A patient with a history of smoking presents to the emergency with a complaint of breathlessness for the last two days. On examination, he was found to be cyanosed and had bilateral rhonchi. ABG was done, which shows: pH: 7.12 PaCO2: 80 mmHg PaO2: 46 mmHg HCO3-: 29 mEq/L Based on the history, clinical examination and ABG finding, the most likely diagnosis is:
COPD exacerbation
The ABG shows an acute-on-chronic respiratory acidosis (very low pH with markedly elevated PaCO2 and compensatory elevated HCO3-) with hypoxemia, consistent with acute exacerbation of COPD in a smoker with bilateral rhonchi and cyanosis, reflecting CO2 retention from severe airway obstruction.
Similar Questions
A patient with a history of chronic smoking presented with breathlessness for the last one year. On examination, there were bilateral rhonchi in the chest. The Chest X-ray was suggestive of hyper-inflated lung field. Which of the following parameters of the pulmonary function test are consistent with the diagnosis of chronic obstructive pulmonary disease in this case?
1. Decreased FEV1
2. Increased diffusion capacity
3. Increased residual volume
4. Decreased peak expiratory flow rate
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A 70-year-old male, with a history of smoking presents with progressive dyspnea and dry cough. Examination reveals clubbing and fine basal crackles. Spirometry shows low forced vital capacity (FVC) and low diffusion capacity (DLCO). CT Chest shows extensive bilateral reticular shadows and subpleural honeycombing. What is the most likely diagnosis?
A 40-year-old obese bank accountant presents with complaints of excessive daytime sleepiness and fatigue. His spouse reports that he has loud snoring and early morning tiredness. Which of the following statements is/are correct?
1. The patient is most likely suffering from obstructive sleep apnea.
2. The diagnosis requires CT/MRI of the neck.
3. Treatment of choice is Zolpidem.
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Important Questions from COPD
- Kartagener syndrome has the following features EXCEPT:
- Which of the following pulmonary function set is characteristic of COPD?
- Total lung capacity is decreased in which one of the following conditions?
- The most common cause of chronic type II respiratory failure is:
- Which of the following are categorised under obstructive lung disease ?
1. Bronchial asthma
2. Bronchiectasis
3. Bronchiolitis
4. Pulmonary sarcoidosis
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