usmle6789
Forum Senior
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Two days after cholecystectomy 42 yr old woman has SOB. 37.5[99.5], 110/70, 103, 24. Abdominal tenderness is present. No other abnormalities found. X-ray shows minimal linear markings in the right lower lobe.ABG on 45% O2
Ph-7.41, pco2--- 40, PO2 --- 52.
Most likely explanation for her hypoxia?
1] ARDS
2] ATELECTASIS
3] CHF
4] Fat embolism syndrome
5] PNEUMONIA
5] PNEUMOTHORAX
My answer is ATELECTASIS.
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| ELM
Forum Guru
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Yeap # 2. Look at her A-a gradient!!!!
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ELM
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| sanz
Forum Elite
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I think this might be ARDS.
She doesnt have a fever to suggest it's post op atelectasia.
She complains of SOB after a maj surgery. She's got respr distress. PaO2/FiO2 ratio is <200.
What do you think?
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| mdwannabe
Forum Guru
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ARDS I think
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| mikyro
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Two days after cholecystectomy 42 yr old woman has SOB. 37.5[99.5], 110/70, 103, 24. Abdominal tenderness is present. No other abnormalities found. X-ray shows minimal linear markings in the right lower lobe.ABG on 45% O2
Ph-7.41, pco2--- 40, PO2 --- 52.
Most likely explanation for her hypoxia?
1] ARDS
2] ATELECTASIS
3] CHF
4] Fat embolism syndrome
5] PNEUMONIA
5] PNEUMOTHORAX
Two days after cholecystectomy :idea:
SOB - dyspnea
37.5[99.5] - fever :idea:
103, 24 - tachycardia, tachypnea
Abdominal tenderness is present :?:
X-ray shows minimal linear markings in the right lower lobe
ABG on 45% O2 -
Ph-7.41, pco2--- 40, PO2 --- 52 - hypoxemia and uncompensated respiratory alkalosis.
That's easy - the MCC of fever 2dys after a surgical procedure is atelectasis :wink: . Nice and easy case. Had a similar case on the real exam  .
Next please .
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| tamriko
Forum Elite
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2. Atelectasis is the right answer. :lol:
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| SA
Forum Elite
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I think the best explanation is that
:arrow: it is the most common presentation of Atelectasis
:arrow: best thing in ABG on 45% O2 is A-a gradient
No other explanation is needed even some will ask me without abg I will go for Atelectasis with this presentation.
Can you explain it further
Ph-7.41, pco2--- 40, PO2 --- 52 - hypoxemia and uncompensated respiratory alkalosis?
I don't understand what you mean by all this if simple things can work as I explained.
Any coment
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| doc_ab
Forum Newbie
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hey,
the right ans is B. atelectasis.
infact this the classic presentation of post-op atelectesis
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| indlaxman
Forum Elite
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ATELECTASIS
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| HKM07
Forum Newbie
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2 is the correct
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