MRCP UK EXAMINATIONS

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RESPIRATORY

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
years old male patient because of shortness of breath and coughing a lot. 3 days ago, the patient had a low fever, the cough gradually increased, the next day the patient found it more difficult to breathe, coughed more sputum, yellow sputum was difficult to spit out, and using ventolin spray only felt a little better. History of COPD for 5 years, NV 4 times in the past 1 year, being treated with Salbutamol 100mcg spray 2 times when breathing difficulty, theophyllin 0.3mg orally to 1 tablet. 9 years hypertension on enalapril treatment. Examination:Patient is awake, pulse 90l/min, SpO2 89% in air, lung rale and snoring scattered in 2 lung fields. CTM:Hb 13g/dl, Hct 35%, WBC 16.5k/mm3, NEU 87%, PLT 300k/mm3. Blood pressure PaO2:52mmHg, PaCO2 60mmHg, blood pH 7.35. The most appropriate diagnosis in this patient
A
Moderate COPD exacerbation
B
Severe COPD exacerbations
C
no respiratory failure
D
life-threatening acute respiratory failure
E
non-life threatening acute respiratory failure
Explanation: 

Detailed explanation-1: -If you are short of breath with a cough and/or fever, you may have a chest infection or pneumonia. Less common causes of breathing problems are lung cancer, a blood clot in the lungs, air leakage around the lungs and scarring of the lung tissue.

Detailed explanation-2: -Most cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.

Detailed explanation-3: -Early symptoms are similar to influenza symptoms: fever, a dry cough, headache, muscle pain, and weakness. Within a day or two, the symptoms typically get worse, with increasing cough, shortness of breath and muscle pain. There may be a high fever and there may be blueness of the lips.

Detailed explanation-4: -A common but under-recognized cause of a chronic cough in adults is pertussis, also known as whooping cough. Chronic cough can also occur with fungal infections of the lung, tuberculosis (TB) infection or lung infection with nontuberculous mycobacterial organisms. Chronic obstructive pulmonary disease (COPD).

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