Patho Exam 3 Questions

Which of the following is TRUE regarding the pathophysiology of asthma? a. Inflammation results in airway hyperresponsiveness. b. IgA is the major factor. c. The inflammatory process is due to loss of bronchial smooth muscle spasm. d. There is decreased vascular permeability.

* Inflammation results in airway hyperresponsiveness. IgE is the major factor. Asthma is caused by increased bronchial smooth muscle spasm and increased vascular permeability.

Which of the following is NOT true concerning pneumonia? a. Viral pneumonia is usually mild and self-limiting. b. The most common community-acquired pneumonia is caused by Streptococcus pneumoniae. c. Most cases are preceded by an upper respiratory infection. d. Mortality from pneumonia is higher in children and young adults.

* Mortality from pneumonia is higher in children and young adults. More than half of those hospitalized for pneumonia are older than age 65; mortality from pneumonia is highest in older adults.

A 63-year-old man presents with a cough and dyspnea. He has been around asbestos. Which chronic condition has been associated with this? a. Pulmonary edema b. Pulmonary fibrosis c. Pneumothorax d. Pneumonia

* Pulmonary fibrosis The inhalation of inorganic dust particles, silicosis, and asbestos can cause this condition. Asbestos exposure can result in a type of pulmonary fibrosis called asbestosis.

Which of the following is NOT a cause of pulmonary fibrosis? a. ARDS b. Tuberculosis c. Inhalation of harmful substances d. Upper respiratory infection

* Upper respiratory infection Upper respiratory infections do not typically result in pulmonary fibrosis.

How is tuberculosis spread from person to person? a. Sexual contact b. Air droplet c. Direct contact d. It is not transmitted person to person

*Air droplet Tuberculosis is very contagious and is transmitted via air droplet.

Which of the following is TRUE regarding ARDS? a. Most commonly caused by infection b. Caused by injury to bronchioles c. Can cause severe pulmonary edema d. Macrophages not involved in response

*Can cause severe pulmonary edema The most common cause of ARDS is either sepsis or multiple trauma. Damage is done to the alveolar capillary membrane and causes severe pulmonary edema. Macrophages, neutrophils, complement, and endotoxins are important mediators.

A person has respirations that are characterized by alternating periods of deep and shallow breathing and apnea. What is the appropriate name for this breathing? a. Cheyne-Stokes b. Hypoventilation c. Kussmaul d. Hyperpnea

*Cheyne-Stokes Kussmaul respirations are characterized by an increased ventilatory rate, large tidal volumes, and no expiratory pause. Hypoventilation is inadequate alveolar ventilation. Hyperpnea is rapid ventilation.

A person has symmetrically dilated airways. Which type of bronchial dilation is this? a. Saccular b. Varicose c. Cylindrical d. Bronchiectasis

*Cylindrical Cylindrical indicates symmetric dilation. Saccular is when the bronchi become large and balloon-like. Varicose is when constrictions and dilations destroy the bronchi. Bronchiectasis is the persistent abnormal dilation of the bronchi.

A woman has bulbous enlargement of the distal segments of her fingers. Which disease is associated with this condition? a. Acute pneumonia b.Acute myocardial infarction c. Sickle cell disease d. Cystic fibrosis

*Cystic fibrosis This is actually describing clubbing. There is enlargement of the distal segment of the finger, associated with bronchiectasis, cystic fibrosis, pulmonary fibrosis, lung abscess, and congenital heart disease.

A person is born with an α-antitrypsin deficiency. Which of the following conditions will most likely manifest? a. Asthma b. Emphysema c. Pulmonary fibrosis d. ARDS

*Emphysema Emphysema is bullous disease of the lungs. There is destruction of the alveolar walls without evidence of fibrosis. Individuals with an α-antitrypsin deficiency have an increased risk because proteolysis in lung tissues is not inhibited.

A woman has pus in the pleural space. She had a previous respiratory infection. What is the name for this condition? a. Abscess b. Consolidation c. Empyema d. Transudate

*Empyema Empyema is the presence of pus in the pleural space and is a complication of respiratory infection. Abscess is a circumscribed area of suppuration and destruction of lung parenchyma. A consolidation is inflamed lung tissue that causes alveoli to fill with exudate.

A woman develops excess water in her lungs. What is the most common cause of this condition? a. Inhalation of toxic gases b.Heart disease c. Pulmonary hypertension d. ARDS

*Heart diseas The most common cause of pulmonary edema is heart disease. Toxic gas inhalation, pulmonary hypertension and ARDS are also causes of pulmonary edema, but not the most common.

Which of the following is TRUE regarding chronic bronchitis? a. Hypersecretion of mucus b. Chronic productive cough that occurs for at least 6 months c. Occurs at least for 5 consecutive years d. Decreased in smokers

*Hypersecretion of mucus There is hypersecretion of mucus. This mucus is thicker and will "hold on" to embedded bacteria. There is a chronic productive cough that lasts for at least 3 months for at least 2 consecutive years. It is increased up to 20-fold in smokers.

Which of the following is the appropriate term for inadequate alveolar ventilation in relation to metabolic demands? a. Hyperpnea b. Hypoventilation c. Orthopnea d. Dyspnea

*Hypoventilation Hyperpnea is rapid breathing. Orthopnea is difficulty breathing when an individual is lying flat. Dyspnea is difficulty breathing.

