Case Study –Fibrothorax Lori was 43 years old when her pulmonaryproblems started. She got extremely ill and was forced to take aweek off of work. During this time her body temperature was 41oCand she experienced severe dyspnea (had to stop for breath afterwalking for 100 yards). She was coughing and producing largeamounts of rust colored sputum. She was diagnosed with lobarpneumonia with pleural empyema. She was treated with antibiotic andthe infection was controlled. After she returned to work she wasstill experiencing moderate dyspnea. To determine the reason forthe lingering symptoms she underwent several pulmonary functiontests. Blood gas measurements and ventilatory function measurementsyielded the following: PaO2 75 mmHg PaCO2 50 mmHg Residual Volume(RV) 2250 ml Forced Vital Capacity (FVC) 2680 ml Force ExpiratoryVolume (FEV1) 2420 ml It was determined that the pleural exudateshad organized into fibrothorax. Her doctor suggested that adecortication surgery might be indicated. She is consulting withher family to decide if she wants to undergo this procedure.

1. What is dyspnea? Why is Lori experiencing this symptom?

2. What is lobar pneumonia? How does it compare to lobular orinterstitial pneumonia?

3. What is pleural empyema? How does it relate to the infectionshe suffered from?

4. Do these blood gas results tell you anything about Lorispulmonary function?

5. Do these ventilatory function measurements tell you anythingabout her disease? Is she suffering from a restrictive or anobstructive disorder?

6. Do you think she should have the surgery? Why?