2
490
7
493
12
483
17
276
22
468
27
500
3
500
8
510
13
479
18
255
23
492
28
496
4
478
9
483
14
488
19
277
24
493
29
488
5
486
10
492
15
491
20
379
25
487
30
489
Questions
1.
Exploring LF’s lung function:
a.
Use the provided spirometry test results in Table 1 to calculate the change in pre- vs
postbronchodilator function for FEV1, FVC, and FEV1/FVC ratio. Present your results
both
as values in litres and as percent-change.
(These values are to be presented in a Table
that does
not
count towards the word count of this question.)
b.
What do the above values tell you about LF’s condition?
c.
Using your knowledge of respiratory physiology, describe
how
use of a bronchodilator
explains the test results observed.
2.
Once LF is stable, you find out he was born prematurely. Prematurity is often associated with
surfactant deficiency. How might a lack of surfactant impact on pulmonary function?
3.
Use the values in Table 3 to graph the following two graphs:
a.
LF’s lung function trajectory over 30 days. Use the figure caption to briefly describe any
trends you observe.
b.
Calculate and graph LF’s ‘weekly average’ PEFR values (
where ‘week’ in this context
means 5 days
). Use the figure caption to briefly describe any trends you observe.
c.
…
then briefly speculate on one plausible explanation for the trends you are observing
(i.e., what is something that might have caused what you are seeing?)
4.
Based on the case values provided, describe the acid-base milieu that LF is experiencing (a) at
the start of his hospital admission and (b) at the end of the 12-h period provided, if different
from the milieu at the start. What methods of compensation would be possible for this milieu
and
how
would these happen? Justify and describe your reasoning by applying your knowledge.
5.
Using the “MDRD” (
Modification of Diet in Renal Disease
) equation for estimating glomerular
filtration, provided below, and the data available in Table 3, calculate LF’s estimated glomerular
filtration rate (eGFR) at admission and 12h after admission.
MDRD GFR Equation (mL/min/1.73 m
2
)
=
175 × (S
cr
)
-1.154
× (Age)
-0.203
× (0.742 if female) × (1.212 if African American)
Based on your calculated values, state whether LF’s function is normal or abnormal?
