Bernie Sullivan is a 73-year old retired seamstress who has never married. She w

Question

Bernie Sullivan is a 73-year old retired seamstress who has never married. She worked in the alterations department of a men's clothier for 48 years. Bernie is a chain smoker. On the job, she was never found without a cigarette hanging from her lips. When her employer announced that smoking was no longer allowed in the store, Bernie retired. Since her retirement three years ago, Bernie has not been feeling well. She fatigues easily, even with light exertion. She has shortness of breath and recently has begun to sleep on two pillows. However, despite these problems, she has refused to stop smoking. Ms. Sullivan made an appointment with her physician, who noted a prolonged expiratory phase in her breathing, expiratory wheezes, and increased anteroposterior (AP) chest diameter. Her nail beds were cyanotic, and she had moderate pitting edema at her ankles. Based on these observations and results of laboratory and pulmonary tests, the physician concluded that Ms. Sullivan has a combination of emphysema and bronchitis, called COPD, which resulted from her long history of smoking. The results of pulmonary function and laboratory tests are given below. Vital Capacit Residual Volume Functional Residual Capacit FEVi; Expiratory Flow RateDe Decreased Increased Increased Decreased 14.5 g/dL (normal is 12-15 85% 45 mm H 70 mm H 34 mEq/L (normal is 24 mEa/L g/dL Hemoglobin O2 saturation Arterial Po2 Arterial Pco bicarbonate

Explanation / Answer

           Alveolar gas equation:

            Equation-1:

PaCo2= K X V'CO2 / V'A

Where, V'CO2 is the CO2 production in the body.

   V'A is alveolar ventilation.

   Factor k (0.863) is constant.

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