Max, a 50 year old office worker, is brought to the ER by his wife, June. Max co
ID: 3518936 • Letter: M
Question
Max, a 50 year old office worker, is brought to the ER by his wife, June. Max complains of shortness of breath on exertion over the last few months; it has become so severe that he now needs to rest after walking only a short distance. He recently almost fainted in the front yard after he checked the mailbox. Max has been a heavy smoker for 25 years; he has a persistent cough with heavy mucus production. He has had several respiratory infections over the last few months. Max is placed on oxygen. A chest X-ray and the following blood test results were obtained: RBC count: 6.2 million/mm3 Hematocrit: 55 Hb: 18 g/dl MCV: 98 mm3 MCH: 30 pg WBC count: 10,000/mm3 Platelets: 250,000/mm3Arterial blood gases (obtained before oxygen administration): pH: 7.25 Partial pressure carbon dioxide: 48 mm Hg Partial pressure oxygen: 55 mm Hg Bicarbonate: greater than 30mEq/L Chest x-ray: normal heart and expanded lungs with small areas of probable fibrotic changes What could cause Max to suffer from shortness of breath (beyond the simple answer of: "He is a smoker")? What are the probable diagnosis? Explain your answer in detail! Use APA format.
Max, a 50 year old office worker, is brought to the ER by his wife, June. Max complains of shortness of breath on exertion over the last few months; it has become so severe that he now needs to rest after walking only a short distance. He recently almost fainted in the front yard after he checked the mailbox. Max has been a heavy smoker for 25 years; he has a persistent cough with heavy mucus production. He has had several respiratory infections over the last few months. Max, a 50 year old office worker, is brought to the ER by his wife, June. Max complains of shortness of breath on exertion over the last few months; it has become so severe that he now needs to rest after walking only a short distance. He recently almost fainted in the front yard after he checked the mailbox. Max has been a heavy smoker for 25 years; he has a persistent cough with heavy mucus production. He has had several respiratory infections over the last few months. Max is placed on oxygen. A chest X-ray and the following blood test results were obtained: RBC count: 6.2 million/mm3 Hematocrit: 55 Hb: 18 g/dl MCV: 98 mm3 MCH: 30 pg WBC count: 10,000/mm3 Platelets: 250,000/mm3
Arterial blood gases (obtained before oxygen administration): pH: 7.25 Partial pressure carbon dioxide: 48 mm Hg Partial pressure oxygen: 55 mm Hg Bicarbonate: greater than 30mEq/L Chest x-ray: normal heart and expanded lungs with small areas of probable fibrotic changes What could cause Max to suffer from shortness of breath (beyond the simple answer of: "He is a smoker")? What are the probable diagnosis? Explain your answer in detail! Use APA format.
Explanation / Answer
Ans.
The diagnosis is Chronic obstructive pulmonary disease (COPD). As the patient is a heavy smoker for 25 years. Smoking is the primary cause of COPD. The patient has persistent cough with heavy mucus production due to which gaseous exchange is not properly taking place at alveoli which has lead to decreased level of pO2 (55) and increased level of pCO2 (48) in blood due to which there is shortness of breath during physical exertion and which becomes normal at rest, this is one of the symptoms of COPD. Due to decreased oxygen levels(that is why patient is placed on oxygen), the RBC count, Hematocrit, Hb and MCV is somewhat raised. Chest Xray reveals fibrosis in lungs which generally takes place in COPD. Frequent respiratory infections is also one of the major symptoms of COPD. Patient faints sometimes due to less oxygen reaching brain. Blood pH is less than normal and high pCO2 indicates condition of respiratory acidosis. Hence all the above blood test results and symptoms confirms that the patient (Max) is suffering from COPD.