S. METABOLIC ACIDOSIS T. METABOLIC ALKALOSIS A. CHRONIC BRONCHITIS B. EMPHYSEMA C. PULMONARY EMBOLUS D. PULMONARY EDEMA E. TUBERCULOSIS F. THIN: SKIN PINK G. OXYGENATED H. FROM BLOWING OFF CO2 I. LUNGS FILLED WITH MUCUS J. DIFFICULTY WITH EXPIRATION K. SKIN BLUE-ISH & PUFFY L. RR 26/MIN; RETRACTIONS PRESENT M. RR 18/MIN; STRIDOR HEARD N. RESPIRATORY ALKALOSIS o. DIFFICULTY WITH INSPIRATION P. RESPIRATORY ACIDOSIS Q. DIFFICULTY BREATHING THROUGH FLUID-FILLED ALVEOLI R. STIFF LUNGS WITH BLEBS Eor questions 13-19, choose one of A-T from box above to answer questions about the scenario below. Don’t re-use a letter. Choose BEST FIT from the choices (a-d) you are given. Ihe scenario: A 50 year old male is evaluated in the emergency room (ER) for a complaint of dyspnea. The dyspnea has become worse over many years but today is especially bad. He reports a history of smoking. His breath sounds are clear but greatly diminished throughout his lungs. ABGS, peak flow test (PF), VQ scan and chest x-ray (CXR) are completed. Results are below. ABGS: pH Z48, PCO2: 30, HCO3: 24, PO2 80, S02 94%. PF: 50 % of predicted norm (ie, “low PF). V/Q scan Q.8 CXR shows hyperinflated aveoli and air trapping. (Remember, you are supposed to know pH range, SO2 range, & RR range) Normal ABG ranges: PO2: 80-100 mmHg PCO2: 35-45 mmHg HCO3: 22-26 mEq/L Putting together all information given, what is the most likely diagnosis on this patient? 13. D a. b. B C c. d. A Using the “patient picture” scenario & correct answer from # 13, what is the expected breathing rate & pattern of this patient? 14 L a b. M C. d. What do you expect his general appearance to be like? 15. a. b. C. K d. The low PF in this scenario indicates 16. Q a. b M C C. d. o d 17 What acid base imbalance does this patient have? a. b. T N C. d. P 18. The acid/base imbalance above is part of a compensatory response to keep the body F a. b. G H C. d. K If you could look at this patient’s lungs directly, you would expect to 19. see D a. b. E C. d.

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