Audio Qbank – Q51 – A 74F with long-standing hypertension

 

A 74-year-old woman with a 20-year history of systemic hypertension presents to the GP because of worsening shortness of breath for the past month. Her vitals are: temperature 98.6F, HR 120, RR 20, BP 110/55. Bibasilar crackles are auscultated across the chest. Cardiac examination shows a normal S1 and S2, with no added sounds. The point of maximal impulse is palpated at the anterior axillary line in the 6th intercostal space. Which of the following sets of values is most likely in this patient?

  ↑ Left ventricular stroke volume; ↑ Left atrial pressure; ↑ Peripheral vascular resistance
  ↑ Left ventricular stroke volume; ↑ Left atrial pressure; ↓ Peripheral vascular resistance
  ↑ Left ventricular stroke volume; ↓ Left atrial pressure; ↑ Peripheral vascular resistance
  ↓ Left ventricular stroke volume; ↑ Left atrial pressure; ↑ Peripheral vascular resistance
  ↓ Left ventricular stroke volume; ↑ Left atrial pressure; ↓ Peripheral vascular resistance
  ↓ Left ventricular stroke volume; ↓ Left atrial pressure; ↑ Peripheral vascular resistance

Cut-to-the-chase Answer (0:55):

HY USMLE Answer (4:01):