Mrs. Tom, a 79 year old female presents to the ER with complaints of a persistent productive cough, fatigue, fever and shortness of breath. Mrs. Tom reports that she has had a persistent cough and shortness of breath with activity for several months. She was given a prescription for antibiotics for a presumed infection 4 weeks ago, with only slight improvement in symptoms. Her past medical history includes stroke 6 months ago. She also smokes 20 cigarettes per day. On exam, she has a fever with decreased lung sounds bilaterally to auscultation with the right side slightly more obvious than the left. She is obviously short of breath and presents with 4-word dyspnea. Her vital signs are BP 110/70, HR 99, SP02 94% on 4 L of oxygen via nasal prongs, Temp 38.9.
- Identify the infection of inflammatory response that Mrs. Tom is experiencing? (2)
- Explain the pathology of how smoking affects the innate defense system of the lungs? (5)
- What diagnostic tools could you expect to be used in this case? (xray,CT,laboratory data etc). (2)
- Identify risk factors that Mrs. Tom has that are associated with the diagnosis? (3)
- Internal medicine assesses Mrs. Tom and orders a STAT lactate and arterial blood gasses. Based on the patient’s vital signs above, what would you expect to see in the results of these tests? (5)
Mrs. Tom, a 79 year old female presents to the ER with complaints of a persistent productive cough, fatigue, fever and shortness of breath. Mrs. Tom reports that she has had a persistent cough and shortness of breath with activity for several months. She was given a prescription for antibiotics for a presumed infection 4 weeks ago, with only slight improvement in symptoms. Her past medical history includes stroke 6 months ago. She also smokes 20 cigarettes per day. On exam, she has a fever with decreased lung sounds bilaterally to auscultation with the right side slightly more obvious than the left. She is obviously short of breath and presents with 4-word dyspnea. Her vital signs are BP 110/70, HR 99, SP02 94% on 4 L of oxygen via nasal prongs, Temp 38.9.
- Identify the infection of inflammatory response that Mrs. Tom is experiencing? (2)
- Explain the pathology of how smoking affects the innate defense system of the lungs? (5)
- What diagnostic tools could you expect to be used in this case? (xray,CT,laboratory data etc). (2)
- Identify risk factors that Mrs. Tom has that are associated with the diagnosis? (3)
- Internal medicine assesses Mrs. Tom and orders a STAT lactate and arterial blood gasses. Based on the patient’s vital signs above, what would you expect to see in the results of these tests? (5)
