Deck 32: Alterations of Pulmonary Function

Question 1

What causes paroxysmal nocturnal dyspnea (PND)?

A) Obstructed bronchi
B) Collapsed alveoli
C) Fluid in the lungs
D) Inflamed bronchioles

Answer 1

Fluid in the lungs

Question 2

An abnormal ventilation-perfusion ratio is the most common cause of hypoxemia.

Answer 2

True

Question 3

Which of the following is a true statement?

A) Hypoventilation causes hypocapniA.
B) Hyperventilation causes hypercapnia.
C) Hyperventilation causes hypocapnia.
D) Hyperventilation results in an increased PaCO₂.

Answer 3

Hyperventilation causes hypocapnia.

Question 4

Persons with an I-antiprotease deficiency are predisposed to asthma.

Question 5

Chronic pulmonary hypertension can lead to cor pulmonale.

Question 6

Mycobacterium tuberculosis remain dormant and walled off in tubercles for life,but may be reactivated if the patient's immune system is impaired.

Question 7

There is no specific treatment for silicosis,although corticosteroids may produce some improvement.

Question 8

The greatest single risk factor for reactivation of tuberculosis is infection with human immunodeficiency virus (HIV).

Question 9

_____ is the selective bulbous enlargement of the distal segment of a digit and is commonly associated with diseases that interfere with oxygenation of the blood.

A) Edema
B) Clubbing
C) Angling
D) Osteoarthropathy

Question 10

By what mechanism do pulmonary edema and pulmonary fibrosis cause hypoxemia?

A) By creating alveolar dead space
B) By decreasing the oxygen in inspired gas
C) By creating a right-to-left shunt
D) By impairing diffusion through the alveolocapillary membrane

Question 11

High altitudes may produce hypoxemia through:

A) shunting.
B) hypoventilation.
C) decreased inspired oxygen.
D) diffusion abnormalities.

Question 12

A pulmonary artery pressure of 23 mm Hg is normal.

Question 13

Pneumoconiosis is a pneumonia caused by pneumococci.

Question 14

What causes respirations that are characterized by alternating periods of deep and shallow breathing?

A) Decreased blood flow to the medulla oblongata
B) Decreased pH,increased PaCO₂,and decreased PaO₂
C) Stimulation of stretch or J receptors
D) Fatigue of the intercostal muscles and diaphragm

Question 15

Which cause of dyspnea is false?

A) Decreased pH,increased PaCO₂,and decreased PaO₂
B) Decreased blood flow to the medulla oblongata
C) Stimulation of stretch or J receptors
D) Fatigue of the intercostal muscles and diaphragm

Question 16

Hypoxemia is reduced oxygenation of cells in tissues,whereas hypoxia is reduced oxygenation of arterial blood.

Question 17

_____ is generally relieved by sitting up in a forward leaning position.

A) Hyperpnea
B) Orthopnea
C) Apnea
D) Dyspnea on exertion

Question 18

If a patient's total hemoglobin (Hb)is 9 g/dl,_____ g/dl of hemoglobin must become desaturated for cyanosis to occur?

A) 3
B) 5
C) 7
D) 9

Question 19

Tuberculosis is transmitted from person to person through airborne droplets.

Question 20

Kussmaul respirations may be characterized as:

A) alternating periods of deep and shallow breathing.
B) a common breathing pattern in pulmonary fibrosis.
C) a common breathing pattern in chronic obstructive pulmonary disease.
D) a slightly increased ventilatory rate;large,tidal volumes;and no expiratory pause.

Question 21

In adult respiratory distress syndrome (ARDS),what releases inflammatory mediators such as proteolytic enzymes,oxygen free radicals,prostaglandins,leukotrienes,and platelet-activating factor?

A) Complement cascade
B) Mast cells
C) Macrophages
D) Neutrophils

Question 22

In _____ pleural effusion,the fluid is watery and diffuses out of the capillaries as a result of increased blood pressure or decreased capillary oncotic pressure.

A) exudative
B) purulent
C) transudative
D) large

Question 23

The most common cause of pulmonary edema is:

A) right-sided heart failure.
B) left-sided heart failure.
C) mitral valve prolapse.
D) aortic stenosis.

Question 24

Which statement about silicosis and asbestosis is false?

