NBME 2 Cardio and Pulmonary take two :) - resident07

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A previously healthy 67-year-old woman is brought to
the emergency department by paramedics 40 minutes after the sudden
onset of shortness of breath while shopping. She is unable to provide
additional medical history. She is in severe respiratory distress. Her
temperature is 37 C (98.6 F), blood pressure is 90/60 mm Hg, pulse is
120/min and regular, and respirations are 24/min. Examination shows marked
jugular venous distention. Diffuse crackles are heard throughout all
lung fields. Cardiac examination shows an enlarged point of maximal
impulse and normal S1 and S2; there is an S3. Abdominal examination
shows no abnormalities. There is no edema of the lower
extremities. Laboratory studies
show:

Hematocrit 38%
Leukocyte count 12,000/mm3
Platelet count 350,000/mm3
Arterial blood gas analysis on 5 L/min of oxygen:
pH 7.5
PCO2 16 mm Hg
PO2 64 mm Hg

A
) Acute gastrointestinal bleeding
B
) Adrenal insufficiency
C
) Aortic valve rupture
D
) Cardiac tamponade
E
) Congestive heart failure
F
) Pneumonia
G
) Pulmonary embolism
H
) Sepsis