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Terms in this set (45)Hypertrophy of the nail beds due to chronic hypoxemia is called: hemoptysis. clubbing. cyanosis. a bulla. Clubbing: Clubbing is manifested by enlargements at the base of the fingernails. Respiratory acidosis can result from: increased minute ventilation. decreased PaCO2. tissue hypoxia. reduced tidal volumes. Reduced tidal volumes: Low tidal volumes (hypoventilation) result in CO2 retention and respiratory acidosis. In individuals with asthma, exposure to an allergen leads to which of the following pathophysiological events? Loss of elastin and increased airway compliance Pulmonary edema and increased alveolar compliance Type II alveolar cell injury and decreased surfactant Bronchoconstriction and airway edema Bronchoconstriction and airway edema: Exposure to an allergen results in mast cell degranulation and release of inflammatory mediators that cause bronchoconstriction and airway edema. Why does airway obstruction in chronic lung disease cause hypercapnia? Airway obstruction causes pulmonary edema. Airway obstruction causes alveolar destruction. Airway obstruction causes prolonged inspiration and rapid expirations. Airway obstruction causes air trapping. Airway obstruction causes air trapping: With airway obstruction, air enters the alveoli but has difficulty escaping during exhalation. Air becomes trapped in the alveoli, and expiration must be more forceful and prolonged. When air is trapped, tidal volumes are reduced, causing hypercapnia. Air that enters the pleural space during inspiration and is unable to exit during expiration creates a condition called: tension pneumothorax. open pneumothorax. pleural effusion. empyema. Tension pneumothorax: A tension pneumothorax can collapse the lung because the pressure of the air in the pleural cavity exceeds the atmospheric pressure in the alveoli. A frequent complication of chronic bronchitis related to the hypersecretion of mucus is: recurrent infections. destruction of the alveolar septa. suppression of the inflammatory response. epithelial desquamation. Recurrent infections: Mucus provides a hospitable environment for bacterial colonization. Non-cardiogenic pulmonary edema most often is caused by: congestive heart failure. systemic infection (sepsis). dehydration. anemia. 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). Cheyne-Stokes respirations are characterized by: audible wheezing or stridor. a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause. rapid respirations alternating with periods of apnea. very slow inhalations and rapid expirations. Rapid respirations alternating with periods of apnea: Apneic spells alternating with hyperventilation are called Cheyne-Stokes respirations and often occur with neurologic injury or profound metabolic alterations.
Risk factors for TB include: age. immunosuppression. gender. excessive use of antibiotics. Immunosuppression: Immunosuppressed individuals, such as those with HIV, are at high risk for TB, which is easily transmitted by personal contact with infected individuals. _________ atelectasis is the collapse of lung tissue caused by external pressure exerted by a tumor, fluid, or air. Absorption Perfusion Fibrotic Compression Compression: Compression atelectasis occurs when a lung tumor, pulmonary edema, pleural effusion, or pneumothorax creates external pressures that collapse alveoli. The collapse of a previously inflated area of lung tissue is called: aspiration. bronchiectasis. bronchiolitis. atelectasis. Atelectasis. When conducting a physical assessment of an individual during an acute asthma episode, you would expect to observe all of the following except: the use of accessory breathing muscles. expiratory wheezing. loss of pulsus paradoxus. coughing. Loss of pulses paradoxus: During an acute asthma episode, pulsus paradoxus increases.
