MRCP UK EXAMINATIONS

RESPIRATORY

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
An 80-year-old male was hospitalized for multiple acute exacerbations of chronic obstructive pulmonary disease. The arterial blood gas analysis showed pH:7.28, PaCO2:65 mm Hg, PaO2:61 mm Hg, HCO3-:24.1 mEq/L, which of the following is wrong?
A
The blood oxygen content should not be too high to avoid the Haldane effect causing the partial pressure of CO2 in the plasma to rise
B
Consider non-invasive positive pressure respirators
C
The inspiratory pressure of the non-invasive positive pressure respirator is adjusted to tidal volume (tidal volume) 4 6 mL/kg
D
If the arterial blood gas analysis PaCO2 is 62 mm Hg after using a non-invasive positive pressure respirator for 1 to 2 hours, the EPAP can be increased to improve the PaCO2 cut-off.
Explanation: 

Detailed explanation-1: -Results In-hospital mortality for patients with an acute exacerbation of COPD was 2.5%. Multivariable analyses identified older age, male sex, higher income, nonroutine admission sources, and more comorbid conditions as independent risk factors for in-hospital mortality.

Detailed explanation-2: -ICD-10 code J44. 1 for Chronic obstructive pulmonary disease with (acute) exacerbation is a medical classification as listed by WHO under the range-Diseases of the respiratory system .

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: -BRONCHODILATORS. Inhaled beta2 agonists should be administered as soon as possible during an acute exacerbation of COPD.

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