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A young woman is brought to the emergency department by ambulance after a severe motor vehicle accident. She is unconscious. Her blood pressure is 64/40 mm Hg; heart rate is 150 bpm. She is intubated and is being hand-ventilated. There is no evidence of head trauma. The pupils are 2 mm and reactive. She withdraws to pain. Cardiac examination reveals no murmurs, gallops, or rubs. The lungs are clear to auscultation. The abdomen is tense, with decreased bowel sounds. The extremities are cool and clammy, with thready pulses. Despite aggressive blood and fluid resuscitation, the patient dies.
Questions
A. What is the likely diagnosis? Why?
B. What are the major pathophysiologic causes of this condition? Which was likely in this patient?
C. What pathogenetic mechanism accounts for this patient's unresponsiveness? For the cool, pale extremities?
It is a very curcial concept to understand how the immune response is mounted against viruses, bacteria, protozoans and helminthes. For an effective immune response, both innate and adaptive immunity should work together.
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Prepare an essay on nosocomial infection.
To increase the awareness of monitoring and recording the blood pressure of patients and practice measuring blood pressure in a safe environment.
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