1. Which of the following is not true of mortality in ARDS? A. It has declined significantly over…

1. Which of the following is not true of mortality in ARDS? A. It has declined significantly over the last 15 years B. It is associated with very low PaO2 /FiO2 C. It is associated with high dead space (Vd/Vt) D. It is higher in patients under age 60 E. It is higher in patients with kidney or liver dysfunction 2. A 45-year-old man with morbid obesity (BMI 55) presents to the ED at 6 am with right leg pain, and cellulitis that has kept him awake all night. He is admitted to the ward and his fevers and skin examination are improved with antibiotics during the first 16 hours of hospitalization.

1. Which of the following is not true of mortality in ARDS? A. It has declined significantly over the last 15 years B. It is associated with very low PaO2 /FiO2 C. It is associated with high dead space (Vd/Vt) D. It is higher in patients under age 60 E. It is higher in patients with kidney or liver dysfunction 2. A 45-year-old man with morbid obesity (BMI 55) presents to the ED at 6 am with right leg pain, and cellulitis that has kept him awake all night. He is admitted to the ward and his fevers and skin examination are improved with antibiotics during the first 16 hours of hospitalization. At 2 am you are called to evaluate the patient for ICU admission because of somnolence and hypoxemia (SpO2 falling to high 70s on 2LNC). The rapid response team had difficulty waking the patient and ABG was performed before your arrival in the patients room: 7.29/74/52. Following arterial puncture, the patient woke up and by your arrival he is able to converse but remains sleepy with eyes closed, denying dyspnea, with SpO2 now 92% on 2LNC, and normal work of breathing. Medication history was reviewed and no opiates have been administered. The ward team is requesting ICU transfer because of acute hypercarbic respiratory failure and initiation of BiPAP. You review recent laboratory test results and note that serum bicarbonate has been 38 to 40 over the last 6 months. Which of the following statements is true: A. Obstructive sleep apnea (OSA) must be present B. In this patient the PaCO2 of 74 is likely to be a major cause of somnolence C. Acetazolamide should be administered to increase his drive to breathe D. The prevalence of Obesity Hypoventilation Syndrome (OHS) in patients with BMI 50 is as high as 50% E. Narcan should be administered

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