Correct!
4. 1 and 3

Bronchospasm in response to the alkyl nitrites has not been described. A literature review describes solely chemical burns and methemoglobinemia as recognized adverse effects of alkyl nitrates. An acute respiratory distress syndrome-like illness has not been described. There is clear association of these three episodes of respiratory illness with the inhalation of isobutyl nitrite. We suspect deep inhalational injury resulting in diffuse alveolar damage as the mechanism of this unique presentation.

Which of the following is true regarding the treatment of methemoglobinemia? (click on the correct answer to proceed to the sixth and final page)

1. Methylene blue is the therapy of choice.
2. Glucose-6-phosphate dehydrogenase deficiency may not respond to standard therapy.
3. Pulse oximetry is not a reliable measure for monitoring.
4. 1 and 3
5. All of the above

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