1. Why would a chest x-ray examination reveal an infiltrate in the basilar segme
ID: 35224 • Letter: 1
Question
1. Why would a chest x-ray examination reveal an infiltrate in the basilar segments of the left lower lobe ?
2. A 52-year-old man who has smoked two packs of cigarettes per day for the past 20 years (40 pack years) experiences increased cough productive of copious amounts of yellow-green mucus and increased shortness of breath. Which of the following statements about [Vdot]/[Qdot] is most likely true?
Perfusion to the lung will be increased while ventilation will be normal( Why is this answer true ? )
3. A 30-year-old man presents with infertility due to immotile sperm. This condition affects all ciliated structures within the body.
He is at risk for abnormalities in immune defense in association with changes in mucociliary transport resulting in mucus retention and secondary infection. ( Why is this true ? )
4.A 77-year-old man complains of shortness of breath with activities of daily living. He has smoked one pack of cigarettes per day for the past 55 years (55 pack years). He has a barrel chest and breath sounds are distant, especially over the apices. His FVC, FEV1, and FEV1/FVC are markedly reduced with a significant elevation in the RV/TLC due to a marked increase in RV. His diffusion capacity for carbon monoxide (DLCO) is reduced. What lung disease is most likely?On chest x-ray, what would most likely be found?
Emphysema, A flattened diaphragm with bullae in the apices and few visible lung markings
( Why is this the answer? )
5. A 59-year-old man is admitted to the ICU for shortness of breath caused by an exacerbation of emphysema. He previously smoked two packs of cigarettes per day for 40 years (80 pack years). His respiratory rate is 40breaths/min with accessory muscle use. His physician decides to mechanically ventilate him and temporarily paralyze him with medication. The ventilator is set for 12breaths/min with tidal volume of 1000mL. The ventilator measures airway pressures at the end of each delivered breath (no airflow), giving an airway pressure of 25cm H2O. The ventilator then allows him to passively exhale, and the airway pressure returns to zero (PB). What is the compliance of his respiratory system?40mL/cm H2O ( Why is this the answer?)
A patient is placed on a ventilator set at 12breaths/min with a tidal volume of 1000mL. The ventilator measures airway pressures at the end of each delivered breath (no airflow), giving an airway pressure of 25cm H2O. The ventilator then allows him to passively exhale, and the airway pressure returns to zero (PB). On further examination, the physician notes that the patient has bilateral wheezes when she listens to his chest. His RAW is measured ((Pao
Explanation / Answer
1) chest x-ray examination would reveal infiltrate accumulation in left lower lobe due to presence of infection with mycobacterium tuberculli which multiply within the alveoli causing characteristic lesion formation which has an avascular granuloma filled with giant cells and a peripheral zone of lymphocytes and fibroblasts. also, edema fluid accumulates which shows typical appearance of lower lobe.
2) the man is probably suffering from TB or bronchitis as smoking increases risk by compromising on lung health and immunity or it can be a case of lung cancer since immunity has been compromised due to smoking. V/Q ratio is used to measure the ventilation i.e. air reaching the alveoli and perfusion is the measure of blood reaching the alveoli.
since the person is feeling shortness of breath it can be said that there is increase in perfusion but there is less aeration in the alveoli i.e. V/Q ratio is almost zero which can be said as "shunt" if there is no ventilation.
3) he is suffering from primary ciliary dyskinesia which affects flagella of sperm, and respiratory tract cilia.
there is retention of mucus and secondary infection seen since the respiratory immune system is impaired. usually cilia that line the respiratory tract can beat synchronously to clear off the mucus towards the throat. however, as the cilia do not beat mucus is accumulated within the lungs and is not cleared off. thus, immotile ciliary dysfunction causes sec. infections and can cause bronchitis (lungs), otitis media(in ear).
4)emphysema also called as chronic obstructive pulmonary disease(COPD) is causing shortness of breath. FEV1/FVC ratio helps measure the obstructive and restrictive lung disease. since a reduced FEV1/FVC ratio is since it indicates presence of an obstructive lung diease which is mostly COPD. increased RV/TLC ratio i.e residual volume /total lung capacity ratio also indicates COPD. and other symptoms of COPD include flattening of the diaphragm.
8)asthma can reduce is FEV1/FVC ration to less than one. however RV can be normal or increased in asthma patience.
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.