MRCP UK EXAMINATIONS

RESPIRATORY

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
A 79-year-old COPD male patient was admitted to the hospital due to asthma. The room air blood gas is as follows:pH:7.52, PaCO2:45 mm Hg, PaO2:50 mm Hg, HCO3-:36 mEq/L. Which of the following is the most appropriate treatment?
A
CPAP FiO2:24%
B
Nasal cannula 5L/min
C
28% air entrainment mask
D
Simple mask 8L/min
Explanation: 

Detailed explanation-1: -Most experts accept the PaO2 value of 60 as the baseline value we want to maintain. If COPD is causing a PaO2 of less than 60, supplemental oxygen is indicated. Usually, with COPD, all that is needed is a low flow of 2-3 LPM. This is usually all that is needed to maintain a PaO2 of 60 or better.

Detailed explanation-2: -Persons with COPD are typically separated into one of two catagories: “pink puffers” (normal PaCO2, PaO2 > 60 mmHg) or “blue bloaters” (PaCO2 > 45 mmHg, PaO2 < 60 mmHg). Pink puffershave severe emphysema, and characteristically are thin and free of signs of right heart failure.

Detailed explanation-3: -Normal values are between 7.38 and 7.42. The acidity or alkalinity of the blood is linked with the amount of carbon dioxide in the blood. Acidic blood (pH less than 7.38) has high carbon dioxide levels in the blood. Alkaline blood (pH greater than 7.42) has low carbon dioxide levels in the blood.

Detailed explanation-4: -Normal Results Partial pressure of oxygen (PaO2): 75 to 100 millimeters of mercury (mm Hg), or 10.5 to 13.5 kilopascal (kPa) Partial pressure of carbon dioxide (PaCO2): 38 to 42 mm Hg (5.1 to 5.6 kPa)

There is 1 question to complete.