Pathophysiology Exam 2 Practice Quiz

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Pathophysiology Quizzes & Trivia
Pulmonaryobstructive and restrictive diseases

  
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  • 1. 
    The steep portion of the oxyhemoglobin dissociation curve represents
    • A. 

      The binding of oxygen by hemoglobin in the lungs

    • B. 

      A left shift, which indicates abnormal hemoglobin

    • C. 

      The release of oxygen from hemoglobin into tissue capillaries

    • D. 

      Acute acidosis


  • 2. 
    Which involves the transfer of gases between air-filled spaces in the lungs and blood?
    • A. 

      Respiration

    • B. 

      Ventilation

    • C. 

      Diffusion

    • D. 

      Perfusion


  • 3. 
    The conducting airways span from
    • A. 

      The oropharynx to the alveoli

    • B. 

      The nasopharynx to the bronchioles

    • C. 

      The nasopharynx to the alveoli

    • D. 

      The oropharynx to the bronchioles


  • 4. 
    PO2 refers to
    • A. 

      The oxygen bound to hemoglobin in the blood

    • B. 

      The oxygen in a dissolved state in the plasma

    • C. 

      The oxygen in bicarbonate

    • D. 

      The oxygen bound to carbon in CO2


  • 5. 
    ___ refers to how stiff the lungs are.
    • A. 

      Elasticity

    • B. 

      Recoil

    • C. 

      Compliance

    • D. 

      Fibrisis


  • 6. 
    In a "normal" patient,the percentage of air left behind in dead spaces after expiration is __ %.
    • A. 

      70

    • B. 

      50

    • C. 

      30

    • D. 

      10


  • 7. 
    A low V/Q ratio could possibly indicate:
    • A. 

      A restrictive disease

    • B. 

      An obstructive disease

    • C. 

      Interstitial lung disease

    • D. 

      Asthma


  • 8. 
    Which means there is normal perfusion and little or no ventilation?
    • A. 

      Dead space unit

    • B. 

      Silent unit

    • C. 

      Shunt

    • D. 

      Obstructive lung disease


  • 9. 
    During a fever, more oxygen is
    • A. 

      Dissolved in the plasma

    • B. 

      Bound to hemoglobin

    • C. 

      Made available to tissues

    • D. 

      Exhaled


  • 10. 
    The most carbon dioxide in the body is transported in the blood as
    • A. 

      CO2 dissolved in plasma

    • B. 

      Carbaminohemoglobin

    • C. 

      Bicarbonate

    • D. 

      Carbon monoxide


  • 11. 
    Which diseases would have normal FVC and FEV1?
    • A. 

      COPD

    • B. 

      Pneumoconioses

    • C. 

      Asthma

    • D. 

      Sarcoidosis


  • 12. 
    ___ provides the gas exchange function.
    • A. 

      Pulmonary circulation

    • B. 

      Bronchial circulation

    • C. 

      The superior vena cava

    • D. 

      The aorta


  • 13. 
    Normal pulmonary blood pressure is
    • A. 

      120/80

    • B. 

      100/60

    • C. 

      75/45

    • D. 

      50/20

    • E. 

      25/10


  • 14. 
    ___ provides oxygenated blood from systemic curculation to meet the lung's metabolic needs.
    • A. 

      Pulmonary circulation

    • B. 

      Bronchial circulation

    • C. 

      The superior vena cava

    • D. 

      The aorta


  • 15. 
    Which is not a morphologic pulmonary assessment tool?
    • A. 

      Radiology

    • B. 

      Biopsy

    • C. 

      Blood gas analysis

    • D. 

      Bronchoscopy


  • 16. 
    Which of these measures of ventilation involve breathing at rest?
    • A. 

      Expiratory reserve volume

    • B. 

      Residual volume

    • C. 

      Forced vital capacity

    • D. 

      Inspiratory reserve volume


  • 17. 
    Which would decrease diffusion capacity?
    • A. 

      COPD

    • B. 

      Asthma

    • C. 

      Thinning of the aveolocapillary membrane

    • D. 

      Loss of alveoli


  • 18. 
    Which of the following are bronchospastic triggers of asthma?
    • A. 

      GERD

    • B. 

      Dust mites

    • C. 

      Cold air

    • D. 

      Viruses

    • E. 

      Pollen


  • 19. 
    Normal SaO2 is
    • A. 

      35-45 mmHg

    • B. 

      80-100 mmHg

    • C. 

      97%

    • D. 

      7.35-7.45

    • E. 

      22 - 26 mEq/L


  • 20. 
    Pleural effusion refers to
    • A. 

      Fluid collected in the lungs

    • B. 

