Acute respiratory distress syndrome Quiz: Ace Your Exams
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A 58-year-old man with a history of chronic alcohol use is admitted to the hospital for management of severe pancreatitis diagnosed three days ago. Despite initial treatment, he has worsening respiratory symptoms. Past medical history is significant for chronic alcohol use and 2 prior episodes of pancreatitis. Temperature is 38.2°C (100.8°F), heart rate is 115/min, respiratory rate is 28/min, blood pressure is 92/60 mmHg, and oxygen saturation is 86% on room air, which improves to 90% with 6 liters of supplemental oxygen via nasal cannula. The patient appears to be in distress and is using accessory muscles to breathe. Physical examination reveals decreased skin turgor, dry mucous membranes, and abdominal tenderness with guarding in the epigastric region and without distension or fluid waves. Chest auscultation reveals bilateral crackles in the lower lung fields. There is no lower extremity edema. Laboratory tests indicate persistent elevation of amylase and lipase. Chest X-ray is shown below. Which of the following can be used to establish the most likely diagnosis in this patient?
Image courtesy of STATdx
Image courtesy of STATdx
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