A 41-year-old man is being evaluated for ongoing productive cough, and shortness of breath. He smokes about 1 pack per day for 5 years but quit recently. His spirometry is in keeping with a severe non-reversible airflow obstruction. Upon further questioning, you discovered that he is being seen by a gastroenterologist for investigation of abnormal liver function testing. His CXR shows evidence of significant hyperinflation and increased lucency involving the bases more than the mid-to- apical areas. While presenting your patient to your consultant, he asked you what further testing you would consider for this patient to reach out the diagnosis?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Alpha-1 Anti-trypsin level and genetic
A young man with only a small smoking history, basal (panacinar) emphysema and concurrent liver disease fits alpha-1 antitrypsin deficiency, so check the serum AAT level and genotype. Spirometry is already done and shows the obstruction; ABG would not give the cause, and liver biopsy is not the first test for AATD.
ليش كل خيار صح أو غلط
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A
ليش غلط
Spirometry has already shown the obstruction (FEV1/FVC < 70% after bronchodilator confirms COPD); the open question is the cause, which is not answered by repeating it.
✓ COPD.pdf · p. 5 -
B
ليش صح
Panlobular emphysema, which affects the lower lobes, is associated with AATD, and the serum AAT level is the screening test.
✓ COPD.pdf · p. 5 -
C
ليش غلط
An ABG is for assessing respiratory failure (SpO2 < 92% or acute illness); it does not identify the cause of emphysema.
✓ COPD.pdf · p. 6 -
D
ليش غلط
Concurrent liver disease is a clue pointing to alpha-1 antitrypsin deficiency (with early onset and minimal smoking), so the AAT level is the test to order, not a liver biopsy.
✓ COPD.pdf · p. 3
- المصدر
- COPD.pdf · p. 3
COPD.pdf · p. 5 - المحاضرة
- COPD · Pulmonology · Module B
- ظهر في
- MED43 ♂ Quiz B · MED43 ♀ Quiz B