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A 57-Year-Old Man Undergoes Bronchoscopy for a Persistent Cough Productive

question 60

Multiple Choice

A 57-year-old man undergoes bronchoscopy for a persistent cough productive of blood-tinged sputum. He denies chest pain, shortness of breath, wheezing, and weight loss. He is a long-term cigarette smoker. He is allergic to peanuts and shell fish. A physical examination does not reveal any significant abnormalities. He is sedated with fentanyl and midazolam, and a local anesthetic is applied. The bronchoscope is subsequently introduced into the trachea without difficulty. About 10 minutes into the procedure, he is noted to be cyanotic by the medical assistant. The procedure is aborted and supplemental oxygen is administered.
His blood pressure is 112/78 mm Hg, pulse is 115/min, and respiratory rate is 20/min. Pulse oximetry has fallen from 94% pre-procedure to 85% at present. There is central cyanosis. Vesicular breath sounds are heard bilaterally. Myoclonic jerks involving all extremities are apparent. There is no skin rash.
Immediate arterial blood gas analysis shows the following:

Which of the following is the most likely diagnosis?

Definitions:

Degrees of Freedom

The number of independent values or quantities which can be assigned to a statistical distribution, often determining the shape and parameters of the distribution.

Multiple T-tests

Refers to performing several Student's t-tests in a study, each comparing means between two groups under different conditions or variables.

Type I Error

The wrongful rejection of an accurate null hypothesis, also known as a "false positive."

One-way ANOVA

A statistical test used to compare the means of three or more independent groups to see if there is a significant difference between them.