Ms. Queen is a 45 year old female patient admitted with fungal pneumonia. She weighs 65 kg, is otherwise healthy and is alert and oriented, but anxious. Her HR is 124 bpm. CXR reveals “diffuse, bilateral infiltrates without cavitation” unresolved after 4 days of treatment. Her ABGs reveal: pH 7.33, PaCO2 49 mmHg, PaO2 78 mmHg, HCO3 23 mEq/L on 0.35 AEM. Her RR = 32 bpm. She is diaphoretic with accessory muscle use and bilateral inspiratory crackles. Which of the following would you recommend?

BONUS: What radiographic technique has the ability to better define the specific parenchymal characteristics associated with specific types of interstitial lung disease?

Justin Time, a home-bound 54 year-old trached patient has developed a gram negative pneumonia. His sputum is green in color and has a “sweet” smell. The most likely causative organism of his pneumonia is:

Hypercapnic (Type II) respiratory failure is a synonym for which one of the following terms?

Chest assessment findings in a patient with ILD would most likely include:I.   pleural friction rub.II.   increased vocal fremitus.III.   vesicular breath sounds.IV.   hyperresonant percussion note.

Predisposing factors of pulmonary emboli include:I.   varicose veins.II.   smoking.III.   obesity.IV.   congestive heart failure.

An 18 year old male has been recently diagnosed with Goodpasture’s Syndrome. His long-term prognosis is:

In a patient with coal worker’s pneumoconiosis or silicosis, the diffusing capacity (DLCO) would be:

BONUS: Which of the following techniques are utilized in the management of patients on mechanical ventilators who are diagnosed with ARDS?I. tidal volumes from 10-15 ml/kg IBWII. PEEP levels to maintain adequate oxygenationIII. Keep Pplat pressures > 35 cmH2OIV. use tidal volumes from 5-7 ml/kg IBW

The following pathophysiological changes occur in the acute inflammatory early stage of pneumoconiosis: I. edema II. increase in airway secretions III. fibrotic changes IV. granuloma and cavity formation