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Author17 Posts
  #1

An obese 40-year-old woman undergoes a laparoscopic cholecystectomy. In the recovery room, she is found to be hypotensive and tachycardic. Her arterial blood gases reveal a pH of 7.29, PaO2 of 60 mm Hg, and PaCO2 of 54 mm Hg. Which of the following is the most likely cause of this patient's problem?

A. Acute pulmonary embolism
B. Carbon dioxide (CO2) absorption from induced pneumoperitoneum
C. Alveolar hypoventilation
D. Pulmonary edema
E. Atelectasis from high diaphragm


  #2

C


  #3

C

are u at work right now, MZA?grin


  #4

why did u ask this? smiling face


  #5

i read the question again and could not help me laughing grin actualy its my sleeping time after the whole day of studying just checking my residual capacity grin that is pathetic grin grin so i should not check it any more and go to sleep


  #6

D??


  #7

ARDS right after the surgery? so it's C


  #8

avir.. when are u planning? u got yahoo msgr?


  #9

c seems right.. but can "b" really happen?


  #10

What is the answer?


  #11

@proven.......done with CK in March, now just killing my time

about hypoventilation vs atelectasis: always remember that the atelectasis patient hyperventilates

EXPLANATION: Because of the ease with which CO2 diffuses across the alveolar membranes, PaCO2 is a highly reliable indicator of alveolar ventilation. In this postoperative patient with respiratory acidosis and hypoxemia, the hypercarbia is diagnostic of alveolar hypoventilation.

Acute hypoxemia can occur with pulmonary embolism, pulmonary edema, and significant atelectasis, but in all those situations the PaCO2 should be normal or reduced, as the patient hyperventilates to improve oxygenation.

The absorption of gas from the peritoneal cavity may transiently affect the PaCO2, but should have no effect on oxygenation.


  #12

answer is C


  #13

One more question? How does hypotension relate to alveolar hypoventilation? Does the source give any explanation on that? Thanks for sharing.


  #14

yea.. and why do they have hypotension in flail chest? they dont have internal bleed with flail chest right?

some more QUESTIONS:

1> wat investigations do you do to confirm diverticulitis?

2> why would repair of neural tube defect lead to increased ICP?

3> Rx of Marijuana Intoxication?

4> Complication of drowning for few mins

5> 38 wks gestation, normal pregnancy comes to u, do you induce labor or wait for spontaneous start of contractions?


  #15

Proven wrote:
yea.. and why do they have hypotension in flail chest? they dont have internal bleed with flail chest right?

some more QUESTIONS:

1> wat investigations do you do to confirm diverticulitis?

CT scan, never endoscopies cuz of risk of perforation

2> why would repair of neural tube defect lead to increased ICP?
give us more details....


3> Rx of Marijuana Intoxication?
lots of Coca Cola?? smiling face


4> Complication of drowning for few mins
Aspiration pneumonia?


5> 38 wks gestation, normal pregnancy comes to u, do you induce labor or wait for spontaneous start of contractions?
I'd wait until 40 weeks if the fetus os stable, no oligoamniosis, mother is stable
Then I would induce pharmacologically, no C-section if not indicated





  #16

thanks for ur input crazyserb>

1> would u do xray before ct if there is strong clinical suspicion?

A 6-month-old girl is brought to the physician for a routine health maintenance examination. She was born with a lumbosacral myelomeningocele which was successfully repaired at 2 days of age. The anterior fontanelle is 6 x 8 cm and bulging, and the posterior fontanelle is 3 x 4 cm and bulging. She has severe motor and sensory deficits involving both lower extremities. A head growth chart shows the following values:
Age
Head circumference (cm)
Birth
34.2
1 month
36.6
2 months
38
4 months
44
6 months
47

Which of the following is the most likely cause of increased intracranial pressure?

A ) Acute cerebral edema
B ) Decreased absorption of cerebrospinal fluid
C ) Dilation of cerebral arteries
D ) Intracranial mass lesion
E ) Obstruction of lateral sinus
F ) Obstruction of superior vena cava
G ) Obstruction of cerebrospinal fluid flow
H ) Overproduction of cerebrospinal fluid


3> coca cola seems right smiling face


  #17

She has associated Danny walker syndrome that is what is causing her problems






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