10th September 2020

A 24-year-old PhD student is brought into the Emergency Department due to severe dyspnoea

A 24-year-old PhD student is brought into the Emergency Department due to severe dyspnoea and tachypnoea that started 2 hours ago. On examination, she looks exhausted, has minimal chest expansion and minimal air entry bilaterally. You can just about hear an intermittent faint wheeze on auscultation. Her friend tells you that she had been ill with the flu for the past 3 days and had been audibly wheezy since last night.

Her basic observations are: T 37.7, Oxygen saturations 87%, RR 10, HR 80, BP 92/60

She is unable to perform a peak flow.

You perform an ABG and the results are: 

• pH – 7.23 (7.35 – 7.45)
• PaO₂ – 7.0 kPa (11 – 13 kPa)
• PaCO₂ – 6.6 kPa (4.7 – 6.0 kPa)
• HCO₃⁻ – 22 mEq/L (22 – 26 mEq/L)

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.