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Short Answer Questions for ED Fellowship Study

Case: COPD exacerbation

A 75-year-old man presents with severe shortness of breath due to an infective exacerbation of COPD. You are considering NIV as part of his management.

1. List four absolute contraindications to NIV for COPD in the Emergency Department. 4 marks

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After 1 hour of BiPAP an ABG is performed: FiO2 0.5 pH 7.26 pCO2 86 pO2 52 HCO3 38 BE 7.1 You note that this result is very similar to the ABG taken on arrival.

2. List the pathological processes evident on the arterial blood gas after one hour of BiPAP, giving supportive evidence. 4 marks

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3. List and justify the changes you would make to his NIV parameters based on the ABG. 2 marks

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4. What are the evidence-based benefits of BiPAP for treatment of COPD? 2 marks

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This case forms part of a collaborative marking project designed to support fellowship preparation. In the week leading up to each tutorial, you can contribute answers to any active case. If you contribute, your answers may be reviewed, marked, and used to refine the model answers during the weekly fellowship teaching sessions.

All responses are displayed anonymously or using anonymised avatars. You remain in full control of your answers and may withdraw them at any time.

Your personal results and updated model answers become available the day after the tutorial.

After the tutorial you can still do the case and self-mark your answers, but your answers will not be included in the group review.