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What's your Diagnosis?

1K views 11 replies 9 participants last post by  akshaya.amc 
#1 ·
A 27 year old female was involved in an automobile accident. As a result of the accident she sustained a cervical frature. She has no significant PMH prior to the accident. She is stable in a halo vest, has a tracheostomy and is tolerating CPAP during the day while being ventilated on SIMV of 8 during the night. Examination has revealed a C5-C6 level of functioning.

The patient prefers to lie in bed with the head elevated to about 30 degrees. She demonstrates a dyscoordinated breathing pattern. Auscultation reveals diminished breath sounds at bilateral bases with faint bilateral upper chest rhonchii. She is unable to generate an adequate cough. CXR reveals patchy basilar densities and cursory PFT’s demonstrate only 50% predicted VC. She is currently being treated with Albuterol and Theophylline. What's your diagnosis?
 
#11 ·
So what is the answer?

:rolleyes::rolleyes::notsure:
A 27 year old female was involved in an automobile accident. As a result of the accident she sustained a cervical frature. She has no significant PMH prior to the accident. She is stable in a halo vest, has a tracheostomy and is tolerating CPAP during the day while being ventilated on SIMV of 8 during the night. Examination has revealed a C5-C6 level of functioning.

The patient prefers to lie in bed with the head elevated to about 30 degrees. She demonstrates a dyscoordinated breathing pattern. Auscultation reveals diminished breath sounds at bilateral bases with faint bilateral upper chest rhonchii. She is unable to generate an adequate cough. CXR reveals patchy basilar densities and cursory PFT's demonstrate only 50% predicted VC. She is currently being treated with Albuterol and Theophylline. What's your diagnosis?
 
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