Answer Keys

Cardiovascular Quiz

1. fat

2. thrombo

3. hypotension

4. claudication

5. (d) embolus

6. (a) bradycardia

7. arteriogram

8. (d) anastomosis

9. pacemaker

10. defibrillator

11. anticoagulant

12. (b) auscultation

13. (c) normotension

14. thrombophlebitis

15. angina.

16. anticoagulant

17. hypertension

18. bicuspid

19. tachycardia

20. cardiomyopathy

 

 

ADMISSION DIAGNOSIS:

  1. Congestive heart failure.

SECONDARY DIAGNOSIS:

  1. Restrictive lung disease secondary to obesity.
  2. Morbid obesity.
  3. History of supraventricular tachycardia1.
  4. Hypertension.
  5. Asthma.
  6. Obstructive sleep apnea.

REASON FOR HOSPITALIZATION:

The patient is a 46-year-old African-American woman with severe obesity, greater than 400 pounds2, admitted to the emergency room with shortness of breath3 for three days. The patient had stopped taking her Lasix two days prior to admission secondary to the fact that she had difficulty4 walking to the bathroom to urinate. The patient also noticed some increasing lower extremity swelling and orthopnea. The patient denied any chest pain or palpitations. The chest x-ray done in the emergency room was consistent with CHF5. The patient was hemodynamically stable6 but had a low 02 saturation of 87% in the emergency room and was admitted to the hospital.

HOSPITAL COURSE:

1. Congestive heart failure. The patient was ruled out for a myocardial infarction by enzymes, and the patient was diuresed with IV Lasix while in the hospital. She diuresed over 8 liters, with improvement in her lungs and decrease in her lower extremity swelling. The day prior to discharge, she was restarted7 on p.o. Lasix and maintained a good urine output, with 40 mg Lasix b.i.d. The patient's chest x-ray also showed improved pulmonary edema. On discharge, the patient will be maintained on 80 mg p.o. Lasix, one time in the morning.

2. Restrictive lung disease. The patient had severe8 restrictive lung disease secondary to her morbid obesity. Her lung exam did improve after diuresis. The patient is also known to retain CO2. Her admit ABG showed a pH of 7.52, CO2 of 93, an O2 of 66. After diuresis, on 1 liter, her ABG improved to a pH of 7.45, CO2 of 57, and O2 of 52.69.

When the patient would ambulate, her oxygen saturations10 on room air would be up to 93% However, at sleep, her O2 saturations would drop. An ABG was drawn on room air when the patient was at rest, and her O2 continued to be low at 34. It is suggested that the patient will need home oxygen, between 1 to 2 liters, to maintain her oxygen saturation between 87% and 90%.

1. Supraventricular tachycardia instead of SVT; always spell out abbreviations in diagnosis.
2. Do not abbreviate the word pounds.
3. breath (noun) instead of breathe (verb)
4. difficulty instead of difficult
5. CHF instead of CHS
6. stable instead of staple
7. restarted is one word
8. severe instead of several
9. 52.6 instead of 526
10. sats should be expanded to saturations

 

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