The PTA is seeing a patient with the diagnosis of Degenerati…

The PTA is seeing a patient with the diagnosis of Degenerative Disc disease and a herniated disc at L1-2 with radiating pain to the Right knee. The PT POC calls for TE, TA, pain management, and mobility training . Which of the following would be the best  treatment plan?

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 65-year-old male with a history of COPD and active tobacco…

A 65-year-old male with a history of COPD and active tobacco use with no prior intubations presented to the emergency department with increased work of breathing and increased wheezing. In the emergency department, he was given stacked nebulizers and IV steroids and initiated on BIPAP. His initial blood gas demonstrated pH 7.2/ pCO2 75/ pO2 65. Following intubation, he was placed on volume control ventilation. His initial peak pressure (peak inspiratory pressure ) was 45 cm H2O, and his plateau pressure (Pplat) was 35 cm H2O. He was placed on a respiratory rate of 30, PEEP 15, FiO2 0.40 and his SpO2 was 90%. Two hours after arrival to the ICU, his ventilator starts to alarm for high pressures. His peak pressures have increased to 65 cm H2O, and his plateau pressure has increased to 55 cm H2O. His heart rate increases from 80 beats per minutes to 110, and his blood pressure drops from 110/70 to 80/50 mm Hg. His SpO2 drops to 75%. His examination is notable for continual wheezing and slight deviation of the trachea toward the left.What is the most likely cause for this acute change?

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 65-year-old male with a history of COPD and active tobacco…

A 65-year-old male with a history of COPD and active tobacco use with no prior intubations presented to the emergency department with increased work of breathing and increased wheezing. In the emergency department, he was given stacked nebulizers and IV steroids and initiated on BIPAP. His initial blood gas demonstrated pH 7.2/ pCO2 75/ pO2 65. Following intubation, he was placed on volume control ventilation. His initial peak pressure (peak inspiratory pressure ) was 45 cm H2O, and his plateau pressure (Pplat) was 35 cm H2O. He was placed on a respiratory rate of 30, PEEP 15, FiO2 0.40 and his SpO2 was 90%. Two hours after arrival to the ICU, his ventilator starts to alarm for high pressures. His peak pressures have increased to 65 cm H2O, and his plateau pressure has increased to 55 cm H2O. His heart rate increases from 80 beats per minutes to 110, and his blood pressure drops from 110/70 to 80/50 mm Hg. His SpO2 drops to 75%. His examination is notable for continual wheezing and slight deviation of the trachea toward the left.What is the most likely cause for this acute change?

A 35-year-old male with no significant past medical history…

A 35-year-old male with no significant past medical history presents to the Emergency Department with one day of worsening chest pain. The chest pain was abrupt in onset, is described as “sharp” in nature, and worsens with inspiration. It is primarily centered in the center of his chest but occasionally radiates to the left upper back. He feels that the pain worsens when he lays down. Vital signs are unremarkable including equal bilateral upper extremity blood pressures and radial pulses. On physical examination, he is febrile to 38.2°C. A triphasic “scratching” sound in time with the cardiac cycle is auscultated at the left lower sternal border. Initial laboratory studies show a negative troponin T and mild elevations in white blood cell count and the C-reactive protein. His ECG is shown below: ECG6.jpg Which of the following is the most appropriate next step?