#february2020mccqe1
A 71-year-old man with a long history of poorly controlled hypertension presents to the emergency department with headache and visual changes. His blood pressure is 220/130 mm Hg. Current medications include atenolol, nifedipine, thiazide, and clonidine. An IV sodium nitroprusside drip is started. The patient is then transferred to the intensive care unit, where his blood pressure is 135/75 mm Hg; however, he becomes hypoxemic with room air saturations falling to 80%. Which of the following is the most likely reason for this patient’s hypoxemia?
(A) Elevation of carboxyhemoglobin levels
(B) Elevation of methemoglobin level
(C) Hypoventilation
(D) Loss of hypoxic pulmonary vasoconstriction
(E) Pulmonary embolism
A 71-year-old man with a long history of poorly controlled hypertension presents to the emergency department with headache and visual changes. His blood pressure is 220/130 mm Hg. Current medications include atenolol, nifedipine, thiazide, and clonidine. An IV sodium nitroprusside drip is started. The patient is then transferred to the intensive care unit, where his blood pressure is 135/75 mm Hg; however, he becomes hypoxemic with room air saturations falling to 80%. Which of the following is the most likely reason for this patient’s hypoxemia?
(A) Elevation of carboxyhemoglobin levels
(B) Elevation of methemoglobin level
(C) Hypoventilation
(D) Loss of hypoxic pulmonary vasoconstriction
(E) Pulmonary embolism
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