Which of the following is NOT a cause of hypercapnia? a. Depression of the respiratory center by drugs b. Disease of the medulla c.Large airway obstruction d. Increased respiratory drive

*Increased respiratory drive Causes of hypercapnia include depression of the respiratory center by drugs, diseases of the medulla, abnormalities of the spinal conducting pathways, diseases of the neuromuscular junction or of the respiratory muscles themselves, thoracic cage abnormalities, large airway obstruction, and increased work of breathing or physiologic dead space.

Which of the following is TRUE regarding bronchiolitis? a. In adults, it is usually caused by a virus. b. It is most common in adults. c. It is an inflammatory obstruction of the small airways or bronchioles. d. It is associated with bacterial infection.

*It is an inflammatory obstruction of the small airways or bronchioles. Bronchiolitis is most common in children and is caused by a virus. It is seen in adults with chronic bronchitis.

A person has been exposed to a contaminated cooling system. A large number of people in the same building have developed pneumonia. The most likely pathogen is which of the following? a. Legionella pneumophila b. Incorrect Streptococcus pneumoniae c. Mycoplasma pneumoniae d. Klebsiella pneumoniae

*Legionella pneumophila Legionella pneumophila is often associated with contaminated water supplies such as cooling systems.

Which of the following pathogens is consistent with nosocomial pneumonia? a. Streptococcus pneumoniae b. Mycoplasma pneumoniae c. Haemophilus influenzae d. Pseudomonas aeruginosa

*Pseudomonas aeruginosa All of the other choices are community acquired. P. aeruginosa is commonly hospital- or nursing-home acquired.

A 19-year-old man experiences a gunshot wound to the chest. He has an increase in pressure in his chest cavity. Which of the following is NOT an appropriate description for this condition? a. Tension pneumothorax b. Spontaneous pneumothorax c. Secondary pneumothorax d. Open pneumothorax

*Spontaneous pneumothorax This pneumothorax is open. Increased pressure indicates tension, and secondary indicates there is a cause such as gunshot or stab wound. Spontaneous pneumothorax is of no known cause.

Which of the following is TRUE regarding asthma? a. 90% of cases occur during childhood. b. 10% of cases occur before age 40. c. The incidence has increased. d. There is no hereditary pattern.

*The incidence has increased. The incidence of asthma has increased over the past 20 years in the United States, especially in urban areas. Half of cases develop in childhood and another third develops during adulthood. There is a genetic pattern.

Which of the following measures is most effective for preventing pulmonary emboli in patients who are recovering from a major surgery?

A) Ambulate patients frequently to prevent blood clot formation. Venous stagnation, a major risk factor for deep vein thrombus and pulmonary embolism formation, can be prevented by frequent ambulation after surgery.

Hypoventilation results in:

A) hypercapnia.

Respiratory failure is defined by which one of the following laboratory alterations?

B) High PaCO2

When exposed to inhaled allergens, a child with asthma produces large quantities of:

B) IgE.

Hypertrophy of the nailbeds due to chronic hypoxemia:

B) clubbing.

Signs and symptoms of dyspnea include:

B) feeling short of breath.

Non-cardiogenic pulmonary edema most often is caused by:

B) systemic infection (sepsis). Inflammation present with systemic infections and sepsis is the main cause of non-cardiogenic pulmonary edema (i.e., acute respiratory distress syndrome, or ARDS).

Which of the following conditions causes a decreased drive to breathe that results in hypoxemia and hypercapnia?

C) Central nervous system disorders Central nervous system disorders result in a decreased drive to breathe due to damage to the respiratory centers.

Primary pulmonary hypertension usually is caused by:

C) hereditary traits

A high ventilation/perfusion (V/Q) ratio can be caused by:

C) obstruction to pulmonary blood flow.

A life-threatening complication of asthma is:

C) status asthmaticus.

Pneumonia leads to hypoxemia due to:

C) the accumulation of exudates and fibrin deposition. The inflammatory response to lung infection results in the accumulation of fibrous exudates, which cause ventilation/perfusion (V/Q) mismatching and impair the diffusion of oxygen at the alveolocapillary membrane.

Which of the following patients is at highest risk for developing a pulmonary embolism?

D) A 67-year-old male hospitalized with a deep vein thrombosis in the femoral vein The presence of deep vein thrombosis in the lower limb is the most important risk factor for pulmonary embolism. Older age is also a risk factor.

Why does airway obstruction in chronic lung disease cause hypercapnia?

D) Airway obstruction causes air trapping. Obstruction- get air in, not out

Which of the following diseases will result in a ventilation/perfusion (V/Q) mismatch? A) Asthma B) Pulmonary edema C) Emphysema D) All of the above

D) All of the above All three pulmonary diseases result in V/Q mismatches due to decreased ventilation and/or impaired diffusion of gases at the alveolar/capillary membrane.

In individuals with asthma, exposure to an allergen leads to which of the following pathophysiological events?

D) Bronchoconstriction and airway edema Exposure to an allergen results in mast cell degranulation and release of inflammatory mediators that cause bronchoconstriction and airway edema.

Chronic pulmonary hypertension can eventually cause which of the following complications?

D) Cor pulmonale Icreased right ventricular afterload from pulmonary hypertension can lead to right ventricular failure. Right ventricular failure due to respiratory disease is also known as "cor pulmonale."

_____ is a term that signifies right-sided heart failure

D) Cor pulmonale Cor pulmonale is right-sided heart failure secondary to pulmonary hypertension.

Lung injury that results in diffuse pulmonary inflammation and infiltrates and that is followed by development of a hyaline membrane at the alveolocapillary interface is a condition known as:

D) acute respiratory distress syndrome (ARDS).

The collapse of a previously inflated area of lung tissue is called:

D) atelectasis.