A 70-year-old man has a chronic obstructive lung disease and on home oxygen to treat his hypoxia, which is sometimes associated with angina. He develops pleuritic chest pain, fever, and purulent sputum over the last 2 days. While he is on oxygen. He becomes disoriented and stuporous. His arterial blood gas show pH 7.2, PO2 55 mmHg, and PO2 65 mmHg. Which of the following is the treatment of choice?
سؤال مجاني 3 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Intubate the trachea and begin mechanical ventilation
He is in hypercapnic respiratory failure with severe acidemia (pH 7.2) and is stuporous. Depressed consciousness rules out NIV, so the treatment is intubation and mechanical ventilation. Stopping oxygen would worsen hypoxemia (target 88-92% instead). Steroids do not fix the immediate ventilatory failure, and bicarbonate is not indicated. (The second "PO2 65" in the stem is presumably PCO2.)
ليش كل خيار صح أو غلط
-
A
ليش صح
Non-invasive ventilation needs a conscious, alert patient; altered level of consciousness and profound acidemia (pH 7.2) point to invasive ventilation (intubation).
✓ Asthma and COPD.pdf · p. 9 -
B
ليش غلط
Oxygen is not stopped; in COPD with CO2 retention it is titrated to a saturation of 88-92%.
✓ Asthma and COPD.pdf · p. 9 -
C
ليش غلط
Systemic steroids improve FEV1, oxygenation and recovery time, but they do not address immediate ventilatory failure; invasive ventilation is used for impaired airway protection or when NIPPV is inadequate.
✓ COPD.pdf · p. 12
- المصدر
- Asthma and COPD.pdf · p. 9
COPD.pdf · p. 12 - المحاضرة
- COPD Exacerbation · Pulmonology · Module B
- ظهر في
- Respi bank