kaplan question - oblongata

[ArchivalUser]

A 65-year-old man with ischemic cardiomyopathy is complaining of increasing shortness of breath. He denies medical or dietary noncompliance. He is on appropriate medications and at maximal doses. He denies recent illness. He has no chest pain, lightheadedness, fever, chills, or shakes. He has no palpitations. His vital signs are stable. He has bilateral crackles. Cardiac examination reveals an S3. Jugular venous pressure is 13 cm of water. He has pedal edema. Echocardiogram reveals stable ejection fraction at 30%. Laboratory studies are normal. Electrocardiogram reveals a left bundle branch block. Which of the following is the appropriate management?
A. Administer oxygen
B. Perform a left heart catheterization
C. Place on a dobutamine drip
D. Refer for a biventricular pacemaker
E. Refer for cardiac transplantation

[ArchivalUser]

is it C ?

[ArchivalUser]

A.?

[ArchivalUser]

Since there is SOB - Give O2 1st
2nd Dobutamine is preffered in Pt w/ Low EF < 40%

[ArchivalUser]

D (as there is biventricular failure, both pedal and pulmonary edema)

[ArchivalUser]

right ben