Question

"You are on-scene with a 60-year-old COPD patient complaining of shortness of breath. During your exam, you note the presence of clubbed fingertips. Which of the following is most likely to cause this finding?

A. Congestive heart failure especially left ventricular failure

B. Long-term hypoxemia

C. Hypocapnia resulting from low carbon-dioxide levels

D. Hemoglobin saturated with red blood cells"

Answer 1

Clubbed fingertips in a COPD patient are likely a result of long-term hypoxemia, which is a common feature in COPD due to reduced gas exchange and alveoli elasticity.

Step-by-step explanation:

In a 60-year-old patient with COPD (Chronic Obstructive Pulmonary Disease) who presents with clubbed fingertips, the most likely cause of this finding is B. Long-term hypoxemia. Clubbing is a physical sign characterized by bulbous enlargement of the ends of one or more fingers or toes and is often associated with chronic low levels of oxygen in the blood.

COPD can lead to such chronic poor airflow that gas exchange is hampered, causing the oxygen levels in the blood to drop and carbon dioxide levels to potentially rise. While congestive heart failure, especially of the left ventricle, and other conditions can also lead to clubbing, long-term hypoxemia is a common feature in patients with COPD due to the nature of the disease, which includes reduced surface area for gas exchange and alveoli reduction in number and elasticity.