SAQ 1997 – Young adult with severe hypoxia after flood cleanup

A 23-year-old man is brought to your urban district ED after 2 weeks of fever and cough that began after working in flood cleanup on the North Queensland coast.

He has well-controlled asthma and no allergies. A senior registrar has started therapy but calls for your help; the patient is receiving a nebuliser and is alert but intermittently combative.

Initial observations: pulse 130, BP 100/65, cool peripheries, SaO2 73% on 6 L oxygen via nebuliser mask, temperature 38.5 degrees C and BSL 6.9. Auscultation reveals bilateral crackles and minimal wheeze.

The chest x-ray is shown below.

List and justify four potential anti-infective choices based on the likely microbiology.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Anti-infective</th> <th>Justification</th> </tr> </thead> <tbody> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 4

List six non-respiratory causes of ARDS in any patient.

(Marked out of 3.0)

/ 3

State your escalating approach to oxygenation in this patient.

(Marked out of 5.0)

/ 5

Total Score: 0 / 12

Percentage: 0%