studyin4ck
Forum Elite
Topics: 45
Posts: 148
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A previously healthy 62-year-old man comes to the physician because of a 2-month history of progressive shortness of breath and a mild nonproductive cough. He does not smoke. He worked in a foundry most of his adult life before retiring 2 years ago. Vital signs are within normal limits. Crackles are heard at both lung Bases with no wheezes. Cardiac examination shows an accentuated P2. The remainder of the examination shows no abnormalities. An x-ray film of the chest shows prominent interstitial markings at the lung bases. Echocardiography shows an ejection fraction of 55%. Pulmonary function testing is most likely to show which of the following?
A) Decreased FEV1:FVC ratio
B) Decreased maximal inspiratory effort
C) Decreased total lung capacity
D) Increased forced vital capacity
E) Normal carbon monoxide diffusion capacity
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| studyin4ck
Forum Elite
Topics: 45
Posts: 148
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i didnt get u fred, what did u say answer is.
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| Venus6
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Fred said the answer is C.
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| studyin4ck
Forum Elite
Topics: 45
Posts: 148
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venus can u explain..is sthis restrictive lung disease. and did u answer the other questions i put up..
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| Venus6
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This one is for you studyin4ck!
Restrictive and Obstructive Lung Disorders:
When the airways of the lungs become narrow or are blocked so that one cannot exhale completely, the disorder is defined as "obstructive." COPD, which includes chronic bronchitis and emphysema, and asthma are considered obstructive lung diseases. Generally these are caused by inflammation in the airways.
When the lungs have lost tissue or the cells stiffen due to invasive environmental factors, the lungs lose their ability to expand on inhalation. They are restricted, and the term "restrictive" is applied to the disease. Lung cancer is a restrictive lung disease as are pulmonary fibrosis, and pneumonia. This eventually impairs the body's ability to transfer oxygen into the bloodstream. Interstitial refers to any restrictive disease of the air sacs around the lung cells.
On CXR for Silicosis you will see;
• Miliary nodules
• Egg shell calcification of lymph nodes
• Progressive massive fibrosis
• Upper lobe distribution of abnormality
PFT;
Restrictive lung diseases are characterized by reduced lung volume, either because of an alteration in lung parenchyma or because of a disease of the pleura, chest wall, or neuromuscular apparatus. In physiological terms, restrictive lung diseases are characterized by reduced total lung capacity (TLC), vital capacity, or resting lung volume. Accompanying characteristics are preserved airflow and normal airway resistance, which are measured as the functional residual capacity (FRC).
Occupational history;
Seek a strict chronological listing of the patient's lifelong employment, including specific duties and known exposures.
Inhaled inorganic dust from substances (eg, silica, asbestos, beryllium, hard metals, cobalt) can cause pneumoconiosis.
Inhaled organic dust may cause hypersensitivity and pneumonitis.
Hope this helps
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| drduck
Forum Guru
Topics: 141
Posts: 964
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C.......
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| Venus6
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drduck wrote:C.......
Duck... where have you been? have you taken the exam yet?
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