      Fluid collected in the pleural space

    • C. 

      Fluid collected in a fistula in the pleural space

    • D. 

      Fluid collected in the pulmonary circulation


  • 21. 
    Which does not have a preexisting pulmonary disease?
    • A. 

      Secondary pneumothorax

    • B. 

      Primary pneumothorax

    • C. 

      Cor pulmonale

    • D. 

      ARDS


  • 22. 
    This may be hereditary or acquired and is caused by airway obstruction, lung compression, or loss of surfactant.
    • A. 

      Bronchiectasis

    • B. 

      Pneumoconioses

    • C. 

      Atelectasis

    • D. 

      Spontaneous pneumothorax


  • 23. 
    Bronchoconstriction
    • A. 

      Takes place in the larger airways

    • B. 

      Takes place in the smaller airways

    • C. 

      Involves the parasympathetic nervous system

    • D. 

      Involves the sympathetic nervous system

    • E. 

      Involves histamine


  • 24. 
    Which of the following is not an obstructive pulmonary disease?
    • A. 

      Pneumoconioses

    • B. 

      Sarcoidosis

    • C. 

      Bronchiectasis

    • D. 

      Cystic fibrosis

    • E. 

      Chronic bronchitis


  • 25. 
    According to the hygiene hypothesis, asthma
    • A. 

      Results from over production of TH1 cells since Th2 cells were not made in response to childhood illness

    • B. 

      Is caused by IgM antibodies responding to harmless substances instead of microbes

    • C. 

      Results from overproduction of TH2 cells since TH1 cells weren't produced to fight the microbes of childhood illness

    • D. 

      Is caused by IgE antibodies responding to harmless substances instead of to helminths

    • E. 

      Is caused by an overabundance of IgE, T1 cells, and IgG


  • 26. 
    The late phase response of asthma
    • A. 

      Is caused by the release of chemical mediators from the mast cells

    • B. 

      Includes epithelial edema and injury

    • C. 

      May last for weeks

    • D. 

      Refers to when histamine attaches to receptor sites on smooth muscle and causes swelling

    • E. 

      Leads to shortness of breath and wheezing


  • 27. 
    The typical patient is a male smoker.
    • A. 

      Emphysema

    • B. 

      Adenocarcinoma

    • C. 

      Squamous cell carcinoma

    • D. 

      Chronic bronchitis

    • E. 

      Large cell carcinoma


  • 28. 
    This disease can be caused by an alpha-1 antitrypsin deficiency:
    • A. 

      Cystic fibrosis

    • B. 

      Emphysema

    • C. 

      Chronic bronchitis

    • D. 

      Asthma

    • E. 

      Pulmonary embolism


  • 29. 
    One of the effects of this disease is that hemoglobin is high, but reduced hemoglobin that comes into contact with oxygen is low, which results in cyanosis:
    • A. 

      Emphysema

    • B. 

      Chronic bronchitis

    • C. 

      Pulmonary embolism

    • D. 

      Adenocarcinoma


  • 30. 
    A mutation in chromosome 7 is associated with:
    • A. 

      Emphysema

    • B. 

      Adenocarcinoma

    • C. 

      Cystic fibrosis

    • D. 

      Primary spontaneous pneumothorax


  • 31. 
    Normal HCO3 is
    • A. 

      35-45 mmHg

    • B. 

      80-100 mmHg

    • C. 

      97%

    • D. 

      7.35-7.45

    • E. 

      22-26 MEq/L


  • 32. 
    Diffusion capacity testing is used to differentiate
    • A. 

      Pulmonary edema from pleural effusion

    • B. 

      COPD from asthma

    • C. 

      Asthma from cystic fibrosis

    • D. 

      Bronchiectasis from cystic fibrosis


  • 33. 
    Interstitial lung diseases can also be called
    • A. 

      Obstructive pulmonary diseases

    • B. 

      COPD

    • C. 

      Pulmonary fibrosis

    • D. 

      Bronchiectasis


  • 34. 
    Pulmonary fibrosis can be caused by
    • A. 

      A chromosome 7 mutation

    • B. 

      Heparin

    • C. 

      Inhalants

    • D. 

      Sarcoidosis

    • E. 

      Alpha-1 antitrypsin deficiency


  • 35. 
    Symptoms of interstitial lung diseases include
    • A. 

      Wheezing

    • B. 

      Airway obstructive

    • C. 

      Clubbing of nails

    • D. 

      Productive cough

    • E. 

      Slow and labored breathing


  • 36. 
    Sarcoidosis
    • A. 

      Is more common in men than in women

    • B. 

      May be related to HLA genes

    • C. 

