You are asked to examine a 68-year old man who is admitted unresponsive having
collapsed shortly after a family member took his picture (see below). Your examination
reveals an axillary temperature of 38.5 degrees centigrade, a pulse rate of 98 beats
per minute, a respiratory rate of 15 breaths per minute, and a blood pressure of 110/80
mm Hg. His skin is dry and erythematous and bilateral inspiratory crackles are audible
on lung examination. His neck is supple and there are no focal neurologic findings.
Pertinent laboratory findings include mildly abdormal liver function tests (elevated
SGOT, SGPT), an elevated creatinine kinase level, and findings compatible with a mild
disseminated intravascular coagulation disorder. A chest x-ray is characteristic of
an acute respiratory distress syndrome (ARDS).
What is your diagnosis, what test(s) would you order to confirm your suspicions,
and what treatment, if any, do you recommend?
In order to receive credit please email your answers to smithj@etsu.edu
.