Respiratory disease
Case 9: A Patient with Chronic Obstructive Pulmonary Disease and Recent Breathlessness
CASE
A 64‐year‐old woman with known chronic obstructive pulmonary disease (COPD) is breathless for 3 days. She is unable to sleep at night and complains of wheeze. She normally uses a salbutamol inhaler and prior to admission to hospital has had to use this more frequently with diminishing effects. In the last year she has been unable to walk more than 200 m without stopping because of dyspnoea. On examinations she is apyrexial. She talks in short sentences. Respiratory rate is 28 breaths/min and she is using her accessory muscles. There is equal expansion of her chest, but wheeze is audible throughout. Examination is otherwise unremarkable. The staff in the emergency department have applied a 28% Venturi mask and performed an arterial blood gas, with the following results:
pH 7.40 PaO2 12 kPa PaCO2 5 kPa HCO3− 24 mmol/L SaO2 96% Base excess −2 Lactate 1.4 mmol/L
QUESTION 1
Your score this session: 0 of 0
Which of the following is true?