Answer Happy

Part III-Scanners John held his wife's hand. The hip replacement surgery had worried her, but at least she understood what was going on. Tests using computers and X-rays were something else because she did not understand them. He smiled as he remembered how she would spend hours on the Internet doing research before surgery. "I didn't know that they could do another X-ray so soon after the ones I had for the surgery, but the technician said that it was necessary to rule out a lot of possibilities. Did you go on the Internet, as I asked you? What did you find out about the V/Q scan I had?" Barbara asked John. "The Internet is a wonderful, thing, Barb. I think I may be your first convert," said John as a fumbled in his pocket. He put on his glasses and read his notes on the folder paper. "Did they get you to inhale a powder and take pictures, and then take more pictures after they injected something into your vein?" asked John. "Yes. The technician said that they were radioactive tracers, but the radiation was at such low levels that it was not dangerous." "Well, that sounds right. This ventilation quantification scan, or V/Q scan as you called it, allows them to see air flow and blood flow through your lungs," said John. "It is used to rule out a pulmonary embolism." 11. What is a V/Q scan? Why is Barbara worried about x-rays and radiation? 12. What is a pulmonary embolism? (look this up if you need to)
13. John flipped the page and found an image of the VQ scan, but he couldn't make sense out of it. Ventilation shows where air flows in the lungs, perfusion shows where blood flows in the lungs. He pulled up an image on google to help him understand the VQ scan. Based on the images below, do you think Barbera has a blood flow problem or an airflow problem. Explain why you think this. VENTILATION PERFUSION Part IV: The Chart "What I don't understand," Barbara continued, "is why they scanned my legs with the CT and then did an ultrasound. I know my legs are swollen, perhaps a little worse than usual, but they always swell up after long car trips." John stood up and walked around the bed. He picked up the chart hanging on the bottom of the bed and glanced at the notes written when his wife was admitted. Test Barbera Normal
Test Heart Rate (b/m) Blood Pressure Arterial PO₂ Arterial PCO₂ Blood Creatine Phosphokinase (CPK) Blood Troponin-I Breathing Rate Barbera 95 90/58 78 49 2.7 nanograms/mL. 1.9 micrograms/L 20, labored. Normal 75 110/65 100 40 3.0 nanograms/mL Less than 3 micrograms/L 12 per minute PO:=oxygen partial pressure (PCO2 = carbon dioxide A troponin test measures the levels of troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T Creatine phosphokinase (CPK) is an enzyme found mainly in the heart, brain, and skeletal muscle. When the total CPK level is very high, it usually means there has been injury or stress to muscle tissue, the heart, or the brain. 11. What vital signs would you look at to determine if Barbera was having a problem with her lungs? 12. What vital signs would you look at to determine if Barbera was having a heart attack? 13. Diagnosis: Choose which of the following diagnoses for Barbara and provide at least two pieces of evidence from the case to support your claim. You can also include evidence that eliminates a choinn
3 Creatine phosphokinase (CPK) is an enzyme found mainly in the heart, brain, and skeletal muscle. When the total CPK level is very high, it usually means there has been injury or stress to muscle tissue, the heart, or the brain. 11. What vital signs would you look at to determine if Barbera was having a problem with her lungs? 12. What vital signs would you look at to determine if Barbera was having a heart attack? 13. Diagnosis: Choose which of the following diagnoses for Barbara and provide at least two pieces of evidence from the case to support your claim. You can also include evidence that eliminates a choice as the likely cause of the symptoms. (Attach page) a) severe allergic reaction to dust or cat b) pulmonary embolism c) cardiac infarction (heart attack)