A 70-year-old male patient presented to the emergency room with increasing shortness of breath. He is known to have COPD on salbutamol inhaler as needed. He denied fever but complained of increasing sputum production. On examination he is distressed with heart rate of 110 per minute. Blood pressure 126/70, respiratory rate of 30 per minute and O2 Saturation of 85% on room air. He had decreased breath sounds bilaterally with expiratory wheeze What will be your appropriate action?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Start bronchodilators, steroids and antibiotics. Give O2 to keep saturation at 90%
An AECOPD with more dyspnea and more sputum is treated with bronchodilators, systemic steroids and antibiotics. Oxygen is titrated to SpO2 88-92%: targeting >95% risks CO2 retention, and withholding oxygen at 85% is wrong. NIV is for respiratory acidosis, which has not been shown here (no ABG).
ليش كل خيار صح أو غلط
-
A
ليش غلط
Bronchodilator plus oxygen alone is incomplete: systemic corticosteroids are used for patients requiring hospitalization, and antibiotics are part of the appropriate steps.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 11 -
B
ليش غلط
Oxygen is given to hypoxemic COPD patients, with a target SpO2 of 88-92%; withholding it at 85% is wrong.
✓ COPD.pdf · p. 11 -
C
ليش صح
The steps are inhaled bronchodilators, systemic steroids, antibiotics and supplemental oxygen, kept at SpO2 88-92%.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 11 -
D
ليش غلط
A saturation target above 95% is too high: above 92% the patient risks CO2 retention.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 11 -
E
ليش غلط
NIPPV is indicated for respiratory acidosis (PaCO2 ≥ 45 and pH ≤ 7.35); no blood gas showing acidosis is given, so the medical regimen comes first.
✓ COPD.pdf · p. 11
- المصدر
- COPD.pdf · p. 11
Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 11 - المحاضرة
- COPD Exacerbation · Pulmonology · Module B
- ظهر في
- Respi bank