A 26-year-old woman with no prior medical history presents to the emergency department (ED) with progressively worsening dyspnea for 1 week. Her symptoms are preceded by 3 days of fever, rigors, and nasal congestion. She is afebrile with HR of 116 beats/min and BP of 92/70 mmHg. Physical examination reveals bilateral rales, elevated jugular venous pressure, 2/6 systolic murmur at the left lower sternal border, cool extremities, and 2+ bilateral lower extremity edema. Echocardiogram reveals LVEF of 20%, nondilated LV (LV end-diastolic diameter of 3.4 cm), global hypokinesis, mild mitral regurgitation, and a normal right ventricular function. Labs are significant for creatinine of 1.6 mg/dL, aspartate aminotransferase (AST) of 385 U/L, alanine aminotransferase (ALT) of 413 U/L, troponin I of 4.8 ng/mL, and serum lactic acid of 2.8 mmol/L. Intravenous diuretics and dobutamine are initiated. Within 24 hours of admission, the patient develops hypotension and worsening heart failure refractory to inotropes and vasopressors. Urine output is 125 cc in the last 6 hours. Which of the following is the best next step in her management to stabilize her?
What writing assignment is due November 9, 2025? (Write out…
What writing assignment is due November 9, 2025? (Write out the entire name of the assignment)
I am enrolled in the DH/DT2132 Head and Neck Anatomy Course
I am enrolled in the DH/DT2132 Head and Neck Anatomy Course
Bilateral brachial arm pressures should not differ by _____…
Bilateral brachial arm pressures should not differ by ___________.
Examine the diagram. In which example are the phospholipids…
Examine the diagram. In which example are the phospholipids oriented correctly?
Based on the vessel configuration, what vessel is more than…
Based on the vessel configuration, what vessel is more than likely located at the arrow?
An 83-year-old male who was on the telemetry unit for a hear…
An 83-year-old male who was on the telemetry unit for a heart failure exacerbation has been transferred to the intensive care unit due to new onset atrial fibrillation with a rapid ventricular response. He was given a diltiazem bolus followed by a continuous diltiazem infusion without successful rate control. It has been less than 48 hours and direct current cardioversion is being considered. The success of electrical cardioversion is inversely proportional to which of the following?
Would the enzyme in the diagram be able to catalyze a reacti…
Would the enzyme in the diagram be able to catalyze a reaction between the reactants? Explain your answer.
Which arterial layer contains collagen that provides the tis…
Which arterial layer contains collagen that provides the tissue with its strength and also houses the vasa vasorum?
A 56-year-old male with 30-pack year smoking history, CAD, a…
A 56-year-old male with 30-pack year smoking history, CAD, and advanced liver disease due to alcoholic cirrhosis is being evaluated for a liver transplantation. He complains of worsening shortness of breath. His heart rate is 110/min, blood pressure is 97/64 mm Hg, respiratory rate is 32/min, and saturation 90% on 5 L/min nasal cannula. When asked to sit up in bed, the patient states that he “usually breathes better” when lying supine. Which of the following is the MOST likely pathophysiology behind the diagnosis?