65-year-old man with chronic obstructive pulmonary disease has a 4-day history of worsening dyspnea, cough and increased in whitish sputum production. On examination, he is in respiratory distress. Temp 36.5°C, BP 145/84 mmHg, HR 102/min, and RR 20/min. He has audible wheezes bilaterally but no crackles. Heart sounds are distant but otherwise normal. Arterial blood gases performed on oxygen 2 L/min nasal cannula: pH 7.31; PCO2 50 mmHg; PO2 65 mmHg. Chest radiograph displays hyperinflation. Intravenous corticosteroids and inhaled salbutamol are begun. Which of the following treatments should be initiated based on the best evidence practice?
سؤال مجاني 8 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Levofloxacin
He has all three cardinal symptoms of an exacerbation: worse dyspnea, more cough and more sputum, plus respiratory acidosis. That is an indication for antibiotics. The summary names a respiratory fluoroquinolone (levofloxacin), and Step Up lists azithromycin, doxycycline or fluoroquinolones, not amoxicillin. Ipratropium is optional (SABA with or without SAMA), and theophylline is not recommended.
ليش كل خيار صح أو غلط
-
A
ليش غلط
The antibiotics listed for COPD exacerbations are azithromycin, doxycycline or fluoroquinolones; amoxicillin is not among them.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 11 -
B
ليش غلط
Ipratropium is optional (SABA with or without SAMA), and he is already on inhaled salbutamol; it is not the missing treatment.
✓ COPD.pdf · p. 12 -
C
ليش صح
He has increased dyspnea, cough and sputum, so antibiotics are indicated; the summary names a fluoroquinolone (levofloxacin, moxifloxacin).
✓ Pulmonology 🫁.pdf · p. 11 -
D
ليش غلط
Theophylline has a controversial role in COPD and a narrow therapeutic index, so it is not the evidence-based choice here.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 7
- المصدر
- Pulmonology 🫁.pdf · p. 11
COPD.pdf · p. 12 - المحاضرة
- COPD · Pulmonology · Module B
- ظهر في
- Respi bank