Pulmonology Questions - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 09-01-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 710 Times in 380 Posts
Reputation: 720
Lungs Pulmonology Questions

A 60 year old male with a history of HTN,diabetes,coronary artery disease ,asthma,and cigarette smoking undergoes emergent laparotomy for a perforated peptic ulcer.He receives 4 liters of intravenous normal saline intraoperatively.Following the procedure he is extubated without complication but subsequently develops respiratory distress.Immediate arterial blood gas analysis on room air shows
PaO2 60
pH 7.46
PaCO2 37
HCO3 22

His temp 37.2(98.9F) and bloob pressure is 126/76 mmHg.Lung auscultation reveals bilatera; rales.His arterial blood gas fails to improve with administration of 100% Oxygen.What is the most likely cause of his respiratory distress?

A. Excessive anesthesia
B. Pulmonary edema
C. Pulmonary Emblosim
D. Aspiration pneumonia
E. Exacerbation of bronchial asthma

Please add reasoning
__________________
"Don't Forget they need us too"
Reply With Quote Quick reply to this message
The above post was thanked by:
cingulate.gyrus (09-02-2012), doc_study (09-02-2012)



  #2  
Old 09-01-2012
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 149
Threads: 13
Thanked 46 Times in 34 Posts
Reputation: 56
Send a message via AIM to absolutjag9
Default

pulm edema ans B as his po2 didn't improve upon administration of o2. also the bilateral rales. his pmh can also predispose him to edema, b/c of probable ventricular weakness.
Reply With Quote Quick reply to this message
The above post was thanked by:
step_enhancer (09-02-2012)
  #3  
Old 09-01-2012
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 791
Threads: 76
Thanked 673 Times in 317 Posts
Reputation: 691
Default

pul edema....hypoxia,respi alkalosis,previous CAD,B/L rales
Reply With Quote Quick reply to this message
The above post was thanked by:
step_enhancer (09-02-2012)
 
  #4  
Old 09-02-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 710 Times in 380 Posts
Reputation: 720
Default

Try Try Everyone !
__________________
"Don't Forget they need us too"
Reply With Quote Quick reply to this message
  #5  
Old 09-02-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 720
Threads: 217
Thanked 552 Times in 309 Posts
Reputation: 562
Default

Quote:
Originally Posted by step_enhancer View Post
A 60 year old male with a history of HTN,diabetes,coronary artery disease ,asthma,and cigarette smoking undergoes emergent laparotomy for a perforated peptic ulcer.He receives 4 liters of intravenous normal saline intraoperatively.Following the procedure he is extubated without complication but subsequently develops respiratory distress.Immediate arterial blood gas analysis on room air shows
PaO2 60
pH 7.46
PaCO2 37
HCO3 22

His temp 37.2(98.9F) and bloob pressure is 126/76 mmHg.Lung auscultation reveals bilatera; rales.His arterial blood gas fails to improve with administration of 100% Oxygen.What is the most likely cause of his respiratory distress?

A. Excessive anesthesia
B. Pulmonary edema
C. Pulmonary Emblosim
D. Aspiration pneumonia
E. Exacerbation of bronchial asthma

Please add reasoning

Pulmonary embolism my answer.
Hypoxia without hypercarbia... due to ventillation perfusion mismatch....
Reply With Quote Quick reply to this message
The above post was thanked by:
step_enhancer (09-03-2012)
  #6  
Old 09-02-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 460
Threads: 278
Thanked 166 Times in 81 Posts
Reputation: 176
Default

Quote:
Originally Posted by step_enhancer View Post
A 60 year old male with a history of HTN,diabetes,coronary artery disease ,asthma,and cigarette smoking undergoes emergent laparotomy for a perforated peptic ulcer.He receives 4 liters of intravenous normal saline intraoperatively.Following the procedure he is extubated without complication but subsequently develops respiratory distress.Immediate arterial blood gas analysis on room air shows
PaO2 60
pH 7.46
PaCO2 37
HCO3 22

His temp 37.2(98.9F) and bloob pressure is 126/76 mmHg.Lung auscultation reveals bilatera; rales.His arterial blood gas fails to improve with administration of 100% Oxygen.What is the most likely cause of his respiratory distress?

A. Excessive anesthesia
B. Pulmonary edema
C. Pulmonary Emblosim
D. Aspiration pneumonia
E. Exacerbation of bronchial asthma

Please add reasoning
pulmonary edema: bilateral rales, previous CAD, but pulmonary edma can lead to hypocarbia??

A.) excessive anesthesia: hypoventilation
C.) pulmonary embolism: hyperventilation
D.) aspiration pneumonia: hypoventilation or hyperventilation
E.) exacerbation of asthma: first hypervntilation then hypoventilation

please correct me, thank you!
Reply With Quote Quick reply to this message
The above post was thanked by:
step_enhancer (09-03-2012)
  #7  
Old 09-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,867
Threads: 149
Thanked 2,104 Times in 1,049 Posts
Reputation: 2124
Default

Quote:
Originally Posted by step_enhancer View Post
A 60 year old male with a history of HTN,diabetes,coronary artery disease ,asthma,and cigarette smoking undergoes emergent laparotomy for a perforated peptic ulcer.He receives 4 liters of intravenous normal saline intraoperatively.Following the procedure he is extubated without complication but subsequently develops respiratory distress.Immediate arterial blood gas analysis on room air shows
PaO2 60
pH 7.46
PaCO2 37
HCO3 22

His temp 37.2(98.9F) and bloob pressure is 126/76 mmHg.Lung auscultation reveals bilateral rales.His arterial blood gas fails to improve with administration of 100% Oxygen.What is the most likely cause of his respiratory distress?

A. Excessive anesthesia
B. Pulmonary edema
C. Pulmonary Emblosim
D. Aspiration pneumonia
E. Exacerbation of bronchial asthma

Please add reasoning

B. Pulmonary edema

He has increased A-a gradient as well as rales with hypoxemia.

Unlikely to be:

A. Excessive anesthesia >>>>Hypoventilation, so he should have raised CO2.

C. Pulmonary Embolism >>>>> should have improved with 100% O2

D. Aspiration pneumonia >>>>>>No fever

E. Exacerbation of bronchial asthma >>>>>>Co2 should be higher and PO2 should improve with 100% O2
Reply With Quote Quick reply to this message
The above post was thanked by:
step_enhancer (09-04-2012)
  #8  
Old 09-04-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 710 Times in 380 Posts
Reputation: 720
Default

Answer B. Pulmonary Edema
__________________
"Don't Forget they need us too"
Reply With Quote Quick reply to this message



Reply

Tags
Pulmonology-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Questions kenlee USMLE Step 1 Forum 6 02-26-2012 07:36 AM
Five Pulmonology Questions - Part 2 sonu.agarwall USMLE Step 2 CK Forum 12 11-14-2011 07:41 PM
5 Pulmonology Questions - Part 1 sonu.agarwall USMLE Step 2 CK Forum 12 10-29-2011 07:23 AM
Two questions about DM ? kemoo USMLE Step 2 CK Forum 2 07-08-2011 07:16 AM
Two questions jessp687 IMG Residency Match Forum 0 10-23-2009 11:41 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)