An 85-year-old man with hypertension and type 2 diabetes mellitus is brought to the emergency department because of a 2-day history of shortness of breath. He has smoked one pack of cigarettes daily for 30 years. His temperature is 36.9°C (98.4°F), pulse is 100/min, respirations are 30/min, and blood pressure is 138/75 mm Hg. Pulmonary function testing shows decreased tidal volume and normal lung compliance. Which of the following is the most likely underlying etiology of this patient's tachypnea?
ADiabetic ketoacidosis
BRib fracture
CPulmonary edema
DEmphysema exacerbation
ETension pneumothorax
A 32-year-old woman presents with progressive shortness of breath and a dry cough. She says that her symptoms onset recently after a 12-hour flight. Past medical history is unremarkable. Current medications are oral estrogen/progesterone containing contraceptive pills. Her vital signs include: blood pressure 110/60 mm Hg, pulse 101/min, respiratory rate 22/min, oxygen saturation 88% on room air, and temperature 37.9℃ (100.2℉). Her weight is 94 kg (207.2 lb) and height is 170 cm (5 ft 7 in). On physical examination, she is acrocyanotic. There are significant swelling and warmth over the right calf. There are widespread bilateral rales present. Cardiac auscultation reveals accentuation of the pulmonic component of the second heart sound (P2) and an S3 gallop. Which of the following ventilation/perfusion (V/Q) ratios most likely corresponds to this patient’s condition?
A1.3
B1
C0.8
D0.5
E0.3
A 60-year-old woman presents to the clinic with a 3-month history of shortness of breath that worsens on exertion. She also complains of chronic cough that has lasted for 10 years. Her symptoms are worsened even with light activities like climbing up a flight of stairs. She denies any weight loss, lightheadedness, or fever. Her medical history is significant for hypertension, for which she takes amlodipine daily. She has a 70-pack-year history of cigarette smoking and drinks 3–4 alcoholic beverages per week. Her blood pressure today is 128/84 mm Hg. A chest X-ray shows flattening of the diaphragm bilaterally. Physical examination is notable for coarse wheezing bilaterally. Which of the following is likely to be seen with pulmonary function testing?
ADecreased FEV1: FVC and decreased total lung capacity
BNormal FEV1: FVC and decreased total lung capacity
CIncreased FEV1: FVC and decreased total lung capacity
DDecreased FEV1: FVC and increased total lung capacity
EIncreased FEV1: FVC and normal total lung capacity
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