Case Questions
Note: While you will work on these in your groups, each student is also responsible for submitting an individual writeup of answers to these questions after class.
1. Th ere is a likelihood that the patient has acquired pneumonia since she exhibited shortness of breath and has
been in contact with family members who had been coughing and were treated for pneumonia. In addition, her
age makes her more susceptible to respiratory infections such as pneumonia. Th e latter is characterized by fever
(a body temperature above 37.2 ºC), coughing, decreased breath sounds, and hyperventilation. Does the patient
have pneumonia? Justify your answer.
2. How does the patient’s blood pH, PO2, PCO2, oxygen saturation levels, and bicarbonate levels compare with
those of a healthy individual?
Reference:
http://www.nlm.nih.gov/medlineplus/ency/article/003855.htm3. Referring to question 7 from your homework, what conclusions can you draw from the results of the patient’s
arterial blood gas analysis? Justify your answer.
4. What was the diagnosis for the patient and what likely caused the condition?
5. Initial arterial blood gas analysis indicated that the patient had a pH of 7.50. By how much is the [H3
O+
] in
defi cit?
6. If the patient has a blood volume of 4.7 L, how much H+
is in defi cit?
7. Why did the patient not respond to oxygen therapy initially?
Hb + O2
HbO2
8. Th e patient had a blood PO2 of 93 mm Hg and PCO2 of 25 mm Hg. What are the molar ratios of O2
and CO2
in
the patient’s blood?
9. Th e patient was treated with a total of 2 mg/kg of methylene blue. If the patient weighs 140 lbs, how much
methylene blue was she treated with?
10. Methylene blue is usually administered intravenously as 1% (m/v) solution. What volume of methylene blue
containing IV solution was administered?
11. Th e intravenous administration of methylene blue was followed by a saline fl ush. What is the reason for the fl ush?
12. Explain the principles underlying the mode of action of methylene blue.
Reference:
http://www.emedicine.com/med/TOPIC1466.HTM13. Why did the patient become responsive to oxygen after the methylene blue treatments?
14. If the patient is a relative of yours, what advice would you give to her (after she is discharged)?
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