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nbme3 qs.......................... - perception
#1
2.) A 67 yr. old man with a hx of COPD is brought to the ER by his family. he is in mild respiratory distress with respirations 32/min and some accessory muscle use. On P/E he is alert and afebrile. Chest exam is significant for B/L lower lobe wheezing, loud upper airway sounds, and cough productive of thick, yellow sputm. In addition to administration of antibiotics, Which of the following is the most appropriate Tx at this time?

A. Immediate Intubation and mechanical ventilation
B. Initiation of bi-level positive airway pressure (BiPAP) ventilation and admission to medical ICU
C. Serial inhaled albuterol Tx
D. Serial inhaled salmeterol Tx
E. Suppliemental Oxygen via 40 % venture mask

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#2
is it c or e thanks
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#3
i would say E.
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#4
I think I chose B but now it could be C
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#5
I would go for CCCCCCCC
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#6
i thought in all emergencies the answer was always ABCDE. so start with O2 then Alubtarol and if his gases aren't good or he is tiring then Intubate.
I hate this exam!!!! in real life he would have multiple things done at the same time! i.e. O2 AND albutarol!
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#7
I agree ellyk!
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#8
thank you all. any one else?? thanks
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#9
ok so i got feedback and i was wrong!! So i choose C now!!
drpepper4u- you were right my friend ;-)
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