3 days after - ben

[ArchivalUser]

being Hospitalized for Rx of hip fracture in a fall a 62 y/o becomes acutely short of breath and coughs up small amount of bloodtinged sputum. She appear anxious. Her BP110/70, P110/min, R 24/min. Exam shows no other abnormalities.
ABG analysis on 40% O2 by face mask are
ph 7.40
PCO2 38
Po2 70

V/Q shows mulitple segmental areas of mismatch on the right
What is the most appropriate next step in Mx?

a. Pulmonary angiogram
b. Dopamine
c. heparin
d. Urokinase
e. Intubation

[ArchivalUser]

c))

[ArchivalUser]

e--

[ArchivalUser]

c and d ci coz of recent surg
so e..

[ArchivalUser]

you can still give low molecular weight heparin (enaxoparin)

[ArchivalUser]

yes you can give LMWH Subcut as prohylaxis even but they do not say LMWH but just heparin.

[ArchivalUser]

but in stem there are no indications for intubation and other options quiet fit in
could you please post the answer
thanks

[ArchivalUser]

this is an nbme step 2ck question no answers given and since there is a CI and no CI to intubation we can do it to bring up her O2 levels to relieve her acutely short of breath = current problem