USMLE Forum Archives - USMLE Step 3 - 2 what is your diagnosis ?
2 what is your diagnosis ?
conym5 - 06-24-09 10:42
A 59-year-old patient presents with fever and agitation. On physical examination, his temperature is
103.2°F. His respirations are 26/min, pulse 126/min, and blood pressure is 100/70 mm Hg. He
appears to be warm and flushed. A Swan-Ganz catheter is inserted that
demonstrates an increased cardiac output, a decreased peripheral vascular resistance (vasodilation), and a normal pulmonary capillary wedge pressure (PCWP). The patient’s urine gram stain reveals
pyuria and gram-negative rods. Which of the following is the most
likely diagnosis?
a. Late septic shock
b. early septic shock
c. Cardiogenic shock
d. Hypovolemic shock
e. Neurogenic shock
conym5 - 06-24-09 10:42
A 59-year-old patient presents with fever and agitation. On physical examination, his temperature is
103.2°F. His respirations are 26/min, pulse 126/min, and blood pressure is 100/70 mm Hg. He
appears to be warm and flushed. A Swan-Ganz catheter is inserted that
demonstrates an increased cardiac output, a decreased peripheral vascular resistance (vasodilation), and a normal pulmonary capillary wedge pressure (PCWP). The patient’s urine gram stain reveals
pyuria and gram-negative rods. Which of the following is the most
likely diagnosis?
a. Late septic shock
b. early septic shock
c. Cardiogenic shock
d. Hypovolemic shock
e. Neurogenic shock
The correct answer and explanation will be available after you answer.
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#5
Re: 2 what is your diagnosis ?
conym5 - 06-25-09 12:54 ans: BBB
The early phase of septic shock is characterized by vasodilation resulting in a warm, flushed
patient with a normal or elevated cardiac output. Fever, agitation, or confusion is often present.
#8
Re: 2 what is your diagnosis ? Youngdoctor - 06-25-09 21:16 What does the late spetic shick show?. Can any one share your ideas?.
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