Part 1: Mr. C's actual PAO2 (The alveolar oxygen pressure (PAO2) was 109.73 mmHg Part 2: His actual (A-a) gradient was 65.73 mmHg. (Say normal range considered in this case is 19) Part 3: His actual dead space to tidal volume ratio (Vd/Vt) was 0.77. (Say normal range is 30-40%) What is clinically happening to the patient?
Mr. C is a 60-year-old male who lives in his 1994 Toyota Corolla. He earns money by collecting aluminum cans along the roadside and from trash dumpsters. He states that he has been coughing up about ¼ cup of white sputum each morning for the past 20 years. About 1 week ago, he noticed a sudden onset of shaking chills, fever, sweating, malaise, chest pain, and shortness of breath at rest. He also began coughing up rust-colored sputum that was thicker than his normal sputum production. Mt. C admits to current consumption of two packs per day of cigarettes (ie 70 pack-year smoking history). He admits to occasional alcohol use but denies having orthopnea, ankle edema, nausea, vomiting, diarrhea, weight loss, dysuria, wheezing, or hemoptysis.
Mr. C's arterial blood gas analysis indicates partially compensated respiratory alkalosis with severe hypoxemia with a base excess of negative 2
Part 1: Mr. C's actual PAO2 (The alveolar oxygen pressure (PAO2) was 109.73 mmHg
Part 2: His actual (A-a) gradient was 65.73 mmHg. (Say normal range considered in this case is 19)
Part 3: His actual dead space to tidal volume ratio (Vd/Vt) was 0.77. (Say normal range is 30-40%)
What is clinically happening to the patient?
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