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A 67-year-old woman presents for an upper endoscop - resi_hopeful
#1
A 67-year-old woman presents for an upper endoscopy scheduled to monitor known Barrett's esophagus. Her medical history is significant for hypertension, reflux disease, and temporal arteritis diagnosed 2 months earlier. Medications include lisinopril 10 mg daily, omeprazole 40 mg daily, prednisone 60 mg daily, and dapsone 100 mg daily. She is given midazolam and fentanyl to induce conscious sedation. A pulse oximeter is placed and reads 85% on room air. The patient is sedated but easily arousable. Her blood pressure is 126/68 mm Hg, pulse is 72/min, and respiratory rate is 14/min. An arterial blood gas analysis obtained before the initiation of supplemental oxygen shows a partial arterial oxygen pressure (PaO2) of 95 mm Hg. The patient is given 6 L of oxygen by nasal cannula without improvement in pulse oximetry.
What condition best explains these findings?

A.Acute respiratory distress syndrome
B.Anaphylaxis
C.Methemoglobinemia
D.Narcotic overdose
E.Spontaneous pneumothorax
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#2
CC
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#3
yes Pa02 normal
saturation dec

is always methemoglobin
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