A 79-year-old female was admitted to the hospital due to worsening CHF. She was too demented to complain of anything but her legs progressively became more swollen. Before the admission, she was a lively person, "pleasantly demented" (as it usually said by non-professionals), and up-and-about as much as she was allowed by her Degenerative Joint Disease. PMH: Dementia, CAD, HTN, CHF, DJD S/P right TKR, osteoporosis Medications: Risperidone, Loratidine, Senna, tramadol, furosemide, simethicone, lisinopril, risedronate, docusate, escitalopram , Trazodone.
Physical examination: Thin lady with no appreciable disease VS 36.7-17-130/80-72 Chest: occasional bibasilar crackles CVS: Clear S1S2, Abd: Soft, NT, ND, +BS Ext: 3+ edema, more on the right, no erythema or pain Neuro: AAO x 1 What can be the differential diagnosis for worsening CHF? What treatment strategy should be recommended? *This…
