skip to main content

Chest wall restriction with hypoventilation — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardRespiratory PhysiologyChest wall restriction with hypoventilationSCE Respiratory

A patient with kyphoscoliosis has PaCO2 7.0 kPa, bicarbonate 33 mmol/L, nocturnal transcutaneous CO2 8.4 kPa and morning headaches despite no COPD. Which long-term intervention addresses the mechanism?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Initiate specialist nocturnal non-invasive ventilation

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · B = shown as D · C = shown as E

E is correct. Chest-wall restriction causes chronic alveolar hypoventilation; nocturnal NIV provides ventilatory assistance and treats nocturnal CO2 rise and symptoms. Oxygen alone may worsen CO2 retention without correcting ventilation. CPAP splints an upper airway but does not necessarily provide adequate pressure support. Inhaled COPD therapy does not treat restrictive pump failure, and phlebotomy is not primary treatment of ventilatory failure.

Reference: BTS/ICS acute hypercapnic respiratory failure guideline: https://thorax.bmj.com/content/71/Suppl_2/ii1