UW question

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jfgavina

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so this basically is 56 yo african american female that develops dysuria and back pain. she has 39.2º 70/40 mmHg and 130 bpm respirations 26. she is confused and her skin is warm to touch. over the next few hours she becomes hypoxic. which of the following lung findings is she most likely to develop:

a. wedge shaped areas of hemorrhagic necrosis
b. fluid accumulation in the alveolar spaces


I picked choice A because I thought about DIC, since she is in sepsis she can also develop pulmonary embolism but the right answer is b, ARDS of course. why do you think choice B is right? for DIC and embolism I should have PT, PTT and BT?

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She is septic and then develops additional respiratory symptoms; the respiratory symptoms are not sudden onset (like an embolus) but gradually develop as the sepsis worsens, hence ARDS
 
DIC isn't really a cause of thromboembolic disease like PE, it's more microvascular thrombosis leading to organ dysfunction along with a consumptive coagulopathy. ards is really the clear choice here. For your second Q, impt labs for DIC include pt, ptt, plts, d-dimer and fibrinogen
 
PE is caused by an embolized DVT, which has nothing to do with DIC. Sepsis is by far one of the most common causes of ARDS
 
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