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The following questions 15 questions refer to the following scenario for Ernestine Lipton Ernestine Lipton is a 56 year old woman with Systemic Lupus Erythematosus (SLE).  She complains of swelling of her hands, face, and feet.  Vital signs are:  37.5C, 78, 26, 164/98

The next 4 questions refer to the scenario for Yoobin Chung Ms. Chung is a 25 year old college student with complaints of fatigue and weight loss these past few months.  Today she comes to the student health center with swelling in her left groin and a fever.  Ms. Chung has a chest x-ray which reveals hilar lymphadenopathy.  Ms. Chung’s legs are pink, warm, and dry, with notable edema of the left leg.  Ms. Chung is quite anxious about her health problems and is sobbing uncontrollably, declaring “I don’t want to die”.  A needle biopsy of the left groin lymphatic mass reveals lymphoid hyperplasia with Reed-Sternberg Cells. Vital signs are:  38.2 C, 106, 26, 96/48.  96% sat, Pain 0/10

The following 5 questions  refer to the scenario for Adelaide Hunting Adelaide Hunting is a 79 year old housewife.  Ms. Hunting smokes two packs of cigarettes a day and says she has tried to quit smoking, but has poor will power.  She has a productive cough of green mucous, barrel chest, and bilateral pedal edema.  Vital Signs are 37.8C, 112, 28, and 148/94.  

The following 7 questions  refer to the following scenario for John Fletcher John Fletcher is a young man with a history of HIV infection who is admitted for fatigue, night sweats, a 20 lb weight loss over the last few months, swollen lymph nodes, and pedal edema. He has a productive cough with yellow/brown mucous & complains of orthopnea. Kaposi Sarcoma was diagnosed last month. Vital signs are  38.9C 112 30 118/76. Labs are assessed & a physical examination is performed. CBC Reveals: RBC, 2.0 mill/mm3, Hgb – 6 gm/dl, HCT -18% MCV – 108fl (80-97)  MCH 29 (27-31), MCHC 34% (32-36) Platelets – 30,000 WBC – 14,900 Polys – 70%, Bands – 2%, Eos – 2%, Basos – 1%, Blasts 20%, Monos 5%   Albumin is 2.9  

The following 6 questions refer to the scenario for Angela Bucaro Angela Bucaro is a 75 year old retired librarian.  Ms. Bucaro smokes two packs of cigarettes a day and says she has tried to quit smoking, but has poor will power.  Ms. Bucaro has a long history of coronary artery disease (CAD).  She had an anterior wall myocardial infarction (AWMI) several years ago and had a 4 vessel coronary artery bypass graft (CABG).  She takes numerous medications, including anti-hypertensives, anti-anginals, diuretics, and anticoagulants.  She continues to have periodic episodes of chest pain when she exerts herself too much, but she always gets relief from either rest alone or sometimes requires nitroglycerine.  She has a productive cough of green mucous, barrel chest, and bilateral pedal edema.  Vital Signs are 37.8C, 112, 28, and 148/94.

Ms. Hunting develops acute onset of wheezing, dyspnea, and coughing related to a staff members strong perfume.  The wheezing is likely related to which of the following?

Ms. Hunting’s breathing difficulty with wheezing and dyspnea may benefit from administration of which of the following?

The following 5 questions  refer to the following scenario for Martin Englewood. Marion Englewood is a 60year old female with a history of coronary artery disease and primary hypertension.  Her medical conditions have been well controlled by medications.  She is admitted to the emergency room with acute onset of confusion, pulmonary crackles, nausea and vomiting, and a BP of 212/154. 

Ms. Bucaro has chest pain that does not respond to rest and nitroglycerine.  A 12 lead ECG is ordered and cardiac enzymes are drawn.

1.3 Explain why tanks were relatively useless in the beginning of the war? (3)