The Master Surgeon | Free Multiple Choice Questions (MCQs)

QUESTION NO

181

A 75 years old male presents with 5 day history of cough and shortness of breath. He is a long term smoker and has a history of COPD. On examination, he was wheezy and breathless. His initial oxygen saturation was 86% on air with respiratory rate of 28 per minute. He was started on 4 litres of oxygen/ nebulisers/ antibiotics and steroids. 9.30 hrs Initial ABG result pH 7.34 pO2 7.5 pCO2 5.4 HCO3 24 10.15 hrs ABG on 4 litres oxygen pH7.28 pO2 8.9 pCO2 8.3. 11.30hrs ABG on 35% venturi pH 7.29 pO2 8.2 pCO2 8.9. What is the most appropriate action?

Please select one of the following:

Increase oxygen to 15 litres non rebreathe mask
Start CPAP
Start BiPAP
Intubate and mechanically ventilate
No change to current management

Question By Dr Ley Taing Chan MBBS, BA.