      Commonly affects the lungs, skin and eyes

    • D. 

      Is characterized by chronic and permanent dilation of the medium szed bronchi and bronchioles

    • E. 

      Can be associated with other pulmonary disorders such as CF


  • 37. 
    In which of the following diseases would the V/Q ratio be higher than 0.8?
    • A. 

      Emphysema

    • B. 

      Chronic bronchitis

    • C. 

      Pulmonary embolism

    • D. 

      Pulmonary hypertension


  • 38. 
    This can present initially with no signs or symptoms and be fatal within minutes
    • A. 

      ARDS

    • B. 

      Acute respiratory failure

    • C. 

      Pulmonary embolism

    • D. 

      Cor pulmonale


  • 39. 
    In cor pulmonale
    • A. 

      Pulmonary vascular resistance is decreased

    • B. 

      A cause of the decrease in pulmonary vascular resistance is hypoxic vasoconstriction of blood vessels

    • C. 

      A cause of the increase in pulmonary vascular resistance is obstruction/destruction of the pulmonary vascular bed

    • D. 

      The obstructive component is more important

    • E. 

      The hypoxic component is more important


  • 40. 
    Causes of pulmonary edema include:
    • A. 

      ARDS

    • B. 

      Left ventricular failure

    • C. 

      Cancer

    • D. 

      Infection


  • 41. 
    Symptoms in the early stages include dyspnea on exertion
    • A. 

      Pulmonary edema

    • B. 

      Emphysema

    • C. 

      Pulmonary embolism

    • D. 

      Interstitial lung disease


  • 42. 
    Centriacinar emphysema
    • A. 

      Is more common in alpha 1 AT deficiency

    • B. 

      Is the most common type

    • C. 

      Involves uniform enlargement of the acinus

    • D. 

      Often affects the lower part of the lungs

    • E. 

      Selectively affects the respiratory bronchioles and alveolar ducts


  • 43. 
    Which of the following is true of acute respiratory failure?
    • A. 

      Obstructive disorders lead to hypoxemic failure

    • B. 

      Restrictive disorders lead to hypercapnic failure

    • C. 

      Extrinsic disorders lead to hypercapnic failure

    • D. 

      Hypoxemia always implies hypercapnia

    • E. 

      Hypercapnea always implies hypoxemia


  • 44. 
    The gas rule
    • A. 

      States that partial pressure of all the alveolar or arterial blood gases adds up to atmospheric pressure of 760 mmHg

    • B. 

      Implies that an increase in PCO2 follows an increase in PO2

    • C. 

      Implies that when PCO2 increases, PO2 decreases

    • D. 

      Implies that an increase in PO2 follows an increase of PCO2


  • 45. 
    The A-s gradient is not corrected by O2 if
    • A. 

      The cause is a dead space unit

    • B. 

      The cause is alveolar hypoventilation

    • C. 

      The cause is shunting

    • D. 

      The cause is pure hypoventilation


  • 46. 
    If alveolar ventilation is halved, PCO2
    • A. 

      Will half

    • B. 

      Will divide by 4

    • C. 

      Will double

    • D. 

      Will quadruple


  • 47. 
    Hemoglobin binds oxygen more strongly in
    • A. 

      Acidosis

    • B. 

      Alkalosis

    • C. 

      An increased amount of CO2

    • D. 

      A decreased amount of CO2


  • 48. 
    The steep section of the OxyHb dissociation curve represents
    • A. 

      The binding of oxygen by hemoglobin

    • B. 

      That at higher PO2 concentrations, hemoglobin is still highly saturated

    • C. 

      Release of oxygen into tissue capillaries

    • D. 

      Reflects small transfer of oxygen to tissues with a large drop in PO2


  • 49. 
    What level of PCO2 could be hypothesized in a semicomatose patient with disorientation and lethargy?
    • A. 

      38 mmHG

    • B. 

      62 mmHg

    • C. 

      87 mmHg

    • D. 

      102 mmHg


  • 50. 
    What the heck is a nomogram, anyway?
    • A. 

      A kind of Japanese puzzle

    • B. 

      A small motif of combined letters

    • C. 

      A two dimensional diagram using a coordinate system other than Cartesian

    • D. 

      It's another name for callipers


  • 51. 
    Respiratory alkalosis =
    • A. 

      Hypercapnea

    • B. 

      Hypocapnia

    • C. 

      Alveolar hypoventilation

    • D. 

      Alveolar hyperventilation


  • 52. 
    The short-acting system to maitain acid base balance is:
    • A. 

      Metabolic

    • B. 

      Lungs

    • C. 

      Respiratory

    • D. 

