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 BOF 47

 

   

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BOF: 47

A 54-year-old female is admitted with a history of headaches and feeling drowsy. She describes the headaches as affecting the entire head, they are worse in the morning on awakening. The symptoms had been present for about a week and started after she developed an upper respiratory tract infection. She gives a history of breathlessness on exertion for some time .she had no significant medical history and was not on any medication.

On examination she was obese, weight 130 kgs height 1.63 m. Apart from a blood pressure of 150/ 90 there were no other abnormalities detected.

Chest x-ray was normal

Blood gases  (on air) pH 7.4, pO2 10.4 kPa, pCO2 6.6 kPa, bicarbonate 32 mmol/L

In this patient which one of the following is the best management for this patient?

a)      Inhaled bronchodilator

b)      Inhaled bronchodilator and inhaled steroid

c)      Lumbar puncture and drainage of CSF

d)      Oral steroids

e)      Weight reduction

 

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