A) Both are caused by inhalation of inorganic dust particles.
B) Both are types of pneumoconiosis.
C) Both cause lung cancer.
D) Both cause inflammation and cellular apoptosis of lung cells.

Question 25

Which inflammatory mediators are produced in asthma?

A) Neutrophil proteases,bradykinin,and histamine
B) Bradykinin,serotonin,and neutrophil proteases
C) Histamine,prostaglandins,and leukotrienes
D) Lymphokines,serotonin,and prostaglandins

Question 26

Clinical manifestations of inspiratory and expiratory wheezing,dyspnea,nonproductive cough,and tachypnea are indicative of which pulmonary disease?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

Question 27

In _____ pulmonary disease either more force is required to expire a given volume of air,or emptying of the lungs is slowed,or both.

A) restrictive
B) obstructive
C) acute
D) communicable

Question 28

Which cause of chest wall restriction is false?

A) Pneumothorax
B) Severe kyphoscoliosis
C) Gross obesity
D) Neuromuscular disease

Question 29

Which pleural abnormality involves a site of pleural rupture that act as a one-way valve,permitting air to enter on inspiration,but preventing its escape by closing during expiration?

A) Spontaneous pneumothorax
B) Tension pneumothorax
C) Open pneumothorax
D) Secondary pneumothorax

Question 30

In adult respiratory distress syndrome (ARDS),what change causes alveoli and respiratory bronchioles to fill with fluid?

A) Pores of Kohn are compressed preventing collateral ventilation.
B) Increased capillary permeability causes alveoli and respiratory bronchioles to fill with fluid.
C) Surfactant is inactivated and type II alveolar cells are impaired.
D) Increased capillary hydrostatic pressure forces fluid into the alveoli and respiratory bronchioles.

Question 31

Which immunoglobulins may contribute to the pathophysiology of asthma?

A) Immunoglobulin A
B) Immunoglobulin E
C) Immunoglobulin G
D) Immunoglobulin M

Question 32

What is the effect of inflammatory cytokines,tumor necrosis factor alpha (TNF-a),and interleukin 1 (Il-1),in asthma?

A) They increase levels of norepinephrine,which causes bronchial smooth muscle contraction and mucus secretion.
B) They increase levels of acetylcholine,which causes bronchial smooth muscle contraction and mucus secretion.
C) They increase levels of epinephrine,which causes bronchial smooth muscle contraction and increases capillary permeability.
D) They increase levels of immunoglobulins G,which initiates the complement cascade and causes smooth muscle contraction and increased capillary permeability.

Question 33

_____ atelectasis is the collapse of lung tissue caused from the lack of collateral ventilation through the pores of Kohn.

A) Compression
B) Perfusion
C) Absorption
D) Hypoventilation

Question 34

_____ is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.

A) Acute respiratory distress syndrome
B) Pneumonia
C) Pulmonary emboli
D) Pulmonary edema

Question 35

Pulmonary edema usually begins at a pulmonary capillary wedge pressure or left atrial pressure of _____ mm Hg.

A) 10
B) 20
C) 30
D) 40

Question 36

_____ involves an infected pleural effusion,the presence of pus in the pleural space,and a complication of respiratory infection,usually pneumonia.

A) Transudative effusion
B) Empyema
C) Exudative effusion
D) Abscess

Question 37

A(n)_____ is a circumscribed area of suppuration and destruction of lung parenchyma.

A) consolidation
B) cavitation
C) empyema
D) abscess

Question 38

In _____ bronchiectasis,constrictions and dilations deform the bronchi.

A) varicose
B) symmetric
C) cylindric
D) saccular

Question 39

Which pulmonary disorder causes alveolar dead space?

A) Pulmonary edema
B) Pulmonary emboli
C) Atelectasis
D) Pneumonia

Question 40

What causes pulmonary edema in adult respiratory distress syndrome (ARDS)?

A) Retention of sodium and water
B) Increased capillary permeability
C) Increased capillary hydrostatic pressure
D) Increased oncotic pressure

Question 41

Pulmonary hypertension results from which alteration?

A) Narrowed pulmonary capillaries
B) Narrowed bronchi and bronchioles
C) Destruction of alveoli
D) Ischemia of the myocardium

Question 42

Clinical manifestations of a thin patient who complains of dyspnea on exertion and who uses accessory muscles and has tachypnea and prolonged expiration are indicative of which pulmonary disease?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

Question 43

In tuberculosis,how does the body wall off the bacilli in a tubercle?

