Case-3: Patient History S.S. is a 37-year-old man in the clinic today for worsen
ID: 88845 • Letter: C
Question
Case-3: Patient History S.S. is a 37-year-old man in the clinic today for worsening shortness of breath. He first noticed decreasing activity tolerance at age 28, at which time an x-ray revealed some hyperinflation consistent with mild emphysema. He had been smoking one pack of cigarettes per day since age 15 and quit at age 28. However, his shortness of breath has continued to progress. Physical examination reveals a thin man in moderate respiratory distress. There is marked increase in the anteroposterior diameter, distant lung sounds, and occasional expiratory wheeze. Blood gases on room air are as follows: pH 7.42, PaCO2 40, PaO2 71, HCO3- 26. Pulmonary function test results are as follows: Predicted Normal Pre-Bronchodilator (Percentage of Predicted) Post-Bronchodilator (Percentage of Predicted) FEV1 3.8 L 16 18 FVC 4.8 L 29 35 FEV1/FVC >70% 44 40 TLC 7 L 130 130 Analyze this case study and answer the next two questions that follow.
What other treatment options could be offered? (select all that apply)
Considering his ABGs and PFT results, how would you categorize S.S.’s lung pathology, and what data indicate this?
Supportive therapy includes adequate rest, proper hydration, and physical reconditioning programs.Explanation / Answer
What other treatment options could be offered? (select all that apply)
Explanation- In the case of Emphysema, the muscles that help you breathe have to work harder which also tired out sooner. Shortness of breath is felt after the slightest activity. This is the cause of changes in lungs which occur over a period of years due to lung damage. Most often it is caused by smoking. In addition to shortness of breath other symptoms observed are wheezing, don't go away cough and chest tightness or pain. Quiting smoking helps in slowing down the lungs damage process.
Supportive therapy increases the quality of life of the patient and decreases the pain.
People with emphysema, COPD have a higher risk of developing influenza or flu asthey have sensitive airways. So, it is advised to have pneumococcal and yearly flu vaccines.
1-Antitrypsin replacement therapy slows the progression of lung disease but it is very costly.
Pursed-lip breathing or abdominal breathing exercises may also be beneficial by improving exchange of oxygen and carbon dioxide. The diaphragm which is a vital muscle of breathing doesn't work well with COPD patients. It helps to train the diaphragm to take over so as to ease the difficulties of daily activities.
Considering his ABGs and PFT results, how would you categorize S.S.’s lung pathology, and what data indicate this?
Explanation- ABGs appear relatively normal.The test results could be related to moderate air flow obstruction as FEV1/FVC ratio is > 70%.
Supportive therapy includes adequate rest, proper hydration, and physical reconditioning programs. Pneumococcal and yearly flu vaccines are recommended 1-Antitrypsin replacement therapy is an expensive option with minimal benefit at his stage of disease. Pursed-lip breathing or abdominal breathing exercises may also be beneficial.