Alveolar edema in pneumococcal pneumonia is caused by: elevated capillary hydrostatic pressure. inflammatory cytokines. decreased capillary oncotic pressure. abnormal ventilation/perfusion (V/Q) ratios. Inflammatory cytokines....edema - think cytokines... Pleuritic pain: is usually sharp and worsens with deep breathing. can be mimicked by pressing on the sternum or ribs. is worse with movement. is often confused with cardiac pain. Is usually sharp and worsens with deep breathing: Pleurtic pain arises from stimulation of receptors in the pleura or chest wall and is usually sharp, fairly localized, and made worse with deep breathing and cough. Lung injury that results in diffuse inflammation of the alveolar-capillary membranes allowing for significant pulmonary edema which is refractory to oxygen therapy is called: sarcoidosis. emphysema. chronic obstructive pulmonary disease (COPD). acute respiratory distress syndrome (ARDS). Acute respiratory distress syndrome (ARDS): ARDS involves a lung-wide inflammatory response to direct or indirect lung injury and manifests with diffuse pulmonary infiltrates and the development of a hyaline membrane. A high ventilation/perfusion (V/Q) ratio can be caused by: increased dead space. alveolar collapse. obstruction to pulmonary blood flow. bronchoconstriction. Obstruction to pulmonary blood flow: Obstruction to pulmonary blood flow results in decreased perfusion and a high V/Q ratio. What is the World Health Organization's major concern regarding the avian flu, which is caused by the H5N1 virus? The virus may develop the ability to cause disease in humans. The virus may cause another outbreak of the bubonic plague. The virus may mutate to a form that can be easily transmitted from person to person. The virus may cause infectious emphysema. The virus may mutate to a form that can be easily be transmitted from person to person...To date, the H5N1 virus has only been transmitted from birds to humans. If the virus develops an ability to be transmitted among humans, there is grave fear of a pandemic. A decrease in tidal volume results in a decrease in: PaCO2. the respiratory rate. minute ventilation. acidity. Minute ventilation: Chronic pulmonary hypertension can eventually cause which of the following complications? Pulmonary emboli Congestive heart failure Chronic obstructive pulmonary disease Cor pulmonale Chronic obstructive pulmonary disease: Increased 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." Which of the following patients is at highest risk for developing a pulmonary embolism? A 25-year-old male with asthma A 28-year-old female in the first trimester of pregnancy A 42-year-old female with a broken arm A 67-year-old male hospitalized with a deep vein thrombosis in the femoral vein 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. Severe acute respiratory distress syndrome (SARS) is transmitted via which of the following mechanisms? Skin contact Sexual contact Droplet inhalation All of the above Droplet inhalation: The particular strain of the coronal virus responsible for SARS is transmitted via inhaled droplets containing the virus or via contact with infected bodily (respiratory) fluids. When exposed to inhaled allergens, a person with asthma produces large quantities of: IgG. IgE. IgA. IgM. IgE: During an allergic response (type I hypersensitivity reaction), plasma cells produce large quantities of IgE. Familial pulmonary hypertension usually is caused by: chronic pulmonary disease. right-sided heart failure. a genetic mutation. pulmonary emboli. A genetic mutation: Familial pulmonary hypertension is caused by a mutation in the genetic coding for BMPR2. Which of the following conditions causes a decreased drive to breathe that results in hypoxemia and hypercapnia? Emphysema Asthma Central nervous system disorders Neuromuscular disorders Central nervous system disorders....Neuromuscular disorders result in a decreased ability to ventilate due to respiratory muscle weakness or paralysis. Signs and symptoms of dyspnea include: decreased work of breathing. feeling short of breath. a failure to use accessory breathing muscles. an improvement of symptoms with exercise. Feeling short of breath.
The increased anterior-posterior chest diameter (barrel chest) associated with obstructive lung disease is caused by: increased pulmonary blood flow. increased expiratory flow rates. increased residual lung volumes. decreased chest wall compliance Increased residual lung volumes: Increased residual lung volumes are a result of air trapping in obstructive lung disease and cause expansion of the chest wall. All of the following physical and laboratory findings are indicative of a bacterial pneumonia EXCEPT: fever. infiltrates on the chest x-ray film. an increased white blood cell count. a dry cough. A dry cough: A dry cough may occur with viral pneumonia. Bacterial pneumonia usually manifests with a productive cough. In acute respiratory distress syndrome (ARDS), alveolar damage and impaired surfactant secretion lead to each of the following problems EXCEPT: pulmonary edema. atelectasis. air trapping. pulmonary thrombus formation. Air trapping...Endothelial damage in ARDS results in platelet aggregation and clot formation in the lungs. Respiratory failure is defined by which one of the following laboratory alterations? High PaO2 and pH > 7.50 High PaCO2 and pH < 7.25 Low hematocrit High blood pH High PaCO2 an pH < 7.25: Respiratory failure results in CO2 retention and elevated PaCO2 with corresponding acidosis. Which of the following diseases will result in a ventilation/perfusion (V/Q) mismatch? Asthma Pulmonary edema Emphysema All of the above All of the above: Asthma, pulmonary edema, & emphysema: All three pulmonary diseases result in V/Q mismatches due to decreased ventilation and/or impaired diffusion of gases at the alveolar/capillary membrane. Pain on inspiration (pleuritic) is associated with which of the following