A 64-year-old female presents with a 5-day history of exerti…

A 64-year-old female presents with a 5-day history of exertional dyspnea and orthopnea. Her medical history is significant for SLE and diastolic heart failure. Chest X-ray reveals significant bilateral pleural effusions. The decision is made to perform a thoracentesis.  Which laboratory value would indicate that the effusions are a result of her known diagnosis of SLE?

A 56-year-old male with advanced idiopathic pulmonary fibros…

A 56-year-old male with advanced idiopathic pulmonary fibrosis presents to the ICU in respiratory distress. He is put on high flow nasal cannula with 50 L flow, 80% FiO2. ABG obtained has a pH significant for 7.32, PaO2 of 80 mm Hg, PaCO2 of 20 mm Hg, HCO3 of 30. Given his underlying disease, what is the primary physiological aberration leading to the patient’s hypoxemia?

A 70-year-old male with chronic hypoxic and hypercapnic resp…

A 70-year-old male with chronic hypoxic and hypercapnic respiratory failure secondary to COPD is intubated for COPD exacerbation for the last 3 days. The patient has been on pressure support for 2 hours and the blood gas shows pH 7.35/pCO2 80 mmHg/pO2 60 mmHg/CO2 35 mmol/L. The patient is awake and following commands. His endotracheal secretions are moderate, and his cough reflex is weak. His RSBI is 85. What is the next step?

A 59-year-old male presents with complaints of chest tightne…

A 59-year-old male presents with complaints of chest tightness and shortness of breath. He has a medical history of CAD, hypertension, and hyperlipidemia. Family history is positive for CAD, hypertension, hyperlipidemia, and asthma. His vital signs are: heart rate 110, blood pressure 189/106, respiratory rate 28, and SpO2 96%. On exam the AG-ACNP appreciates bilateral expiratory wheezes, but no rubs, gallops, or murmurs. Capillary refill time is less than 3 seconds. Which medication should be avoided until asthma has been ruled out?