08-04-2006, 10:43 AM
8. A 57-year-old woman comes in November for an annual health maintenance examination. She has chronic bronchitis treated twice daily with a p_-adrenergic agonist. Since her last visit 1 year ago, she has not had any 2 changes in daily cough, sputum production, or exercise tolerance. She has had a 2.3-kg (5-lb) weight loss due to decreased appetite since her last examination. She currently weighs 54 kg (120 lb) and is 157 cm (62 in)
tall; BMI is 22 kg/m2. Her blood pressure is 130/80 mm Hg, pulse is 96/min, and respirations are 20/min. Examination shows a barrel-shaped chest. Breath sounds are decreased throughout all lung fields; scant rhonchi are heard at both lung bases. Pulse oximetry on room air shows an oxygen saturation of 92%. An x-ray film of the chest shows hyperinflation of the lungs, unchanged from 1 year ago. Pulmonary function tests show severe obstruction and are also unchanged from her last examination. Which of the following is the most appropriate recommendation for this patient?
A) Measurement of daily caloric intake
B) PPD skin testing
C) Sputum culture
D) Pulmonary rehabilitation program
E) Influenza virus vaccine
tall; BMI is 22 kg/m2. Her blood pressure is 130/80 mm Hg, pulse is 96/min, and respirations are 20/min. Examination shows a barrel-shaped chest. Breath sounds are decreased throughout all lung fields; scant rhonchi are heard at both lung bases. Pulse oximetry on room air shows an oxygen saturation of 92%. An x-ray film of the chest shows hyperinflation of the lungs, unchanged from 1 year ago. Pulmonary function tests show severe obstruction and are also unchanged from her last examination. Which of the following is the most appropriate recommendation for this patient?
A) Measurement of daily caloric intake
B) PPD skin testing
C) Sputum culture
D) Pulmonary rehabilitation program
E) Influenza virus vaccine