Quiz: What Do You Know About Respiratory Failure? Trivia Questions

A 73-year-old man with hypertension, coronary artery disease, and diabetes mellitus presents to your office complaining of cough and shortness of breath. He reports that for the past 3 or 4 days, he has been experiencing progressive dyspnea on exertion, and he now has mild dyspnea at rest. He also states that he has been having fevers, chills, and purulent sputum production over this period. He denies having come into contact with anyone who was sick. Results of physical examination are as follows: blood pressure, 124/87 mm Hg; heart rate, 95 beats/min; respiratory rate, 26 breaths/min; temperature, 101.3° F (38.5° C); and oxygen saturation on room air, 88%. The patient exhibits tachypnea without the use of accessory muscles. Bronchial breath sounds are noted over the right lower lung zones consistent with consolidation. A chest radiograph in the office confirms a right lower lobe infiltrate. You plan to admit the patient to the hospital for intravenous antibiotics and further monitoring.   Which of the following is a likely cause of this patient's low oxygen saturation?

A 64-year-old man with moderate chronic obstructive pulmonary disease presents to your office complaining that for the past 5 days, he has been experiencing worsening shortness of breath. He denies having fevers or chills, but he does report increasing purulent sputum production. He visited his 6-year-old grandson this past weekend, and the child had symptoms of an upper respiratory infection. The patient's vital signs are normal except that oxygen saturation on room air is 88%. Examination reveals bilateral expiratory wheezing. A chest radiograph is normal. Results of laboratory testing are as follows: white blood cell count, 12,500/mm3; arterial blood gas pH, 7.35; arterial oxygen tension (PaO2), 65 mm Hg; and carbon dioxide tension (PCO2), 60 mm Hg. You arrange for the hospital admission. Which of the following is the most appropriate step to take next for this patient after he is admitted to the hospital?

An 82-year-old woman is brought to your clinic by her family. They report that the patient has been increasingly confused for the past few days. She is lethargic and barely arousable. The patient has stage IV breast cancer with widespread bony metastases and requires long- and short-acting narcotics for pain control. Her daughter reports that the patient has been taking increasing doses of her long-acting morphine to control the pain. Results of physical examination are as follows: blood pressure, 98/62 mm Hg; heart rate, 63 beats/min; respiratory rate, 8 breaths/min; temperature, 98.2�° F (36.8�° C); and oxygen saturation on room air, 95%. Arterial blood gas measurement reveals an acute respiratory acidosis. Because of the patient's altered mental status and the inability to protect her airway, the patient is admitted to the intensive care unit for mechanical ventilation. Which of the following conditions would place this patient at risk for acute hypercapnic respiratory failure?

A 38-year-old woman with severe asthma presents to your clinic complaining that for the past 2 days, she has been experiencing progressive shortness of breath. She now experiences shortness of breath while at rest. She reports little relief of her symptoms with the use of her albuterol inhaler. She says that she is feeling tired. On examination, the patient's respiratory rate is 18 breaths/min; oxygen saturation on room air is 86%. She has few expiratory wheezes with very little air movement. Results of arterial blood gas measurements are as follows: pH, 7.2; PaO2, 62 mm Hg; and PCO2, 63 mm Hg. On the basis of the arterial blood gas measurements, which of the following best describes this patient's condition?

A 29-year-old woman presents to your office complaining of shortness of breath. She has no medical problems and takes no medications. She reports recently flying home from a trip to Japan. Her vital signs are as follows: blood pressure, 105/70 mm Hg; heart rate, 82 beats/min; respiratory rate, 18 breaths/min; and temperature, 98.6° F (37° C). The results of cardiac and pulmonary examinations are normal. A chest radiograph is unremarkable. Before ordering a spiral CT of the chest, you measure arterial blood gas on room air to evaluate the patient's alveolar-arterial difference in oxygen (A-aDO2). What is the normal value for A-aDO2?