(D) hypoventilation(E) carbon monoxide poisoning 10. (A) ventilation-perfusion ratio inequality Which of the following is the most likely cause for the elevated PCO 2? As part of his workup, an arterial blood gas is done and the PCO2 is 60 mm Hg. A 63-year-old man is having symptoms of shortness of breath. Which of the following is the most appropriate test to confirm the diagnosis?ĩ. Primary pulmonary hypertension is suspected. Pulmonary function tests show a slight restrictive pattern. CXR reveals clear lung fields and an ECG shows evidence of right ventricular hypertrophy. Precordial examination reveals a left parasternal lift, loud P2, and rightsided S 3 and S4. Physical examination reveals increased jugular venous pressure (JVP) with prominent c-v wave, and a reduced carotid pulse. A40-year-old woman has been complaining of a 3-year history of increasing dyspnea and fatigue. (E) normal magnetic resonance image (MRI)Ĩ. (C) normal ventilation-perfusion lung scan Which of the following investigations is most likely to rule out a pulmonary embolism (PE)? There are no clinical signs of deep venous thrombosis (DVT). On examination, her blood pressure is 120/80 mm Hg, pulse 100/min, and heart and lungs are normal. She was recently diagnosed with breast cancer and is undergoing active treatment. There is no history of heart or lung problems in the past. A 63-year-old woman is seen in the emergency room with acute shortness of breath. (D) may worsen with oxygen administrationħ. (C) does not occur in restrictive lung disease (B) does not occur in obstructive lung disease Which of the following explanations regarding his elevated PCO2 is correct? A PCO2 determination reveals severe hypercarbia (PCO2 70 mmHg). The next day he is found in his roomĬonfused and sleepy. Inhaled bronchodilators and anticholinergic agents. A 53-year-old man with a long respiratory history is admitted to the hospital because of increasing shortness of breath and sputum production. Which of the following is the most appropriate next step in management?Ħ. Hilar adenopathy and reticulonodular changes in both lungs.
In both lower lung lobes and tender erythematous nodules on his legs. Physical examination reveals fine inspiratory crackles He also has feverĪnd red tender rash on his shins. A 31-year-old African American man presents with dyspnea on exertion. (E) long-term systemic glucocorticoid therapyĥ. (B) a short course of systemic glucocorticoid therapy Serum precipitating antibodies to Aspergillus are positive. Infection is suspectedĪnd a CXR reveals upper lobe pulmonary infiltrates. On examination, there is bilateral wheezing. She now has a flare and experiences recurrent episodes of bronchial obstruction, fever, malaise, and expectoration of brownish mucous plugs. A 29-year-old woman has a long history of mild asthma. Which of the following treatments or medications should be avoided in her?Ĥ. She is hospitalized for further treatment. Arterial blood gases on oxygen reveal a pH of 7.40, PO2 340 mm Hg, PCO2 40 mm Hg, and bicarbonate of 24 mEq/L. She is still wheezing and now feels tremulous and anxious with a pulse of 110/min and respirations 30/min. After receiving oxygen, steroids, and salbutamol (Ventolin) in the emergency room, her breathing improves. An agitated and nervous 24-year-old woman has had severe wheezing and shortness ofīreath for 2 days. (D) it is due to destruction and dilatation of lung alveoliģ. (C) it is airflow limitation that is not fullyreversible Which of the following is the best definition of this condition? Pulmonary function tests confirm the diagnosis of chronic obstructive lung disease (COPD). He has bilateral wheezes on expiration and increased resonance to percussion of the chest. A 57-year-old man with a 40-pack-per-year history of smoking experiences symptoms of Which of the following is the most likely diagnosis?Ģ. His laboratory work is normal with no increase in eosinophils and the chest x-ray (CXR) reveals patchy lower lobe infiltrates. On auscultation, there are bibasilar crackles and heart sounds are normal. A 33-year-old farmer complains of recurrent episodes of wheezing after working in a barn
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