      Hematologic

    • E. 

      Kidneys


  • 53. 
    The Hallmark of this disease is hypoxemia refractory to conventional treatment.
    • A. 

      Cystic fibrosis

    • B. 

      Pulmonary embolism

    • C. 

      Acute respiratoryy failure

    • D. 

      Adult respiratory distress syndrome


  • 54. 
    This phase of ARDS involves hardening and obliteration of the alveoli, and it affects the interstitium also.
    • A. 

      Hemorrhagic

    • B. 

      Fibrotic

    • C. 

      Bodywide

    • D. 

      Terminal


  • 55. 
    During the clinical course of ARDS, what follows metabolic acidosis?
    • A. 

      Respiratory alkalosis

    • B. 

      Hypoxemia

    • C. 

      Respiratory acidosis

    • D. 

      Dysppnea


  • 56. 
    What is the 5 year survival rate of pulmonary malignancies?
    • A. 

      5%

    • B. 

      15%

    • C. 

      50%

    • D. 

      85%


  • 57. 
    Which bronchogenic carcinoma is almost always found in smokers?
    • A. 

      Squamous cell carcinoma

    • B. 

      Adenocarcinoma

    • C. 

      Large cell carcinoma

    • D. 

      Small cell carcinoma


  • 58. 
    Which bronchogenic carcinoma can cause tracheal deviation?
    • A. 

      Squamous cell carcinoma

    • B. 

      Adenocarcinoma

    • C. 

      Large cell carcinoma

    • D. 

      Small cell carcinoma


  • 59. 
    Which bronchogenic carcinoma is not treatable by surgery?
    • A. 

      Squamous cell carcinoma

    • B. 

      Large cell carcinoma

    • C. 

      Small cell carcinoma

    • D. 

      Adenocarcinoma


  • 60. 
    Which bronchogenic carcinoma accounts for less than 30% of bronchogenic carcinomas?
    • A. 

      Squamous cell carcinoma

    • B. 

      Adenocarcinoma

    • C. 

      Large cell carcinoma

    • D. 

      Small cell carcinoma


  • 61. 
    Which bronchogenic carcinoma originates in the bronchiolar or alveolar tissues of the lung?
    • A. 

      Squamous cell carcinoma

    • B. 

      Adenocarcinoma

    • C. 

      Large cell carcinoma

    • D. 

      Small cell carcinoma


  • 62. 
    ThrOne of the more common manifestations of paraneoplastic syndrome is:
    • A. 

      Hypercalcemia

    • B. 

      Release of gastrin releasing peptides

    • C. 

      Release of testosterone

    • D. 

      Cushing's syndrome


  • 63. 
    The most common metastases that arise from lung cancers are in the
    • A. 

      Kidneys

    • B. 

      Bones

    • C. 

      Liver

    • D. 

      Axial lymph nodes

    • E. 

      Brain


  • 64. 
    Lung "mets" often originate from
    • A. 

      Brain cancer

    • B. 

      Breast cancer

    • C. 

      Tongue cancer

    • D. 

      Malignant melanoma


  • 65. 
    This is made up of the tubercle bacilli, the modified macrophages, and other immune cells involved in a TB infection
    • A. 

      Ghon complex

    • B. 

      Ghon focus

    • C. 

      Caseous necrosis

    • D. 

      Calcification


  • 66. 
    TB is not confined to the lungs and can present as
    • A. 

      Meningitis

    • B. 

      Osteomyelitis

    • C. 

      Encephalitis

    • D. 

      Pharyngitis


  • 67. 
    This manifests as fatigue, distention of the jugular vein, liver engorgement, acites and hepatomegaly
    • A. 

      Cor pulmonale

    • B. 

      Right side heart failure

    • C. 

      Pulmonary hypertension

    • D. 

      Pulmonary hypotension


  • 68. 
    What is ascites anyway?
    • A. 

      Accumulation of fluid in the pleural cavity

    • B. 

      Accumulation of fluid in the peritoneal cavity

    • C. 

      Hydroperitoneum

    • D. 

      Abdominal dropsy


  • 69. 
    What is the best way to ascertain whether someone has a PE?
    • A. 

      Pulmonary function test

    • B. 

      Arterial blood gas

    • C. 

      Helical CT scan

    • D. 

      Diffusion capacity testing


  • 70. 
    In a __, the intrapleural pressure is higher than atmospheric pressure; therefore there is compression of the lung, heart, and great vessels.
    • A. 

      Penetrating pneumothorax

    • B. 

      Primary spontaneous pneumothorax

    • C. 

      Tension pneumothorax

    • D. 

      Secondary spontaneous pneumothorax


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