...vi har ju äntligen fått lite studiemateriel i form av 5 patientfall/10 frågor som är exempel tagna ur tidigare prov (detta är det enda vi fått från sjukgymnastförbunder), samt att vissa som skrivit provet tidigare och på något sätt lyckats få med sig en kopia av frågorna nu tagit mod till sig och skickat ut dessa till oss andra. Vissa frågor är tack och lov enkla men de allra flesta är väldigt svåra och känns knappt ens sjukgymnastikrelaterade. Jag har tyvärr inte alltför stora förhoppningar om att jag kommer klara detta prov kan jag säga... Ett exempel kommer iaf här:
Mrs D is a 62 year-old lady admitted to hospital with a 5 day history of increased
shortness of breath and marked swelling of both legs. She smokes between 25 and 30
cigarettes/day and has done so since she was 16 years old. She had a total hip
replacement 2 years ago. She lives alone in a first floor unit. Mrs D does most of her
own housework.
On admission Mrs D’s arterial blood gases (ABGs) (breathing room air) were:
pH 7.34
PaCO2 60 mmHg
PaO2 51 mmHg
HCO3_ 32 mmol/l
Other observations:
blood pressure (BP) 100/60mmHg
respiratory rate (RR) 26 breaths/min
The physical examination revealed that she was overweight and appeared cyanotic.
Her skin was mottled and her legs were purplish with blanching. Three heart
sounds were audible. Decreased breath sounds throughout both lungs were heard
on auscultation and no added sounds were audible. Her legs had significant pitting
oedema to the mid-calf level.
Chest X-ray findings were consistent with chronic obstructive pulmonary disease
(COPD) with hyperinflation, flattened diaphragm, hyperlucent lung markings, and
prominent pulmonary artery. The heart was enlarged.
Physiotherapy examination revealed that Mrs D was breathless, not productive of
sputum and had reduced exercise tolerance.
9. Which of the following statements about Mrs D’s signs is TRUE?
a) the enlarged heart shown on the chest X-ray is indicative of hypertrophy of
the left ventricle
b) the prominent pulmonary artery shown on the chest X-ray is unlikely to be
associated with cor pulmonale
c) Mrs D may be found to have increased jugular venous pressure
d) cor pulmonale is caused by Mrs D’s ischaemic heart disease
10. In establishing a physiotherapy problem list on admission for Mrs D, which of
the following would NOT be included?
a) her breathing pattern
b) her total hip replacement and its consequences
c) her decreased exercise tolerance
d) her airflow limitation
