Author Question: A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient ... (Read 34 times)

jace · **on:** Jun 25, 2018

A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as:

A. 50 x 2-pack years
B. 100-pack years
C. 50-year, 2-pack history
D. 100 pack history

Question 2

Which of the following ankle-brachial index measurements require a referral to a vascular consultant?

A. ABI 1.2
B. ABI 1
C. ABI 0.9
D. ABI 0.5

macybarnes · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
When recording the smoking history, the measure is calculated by the number of packs per day multiplied by the number of years the patient smoked. In this scenario, the patient smoked 2 packs per day for 66 16 years = 50 years. This is 100-pack years.

Answer to Question 2

ANS: D
The ankle-brachial index (ABI) is currently the easiest, least expensive noninvasive method for diagnosing PAD and is particularly helpful in the office and home settings. The ABI is obtained by the following steps:
1. Obtain brachial systolic pressure in both arms. Select the higher of these two values.
2. Use Doppler stethoscope to obtain systolic pressure in the dorsalis pedis or posterior tibialis vessel.
3. Divide ankle pressure by the higher brachial pressure.
The index should be 1 or higher. If it is less than 0.5, impairment to blood flow is significant. An abnormal ABI indicates the need for a vascular consult.