05-14-2009, 07:34 PM
4. A 13-year-old girl is brought to the emergency
department because
of shortness of breath for 2 hours. The symptoms
began after consuming
chili, cornbread, and fruit salad with strawberries,
kiwi, and bananas.
She has a 1-year history of shortness of breath while
playing soccer or
baseball and uses a bronchodilator inhaler as needed
while exercising.
She is allergic to penicillin and pineapples. Her
blood pressure is
80/60 mm Hg, pulse is 120/min and regular, and
respirations are 20/min
with use of accessory muscles. Examination of the
lungs shows poor air
entry bilaterally with diffuse expiratory wheezes.
Which of the
following is the most appropriate initial
pharmacotherapy?
A
) Inhaled bronchodilators
B
) Inhaled cromolyn sodium
C
) Inhaled ipratropium bromide
D
) Intravenous corticosteroids
E
) Subcutaneous epinephrine
5..A 52-year-old woman comes to the emergency department
6 days after knee
arthroplasty because of constant, right-sided chest
pain and shortness
of breath for 24 hours. Her blood pressure is 110/50
mm Hg, pulse is
114/min, and respirations are 24/min. Examination of
the heart, lungs,
and extremities shows no abnormalities. Arterial
blood gas analysis on
room air shows:
pH 7.49
PCO2 29 mm Hg
PO2 66 mm Hg
Ventilation-perfusion lung scans show a low
probability for pulmonary
embolus. An ECG shows sinus tachycardia; an x-ray
film of the chest
shows no abnormalities. After the evaluation, the
patient is pain-free
and wishes to go home. Which of the following is the
most appropriate
next step in management?
A
) Discharge home and reexamination in 2 weeks
B
) Exercise stress test
C
) Pulmonary function tests
D
) Echocardiography
E
) Pulmonary angiography
F
) Ibuprofen therapy
department because
of shortness of breath for 2 hours. The symptoms
began after consuming
chili, cornbread, and fruit salad with strawberries,
kiwi, and bananas.
She has a 1-year history of shortness of breath while
playing soccer or
baseball and uses a bronchodilator inhaler as needed
while exercising.
She is allergic to penicillin and pineapples. Her
blood pressure is
80/60 mm Hg, pulse is 120/min and regular, and
respirations are 20/min
with use of accessory muscles. Examination of the
lungs shows poor air
entry bilaterally with diffuse expiratory wheezes.
Which of the
following is the most appropriate initial
pharmacotherapy?
A
) Inhaled bronchodilators
B
) Inhaled cromolyn sodium
C
) Inhaled ipratropium bromide
D
) Intravenous corticosteroids
E
) Subcutaneous epinephrine
5..A 52-year-old woman comes to the emergency department
6 days after knee
arthroplasty because of constant, right-sided chest
pain and shortness
of breath for 24 hours. Her blood pressure is 110/50
mm Hg, pulse is
114/min, and respirations are 24/min. Examination of
the heart, lungs,
and extremities shows no abnormalities. Arterial
blood gas analysis on
room air shows:
pH 7.49
PCO2 29 mm Hg
PO2 66 mm Hg
Ventilation-perfusion lung scans show a low
probability for pulmonary
embolus. An ECG shows sinus tachycardia; an x-ray
film of the chest
shows no abnormalities. After the evaluation, the
patient is pain-free
and wishes to go home. Which of the following is the
most appropriate
next step in management?
A
) Discharge home and reexamination in 2 weeks
B
) Exercise stress test
C
) Pulmonary function tests
D
) Echocardiography
E
) Pulmonary angiography
F
) Ibuprofen therapy