of the dose prescribed in alleviating
her symptoms, it is unacceptable to send this
patient away with such a regimen.
Referring for an echocardiogram and re-evaluating in
3 months (choice E) is unacceptable, given that the
interval of time between her echocardiogram and initiation
of therapy could result in this patient incurring
severe morbidity or even death.
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
|
| |
| | | 
Similar forum topics