A) By stimulating macrophages that release tumor necrosis factor alpha (TNF-a)
B) From phagocytosis by neutrophils and eosinophils
C) By stimulating the formation of immunoglobulins G to initiate the complement cascade
D) By stimulating apoptotic infected macrophages that activate cytotoxic T cells

Question 44

Which description applies to squamous cell carcinoma of the lung?

A) Very rapid growing tumor that causes airway obstruction and ectopic hormone production
B) Slow-growing tumor that produces a productive cough and airway obstruction in addition to pneumonia and atelectasis
C) Slow-growing tumor that causes pleural effusion and shortness of breath
D) Rapid growing tumor that produces chest wall pain,pleural effusion,productive cough,and hemoptysis

Question 45

The most successful treatment for asthma involves:

A) elimination of the causative agent.
B) broad-spectrum antibiotics.
C) drugs that reduce bronchospasm.
D) drugs that decrease airway inflammation.

Question 46

What is the most common paraneoplastic syndrome associated with small cell lung cancer?

A) Secretion of adrenocorticotropin hormone (ACTH)
B) Secretion of thyroid stimulating hormone (TSH)
C) Secretion of luteinizing hormone (LH)
D) Secretion of antidiuretic hormone (ADH)

Question 47

Clinical manifestations of decreased exercise tolerance,wheezing,shortness of breath,and productive cough are indicative of which pulmonary disease?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

Question 48

How does smoking contribute to emphysema?

A) By interrupting the production of elastase
B) By destroying cilia in the bronchi
C) By reducing the alpha₁antitrypsin (a₁a)
D) By creating hyperplasia of submucosal glands

Question 49

Which bacteria become embedded in the airway secretions in chronic bronchitis?

A) Legionella pneumophila and Chlamydia pneumoniae
B) Klebsiella pneumoniae and Pneumocystis jirovici
C) Haemophilus influenzae and Streptococcus pneumoniae
D) Mycoplasma pneumoniae and Staphylococcus aureus

Question 50

MATCHING
Match the descriptions with the corresponding terms.
Bronchiectasis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Alveolar collapse
E)Abnormal dilation of the bronchi

Question 51

MATCHING
Match the descriptions with the corresponding terms.
Bronchiolitis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Alveolar collapse
E)Abnormal dilation of the bronchi

Question 52

MATCHING
Match the descriptions with the corresponding terms.
Aspiration

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Alveolar collapse
E)Abnormal dilation of the bronchi

Question 53

What is the most common route of lower respiratory tract infection?

A) Aspiration of oropharyngeal secretions
B) Inhalation of microorganisms
C) Microorganisms spread to lung via blood

Question 54

Match the descriptions with the corresponding terms.
Pneumothorax

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 55

MATCHING
Match the descriptions with the corresponding terms.
Atelectasis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Alveolar collapse
E)Abnormal dilation of the bronchi

Question 56

Clinical manifestations of inspiratory crackles,increased tactile fremitus,egophony,and whispered pectoriloquy are indicative of which pulmonary disease?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

Question 57

Match the descriptions with the corresponding terms.
Flail chest

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 58

MATCHING
Match the descriptions with the corresponding terms.
Pulmonary fibrosis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Alveolar collapse
E)Abnormal dilation of the bronchi

Question 59

Which are clinical manifestations of pulmonary hypertension?

A) Systemic blood pressure greater than 130/90
B) Productive cough and rhonchi bilaterally
C) Dyspnea on exertion and paroxysmal nocturnal dyspnea
D) Peripheral edema and jugular vein distention

Question 60

The pathophysiology of chronic bronchitis can be explained by which of the following descriptions?

A) Inflammation of airways with bronchial smooth muscle spasm,vascular engorgement,increased vascular permeability,and production of thick tenacious mucus
B) Increase in the number and size of mucous glands and goblet cells in airway epithelium
C) Abnormal permanent enlargement of gas exchange airways with destruction of alveolar walls
D) Release of inflammatory cytokines and cells are released that cause alveolar edema

Question 61

Match the descriptions with the corresponding terms.
Pleural effusion

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 62

Match the descriptions with the corresponding terms.
Pleurisy

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 63

Match the descriptions with the corresponding terms.
Empyema

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures