Lung cancer

Discussion in 'USMLE STEP 2 CS' started by Heena., May 30, 2008.

  1. Heena.

    Heena. Guest

    A 67-year-old woman has been intubated for 1 week after undergoing a left lobectomy for lung cancer. She has chronic obstructive pulmonary disease. Her preoperative functional vital capacity was 40% of predicted. She is awake and alert. Her blood pressure is 130/75 mm Hg, and pulse is 72/min. The ventilator settings are a synchronized intermittent mandatory ventilation of 8/min, FIO2 of 40%, and positive-end expiratory pressure of 5 cm H2O. Arterial blood gas analysis shows:

    pH 7.42
    PCO2 47 mm Hg
    PO2 90 mm Hg
    O2 saturation 96%

    Which of the following is the most appropriate next step in management?

    A ) Antibiotic therapy

    B ) Bronchodilator therapy

    C ) Chest physiotherapy

    D ) Decrease inotropes

    E ) Diuretic therapy

    F ) Fiberoptic bronchoscopy

    G ) Heparin therapy

    H ) Incentive spirometry

    I ) Increase FIO2

    J ) Increase inotropes

    K ) Increase respiratory rate

    L ) Placement of thoracostomy tube

    M ) Tracheostomy

    N ) Wean from the ventilator

Share This Page