disorders? An abscess Pleural inflammation Flail chest Pleural effusion Pleural inflammation: Inflammation of the pleura often manifests with pain on inspiration, fever, and chills. Which of the following measures is most effective for preventing pulmonary emboli in patients who are recovering from major surgery? Ambulate patients frequently to prevent blood clot formation. Ensure that patients use supplemental oxygen. Prevent the development of anemia. Promote aggressive fluid intake. Ambulate patients frequently to prevent blood clot formation: Venous stagnation, a major risk factor for deep vein thrombosis and pulmonary embolism formation, can be prevented by frequent ambulation after surgery. Common sites of metastasis for lung cancer include all of the following except: the liver. the kidneys. bone. the brain. The kidneys...The brain is a common site for metastasis due to the volume of blood that passes through it. The loss of alpha1-antitrypsin in emphysema results in: chronic mucus secretion and airway fibrosis. the destruction of alveolar septa and the loss of elastic recoil. pulmonary edema and increased alveolar compliance. bronchoconstriction and airway edema. The destruction of alveolar septa and loss of elastic recoil: The destruction of alveolar septa and the loss of elastic recoil in emphysema lead to the loss of alveolar surface area and the collapse of airways during expiration. ________ is a term that signifies right-sided heart failure secondary to pulmonary hypertension. Congestive heart failure High output failure Coronary disease Cor pulmonale Cor pulmonale: Cor pulmonale is right-sided heart failure secondary to pulmonary hypertension. Which of the following characteristics is NOT typical of asthma? Asthma is a chronic inflammatory disorder. Asthma is caused by bronchial hyperresponsiveness. Asthma causes alveolar collapse. Genetic susceptibility plays a role in the development of asthma. Asthma causes alveolar collapse: The pathophysiology of asthma does not involve alveolar collapse...it is an upper respiratory condition. Staff at an inner-city homeless shelter send 46-year-old Henry Ship by ambulance to a local hospital after he begins coughing up blood. On arrival at the emergency room, he is feverish and says that he has felt very fatigued for several weeks. He also reports experiencing night sweats. Mr. Ship's symptoms are most likely caused by: viral pneumonia. a pulmonary embolus. tuberculosis. aspiration pneumonia. Tuberculosis (TB): All of Mr. Ship's symptoms are typical of tuberculosis infection (TB). Being homeless and living in a shelter are risk factors for TB since the bacteria are easily transmitted from person to person. Metaplastic changes to bronchial epithelial tissues are frequently caused by: genetic mutations. chronic obstructive pulmonary disease. cigarette smoking. endocrine disorders. Cigarette smoking: Cigarette smoking is the most common stimulus for metaplastic changes in the bronchial epithelium. Although metaplasia is generally reversible, the metaplastic cells can become cancerous if an individual continues to smoke. Pneumonia leads to hypoxemia due to: cardiogenic pulmonary edema. upper airway obstruction. the accumulation of exudates and fibrin deposition. the decreased fraction of inspired oxygen. 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. Individuals who have recently developed chronic bronchitis often present with all of the following except: productive cough. wheezing. a barrel chest. shortness of breath. A barrel chest: a barrel chest is sign of emphysema. Airway obstruction in chronic bronchitis is generally the result of: thick mucus secretions and smooth muscle hyperplasia. loss of alveolar elastin. the accumulation of pulmonary edema. hyperplasia of bronchial cartilage. Thick mucus secretions and smooth muscle hyperplasia: Inspired irritants stimulate inflammation, mucus secretion, and bronchospasm, which can lead to smooth muscle thickening in the airways. All of these factors contribute to airway obstruction in chronic bronchitis. Which of the following alterations in lab values would indicate that a patient is hyperventilating? High PaO2 High pH High PaCO2 High osmolarity High pH: rapid respirations cause exhalation of CO2, which is volatile acid, thus making the patient have a high/increased pH (alkaline). Coal miners or individuals exposed to asbestos often develop a chronic respiratory condition called: bronchiolitis. pneumoconiosis. empyema. allergic alveolitis. Pneumoconiosis: Severe inflammation and scarring in the pulmonary tissue due to prolonged exposure to coal dust, asbestos, and other inhaled toxins is called pneumoconiosis. Pulmonary edema is an example of ______ pulmonary disease. malignant restrictive obstructive pleuritic Restrictive: Pulmonary edema restricts alveolar or lung expansion. Hypoventilation results in: hypercapnia. respiratory alkalosis. increased minute ventilation. decreased PaCO2. Hypercapnia: Hypoventilation results in increased PaCO2, a condition called hypercapnia. 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Which of the following diseases will result in a ventilation perfusion mismatch?Characteristic features of ventilation/perfusion mismatch
Some common causes of hypoxemia due to V/Q mismatch include asthma, COPD, bronchiectasis, cystic fibrosis, interstitial lung diseases (ILDs), and pulmonary hypertension.
Which pulmonary function test result is consistent with a diagnosis of asthma?The ratio between your FEV 1 and FVC known as FEV 1/ FVC can also help diagnose asthma. If your FEV 1/ FVC is lower than normal, it can mean asthma.
Which of the following conditions causes a decreased drive to breathe that results in hypoxia and hypercapnia?Neuromuscular Disease
Respiratory muscle weakness eventually occurs in neuromuscular diseases, causing hypoventilation and resultant hypoxia and hypercapnia.
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