dd
发帖数: 73 | 1 A 72-year-old skilled nursing care facility resident with dementia is
brought to the emergency department
2 days after the onset of fever, confusion, and generalized weakness. His
symptoms began following
irrigation of his urinary catheter, which was not draining well. He has
chronic obstructive pulmonary disease
and osteoarthritis. He appears lethargic. His temperature is 36.2 C (97.2 F)
, pulse is 110/min, and blood
pressure is 90/50 mmHg. Examination shows a supple neck. There are Heberden
no | P*D
发帖数: 2194 | | dd
发帖数: 73 | 3 Thank you for your explanation. I agree with septic shock, fits in the
fever, leukocytosis and low BP. But why
the patient also has low NaCl and flattening of ST-T?
【在 P*D 的大作中提到】
: 感染性休克,动静脉短路,高排低阻.
| P*D
发帖数: 2194 | 4 ST段低电压和心肌缺血有关.
至于低Cl-,我也在琢磨.这个病人阴离子间隙增大,可能有代酸.光从题干里,
似乎不能找到足够的解释.
【在 dd 的大作中提到】
: Thank you for your explanation. I agree with septic shock, fits in the
: fever, leukocytosis and low BP. But why
: the patient also has low NaCl and flattening of ST-T?
| dd
发帖数: 73 | 5 也许低 NaCl 只是个 distracting information。 病人 dementia, confusion 可能有
进食进水不足。
【在 P*D 的大作中提到】
: ST段低电压和心肌缺血有关.
: 至于低Cl-,我也在琢磨.这个病人阴离子间隙增大,可能有代酸.光从题干里,
: 似乎不能找到足够的解释.
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