Pathology Notes

Practice questions answers Shock © Jun Wang, MD, PhD   1. A. Presentations of fever and chills are suspicious of infection. In addition, this patient has lower abdominal pain with image studies showing extraluminal gas or feces, consistent with ruptured internal organ, most likely colon. The presence of tachypnea, tachycardia and skin cyanosis is highly suggestive for shock , further supported by persistent hypotension after adequate fluid resuscitation. In this case, this is most likely a septic shock , due to presentations of sepsis . Although diagnosis of sepsis is usually made empirically based on clinical presentations, especially evidence of organ dysfunctions, it is commonly required to have either positive blood culture results or clinical responses to antibiotics to confirm the diagnosis. Chest X-ray and echocardiography are used in diagnosis of obstructive shock . EKG can be used to diagnose cardiogenic shock . Flow cytometry can be used in diagnosis of lymphoid n

Practice questions Shock © Jun Wang, MD, PhD   1. Use this case for the next 7 questions . A 56-year-old man presented with fever, chills and lower abdominal pain for 2 days.   He has a history of hypertension, type 2 diabetes, and hyperlipidemia. He drinks beer occasionally but does not drink other alcohol beverage. He does not smoke cigarette. On physical examination, he appears to have acute stress and confused. He has a temperature of 39.6°C, blood pressure of 75/50 mm Hg, a heart rate of 125 beats per minute and respiratory rate of 25/min. His skin is warm and dry with focal cyanosis. His heart and breath sounds are normal. The abdomen was diffusely tense and distended. His CBC reveals a hemoglobin of 13.5 g/dl (normal 14-18 g/dl), white cell count of 27.5 x 10 9 /L (normal 5-11 x 10 9 /L), platelet count 54 x 10 9 /L (normal 150-450 x 10 9 /L). His white cells show left shift, but no blast is seen. He has a PT of 21 second (normal 8.8-12.7 second), aPTT of 90 second (n