What is the leading risk factor for the development of COPD?
a. Air pollution
b. Alpha1-antitrypsin deficiency
c. Cigarette smoking
d. Secondhand smoke
ANS: C
Although many risk factors exist for COPD (Box 25-1), the two most common are cigarette smoking (which has been estimated to account for 80% to 90% of all COPD-related deaths) and alpha1-antitrypsin deficiency.
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Apply a towel over a hot pack to keep heat from ________
Fill in the blank(s) with the appropriate word(s).
Which of the following techniques can help to decrease a patient's imposed work of breathing during weaning from ventilatory support?
1. Use of pressure-supported ventilation (PSV) 2. Trigger breath by flow, not pressure 3. Application of small amounts of continuous positive airway pressure (CPAP) or positive end expiratory pressure (PEEP) 4. Use of automatic tube compensation (ATC) a. 2 and 4 only b. 1, 2, and 3 only c. 3 and 4 only d. 1, 2, 3, and 4
Thomas is a 58-year-old male with ASHD, DM type 2, HTN, and GERD who presents with c/o rectal bleeding. He states, "There was blood in the toilet after I had a bowel movement." He admits he was straining a lot to pass the stool
PMH: As noted, the patient has ASHD, DM type 2, which is well controlled with metformin and Byetta, HTN—controlled by Norvasc. He also takes omeprazole, Simvistatin, and Neurontin for diabetic neuropathy. He reports the ASHD is "stable at this time, according to my cardiologist." Temp: 99 Pulse: 76 BP: 130/74 Blood sugar: 110 Physical Exam: ENT—PERRLA, no PND Neck: WNL—no lymphadenopathy Cardiovascular—RRR, no JVD, no carotid bruits Lungs—normal breath sounds; no rales or crackles Abdomen —normal bowel sounds Digital Rectal Exam—stool on glove was brown. No evidence of blood. Hemorrhoids were noted. Fecal occult blood test was negative. EKG—WNL CBC—both H&H are within normal limits I discussed my findings with the patient. Since the fecal occult blood test was negative, and the EKG and H&H are normal, I do not think he is bleeding internally. He has both internal and external hemorrhoids. What I believe happened is that one of the hemorrhoids "popped" as he was straining to defecate. I am discharging him home with instructions to return to the ED should he experience any additional rectal bleeding, or if he notes any blood in his stool. Otherwise, I would like him to follow up with Dr. Jason Kittridge at our GI clinic within the next week. Impression: ASHD, Hemorrhoids, DM with neuropathy, GERD What will be an ideal response?
Ingestion of excessive calories that are metabolized, converted, and stored as fat result in a condition known as ________
Fill in the blank(s) with correct word