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NNL
Awaitin The Unexpected Topics: 779 Posts: 6613 |
A 44-year-old HIV positive man admitted to the hospital for presumed pneumocystis carinii pneumonia. His pulse oxymetery revealed an oxygen saturation of 85%. Hypoxemia that is corrected with O2 therapy includes all of the following, except? a- Large pulmonary arterio-venous malformation. b- Acute pneumonia. c- Pulmonary hemorrhage. d- Pulmonary thromboembolism e- Acute asthma.
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SILVER
| DoWhatYouGotToDo! Topics: 56 Posts: 1289
D ??
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maoudoody
| Forum Junior Topics: 157 Posts: 1823
a- pulmonary shunt
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agnosia
| Forum Newbie Topics: 25 Posts: 241
shunting of course... i hate these kind of questions why dont they just ask directly instead of correlating with a case , no use
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gridlock
| Forum Junior Topics: 13 Posts: 73
ok, maybe i understand a concept incorrectly, i thought that perfusion defects respond to 100% O2 (ie u'll see increase in blood O2..).. while the ventilation defect doesnt lead to increase in O2 secondary to administration of 100% O2 So the only vent defect i could pick from here is: .. i dont know B / E? Asthma sounds too weird.. Acute pneumonia.. a possibility i am confused
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SILVER
| DoWhatYouGotToDo! Topics: 56 Posts: 1289
hmm....you guys are right. i muddled it up and went for D. it should be A. can't be D cuz perfusion defects respond to oxygen therapy. has to be A cuz supplemental oxygen will raise PaO2 slightly but NEVER produce full saturation of hemoglobin. and in fact, the lack of response to supplemental oxygen is diagnostic for pul. shunt.
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icarus
| Forum Junior Topics: 57 Posts: 832
I think the answer is the Asthma ... in pneumonia you dont have a ventiliation problem, rather its a diffusion problem, all the other choices may respond to a high o2 sat, even the shunt (although it might elevate it slightly) this is what i think, waiting for the right answer ... thanks
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icarus
| Forum Junior Topics: 57 Posts: 832
Guys ??? Why is the forum soooo slow ??!??!
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doctorforever
| Forum Junior Topics: 91 Posts: 276
i agree with gridlock! i know that pneumonia is one of causes of ventilation defect but maybe not in acute phase? astma forsure is a ventilation defect ONLY in ventilation defect we can NOT correct hypoxemia by giving 02. why do not u paste the correct answer NNL? Edited by doctorforever on Apr 27, 2010 - 6:33 PM
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