You are dispatched to a person who is reporting chest pain and shortness of breath. you arrive to find a conscious 58-yearold woman who is sitting up and reporting severe chest pain and shortness of breath. she is very anxious and tells you she feels like she is going to die. physical examination shows that her skin is pale, cool, and clammy and her pulse is rapid, weak, and irregular. her breathing is labored, with a respiratory rate of 28 breaths/ min. her spo2 is 90%. lung sounds show crackles in all fields. blood pressure is 92/60 mm hg. what is your differential diagnosis of this patient?
- hypovolemic shock
- septic shock
- cardiogenic shock
- neurogenic shock

Asap during the past few weeks or months, have you noticed any exercises that have become too easy for you? do you think you need to increase the intensity in any of the three exercise areas in your workouts? evaluate your exercise progress in the three exercise areas (cardiovascular, resistance, and flexibility) and list what modifications, if any, you may need to make in your exercise routine.

Design a questionnaire to indicate the level of a person’s wellness. have a friend or family member complete the questionnaire. make a prediction about that person’s wellness and justify your prediction using two or more complete sentences.

A46-year-old man with a history of hypertension and hypercholesterolemia visits the physician for a routine followup. the patient's job involves a lot of travelling, and he admits to occasionally forgetting to take his medications with him when he travels. he complains of several episodes of chest pain in the past few months. the pain is sharp in nature, mainly over his lower chest and epigastrium, and tends to come on when walking. he believes these episodes are due to indigestion and has been taking antacids. there is a family history of heart disease, and his father died of a heart attack at age 48. on physical examination, his blood pressure is 150/80 mmhg and heart rate is 86/min. his lungs are clear to auscultation. cardiac auscultation reveals normal rate and rhythm, without rubs, gallops, or murmurs. there is no pedal oedema. he is sent for an exercise stress test. five minutes into the test, he develops st depression of 3mm in leads v1-v5. the st segment depression is greater than 0.12 seconds in duration and the stress test is stopped. which of the following is the most appropriate next step in management? - coronary angiography- holter monitor- no further tests are required- repeat stress test with thallium- upper gastrointestinal endoscopy