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Solving a Medical Mystery: How COVID-19 Silenced Hypoxia

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1.  Which of the following PaO2 and SaO2 physiologic hypoxemia thresholds are INCORRECT?
  1. Mild hypoxemia, 50-60 / 85-90%
  2. Severe hypoxemia, 40-50 / 75-80%
  3. Profound hypoxemia, less than 30 / less than 50%
  4. Moderate hypoxemia, 40-50 / 75-85%
2.  Which of the following are CORRECT concerning the relationship between respiratory drive and dyspnea?
  1. Dyspnea and respiratory drive are mediated solely by inspiratory muscle loads
  2. Dyspnea and respiratory drive are mediated solely by PaO2 and PaCO2
  3. Dyspnea and respiratory drive are processed by different brain structures
  4. Dyspnea and respiratory drive are processed by the same central neural pathways
3.  The term “hypoxic ventilatory decline” describes which of the following?
  1. Sudden, initial increase in minute ventilation to a subsequent decrease in the plateau above the initial baseline
  2. Minute ventilation decline prior to death during profound hypoxemia
  3. Minute ventilation decline in response to O2 therapy
  4. Minute ventilation decline lower than baseline after the initial spike with hypoxemia
4.  Which of the following combination of factors severely increases dyspnea and respiratory drive?
  1. Hypocapnia and mild sedation
  2. Toxic FiO2 and alkalemia
  3. Excessive work of breathing and severe lung inflammation
  4. Paralytics and intravenous midazolam
5.  Which of the following factors likely explains the appearance of “silent hypoxemia”?
  1. Hypoxic ventilatory decline and hypocapnia
  2. Blunted drive from diabetes and old age
  3. Early Type-L ARDS
  4. All of the above

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