epica
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Try to do this guys, (50sec) Step 2 and step 1 v similar
Five days after undergoing an emergency appendectomy for a perforated appendicitis, a 47-year-old woman has abdominal pain, nausea, and vomiting. She is pale and diaphoretic. Her temperature is 39�C (102.2�F), blood pressure is 82/44 mm Hg, pulse is 115/min, and respirations are 18/min. There is no jugular venous distention. The lungs are clear to auscultation. Abdominal examination shows mild distention and tenderness in the right lower quadrant. The upper and lower extremities are warm. Rectal examination shows a tender mass in the right pelvis extrinsic to the rectum. Which of the following is the most likely set of hemodynamic findings in this patient?
Preload Cardiac Contractility Afterload
A)↓ ↓ ↓
B)↓ ↑ ↓
C)↓ ↑ ↑
D)↑ ↓ ↑
E)↑ ↑ ↓
F)↑ ↑ ↑
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| new_n_lost
Politically InCorrect
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B ??
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| epica
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Agree,
What is Ds please?
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| hope4dabest
Forum Elite
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is it a...or b....m confused....whats the answer and plzz expalin also...though i think its a...
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| hope4dabest
Forum Elite
Topics: 16
Posts: 433
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hey nnl...how come contractility increasing???
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| epica
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If u know corr Diagnosis u will see the ans
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| new_n_lost
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Ischemic Bowel ??
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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WAIT
GOT IT
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| hope4dabest
Forum Elite
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is it cardiogenic shock with peritonitis
????
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| new_n_lost
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Sepsis >> Shock by Gram negative bacteria
For a moment Small bowel obstruction did occur to me but warm extremeties lead me to believe that its Sepsis
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| hope4dabest
Forum Elite
Topics: 16
Posts: 433
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yep peritonitis die to the rupture of the appendix..thats fine but m still not able to get cardiac contrctility???
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| epica
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Yes, NNl Your Ds is corr
Still warm, septic shock, early stage
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| yoga
usmlelogy professor
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Rectal examination shows a tender mass in the right pelvis extrinsic to the rectum=>how & y??
i didnt get this mass thing
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| new_n_lost
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Hey Epcia can u post the Explanation to this cos i wud also like to know whether the mass is the infarcted bowel or something else.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| epica
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It's from step 2 forum, pl read their expl.
GL
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| new_n_lost
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epica wrote:
It's from step 2 forum, pl read their expl.
GL
Where can u give me the link ???
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| epica
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Oh, sorry.
IM forum, prep4usmle.com
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| yoga
usmlelogy professor
Topics: 73
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why is her breathing not rapid?? shouldnt septic shock pt have tachpnea??
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| amritt786
Forum Senior
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B, mass in rectal exammay be fluid accomulated in pouch of douglus
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| cricket9014
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Postoperative complications are typically infectious complications. The most common complication is wound infection, especially with a perforated appendix. Fever and erythema of the wound are classic hallmarks, and the wound should be opened to drain the pus. Healing by secondary intention is the rule. Oral antibiotics on an outpatient basis are used for mild infections, while intravenous antibiotics and hospitalization are reserved for patients who have evidence of cellulitis, sepsis, or both.
Intra-abdominal abscesses, most commonly pelvic, occur postoperatively in about 5% of cases of perforated appendicitis. If the abscess is unilocular, it may be drained with CT-guided percutaneous techniques. If multiple intraloop abscesses exist or if the unilocular abscess is not accessible with drainage techniques, operative exploration and drainage are required.
Short-term complications of intra-abdominal abscesses include sepsis, ileus, and even bowel obstruction
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