Pathophysiology Exam 2 Practice Quiz

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Pathophysiology Exam 2 Practice Quiz - Quiz

Pulmonary
obstructive and restrictive diseases


Questions and Answers
  • 1. 

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

    • A.

      Respiration

    • B.

      Ventilation

    • C.

      Diffusion

    • D.

      Perfusion

    Correct Answer
    C. Diffusion
    Explanation
    Diffusion involves the transfer of gases between air-filled spaces in the lungs and blood. It is the process by which oxygen from the air moves into the bloodstream and carbon dioxide, a waste product, moves out of the bloodstream into the air sacs in the lungs to be exhaled. This process occurs due to the concentration gradient of gases, with oxygen moving from an area of high concentration (air) to an area of low concentration (blood) and carbon dioxide moving in the opposite direction.

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  • 2. 

    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

    Correct Answer
    B. The nasopharynx to the bronchioles
    Explanation
    The conducting airways refer to the passageways through which air flows during the process of respiration. These airways start from the nasopharynx, which is the upper part of the throat behind the nose, and extend down to the bronchioles, which are the smallest branches of the bronchial tubes in the lungs. Therefore, the correct answer is "the nasopharynx to the bronchioles."

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  • 3. 

    ___ refers to how stiff the lungs are.

    • A.

      Elasticity

    • B.

      Recoil

    • C.

      Compliance

    • D.

      Fibrisis

    Correct Answer
    C. Compliance
    Explanation
    Compliance refers to how stiff the lungs are. It is a measure of the lung's ability to expand and contract in response to changes in pressure. High compliance means the lungs are more elastic and can easily expand, while low compliance indicates stiffness and reduced ability to expand.

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  • 4. 

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

    • A.

      70

    • B.

      50

    • C.

      30

    • D.

      10

    Correct Answer
    C. 30
    Explanation
    In a "normal" patient, the percentage of air left behind in dead spaces after expiration is 30%. Dead spaces refer to areas in the respiratory system where no gas exchange occurs, such as the trachea and bronchi. During expiration, not all the air in these dead spaces is expelled, resulting in a certain percentage remaining. In a healthy individual, this amount is typically around 30%.

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  • 5. 

    A low V/Q ratio could possibly indicate:

    • A.

      A restrictive disease

    • B.

      An obstructive disease

    • C.

      Interstitial lung disease

    • D.

      Asthma

    Correct Answer(s)
    B. An obstructive disease
    D. Asthma
    Explanation
    A low V/Q ratio refers to a mismatch between the volume of air reaching the alveoli (V) and the blood flow through the pulmonary capillaries (Q). In obstructive diseases such as asthma, there is an obstruction in the airways that restricts the flow of air, resulting in a decreased V/Q ratio. This means that there is less air reaching the alveoli compared to the amount of blood flowing through the capillaries. Therefore, the given answer of "an obstructive disease, asthma" is correct as both conditions can lead to a low V/Q ratio.

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  • 6. 

    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

    Correct Answer
    B. The oxygen in a dissolved state in the plasma
    Explanation
    PO2 refers to the partial pressure of oxygen in the blood plasma. It represents the amount of oxygen that is dissolved in the plasma and is available for diffusion into the tissues. This measurement is important in assessing the oxygen-carrying capacity of the blood and the efficiency of oxygen delivery to the tissues. It is different from the oxygen bound to hemoglobin, which is measured by the oxygen saturation level, and from the oxygen in bicarbonate or bound to carbon in CO2, which are involved in the transport and buffering of carbon dioxide in the blood.

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  • 7. 

    Which means there is normal perfusion and little or no ventilation?

    • A.

      Dead space unit

    • B.

      Silent unit

    • C.

      Shunt

    • D.

      Obstructive lung disease

    Correct Answer(s)
    C. Shunt
    D. Obstructive lung disease
    Explanation
    The correct answer is shunt. A shunt refers to a condition where there is normal blood flow (perfusion) but little or no air movement (ventilation) in a specific area of the lungs. This can occur due to various reasons such as collapsed airways, fluid-filled alveoli, or blockage in the air passages. Obstructive lung disease, on the other hand, refers to a condition where there is difficulty in exhaling air out of the lungs, but it does not necessarily imply a mismatch between perfusion and ventilation.

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  • 8. 

    During a fever, more oxygen is

    • A.

      Dissolved in the plasma

    • B.

      Bound to hemoglobin

    • C.

      Made available to tissues

    • D.

      Exhaled

    Correct Answer(s)
    A. Dissolved in the plasma
    C. Made available to tissues
    Explanation
    During a fever, the body's temperature increases, which leads to an increased metabolic rate. This increased metabolic rate requires more oxygen to be delivered to the tissues for energy production. As a result, more oxygen is dissolved in the plasma, increasing the amount available to the tissues. This allows the body to meet the higher demand for oxygen during a fever and support the increased metabolic activity.

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  • 9. 

    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

    Correct Answer
    C. Bicarbonate
    Explanation
    Bicarbonate is the correct answer because it is the primary form in which carbon dioxide is transported in the blood. When carbon dioxide enters the red blood cells, it combines with water to form carbonic acid, which then quickly dissociates into bicarbonate ions and hydrogen ions. The bicarbonate ions are then transported in the plasma to the lungs, where they are converted back into carbon dioxide and exhaled. This bicarbonate buffering system helps regulate the pH of the blood and ensures efficient transport of carbon dioxide throughout the body.

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  • 10. 

    Normal pulmonary blood pressure is

    • A.

      120/80

    • B.

      100/60

    • C.

      75/45

    • D.

      50/20

    • E.

      25/10

    Correct Answer
    E. 25/10
    Explanation
    The normal pulmonary blood pressure is 25/10. This means that the pressure in the pulmonary artery during contraction of the heart is 25 mmHg (millimeters of mercury) and during relaxation it is 10 mmHg. The pulmonary blood pressure is lower than the systemic blood pressure because the lungs have a lower resistance to blood flow compared to the rest of the body. This allows for efficient oxygenation of the blood in the lungs before it is pumped to the rest of the body.

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  • 11. 

    ___ 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

    Correct Answer
    B. Bronchial circulation
    Explanation
    Bronchial circulation is responsible for providing oxygenated blood from the systemic circulation to meet the metabolic needs of the lungs. This circulation supplies oxygen and nutrients to the lung tissues, allowing them to function properly. The bronchial arteries branch off from the aorta and deliver oxygenated blood to the bronchi, bronchioles, and other lung structures. This ensures that the lungs receive their own blood supply separate from the oxygen-depleted blood returning to the heart through the pulmonary circulation.

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  • 12. 

    ___ provides the gas exchange function.

    • A.

      Pulmonary circulation

    • B.

      Bronchial circulation

    • C.

      The superior vena cava

    • D.

      The aorta

    Correct Answer
    A. Pulmonary circulation
    Explanation
    Pulmonary circulation refers to the movement of blood between the heart and the lungs. It is responsible for the gas exchange function, where oxygen is taken up by the blood in the lungs and carbon dioxide is released. This process ensures that oxygenated blood is delivered to the body's tissues while deoxygenated blood is returned to the lungs for oxygenation. Therefore, pulmonary circulation is the correct answer as it specifically relates to the function of gas exchange.

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  • 13. 

    Which is not a morphologic pulmonary assessment tool?

    • A.

      Radiology

    • B.

      Biopsy

    • C.

      Blood gas analysis

    • D.

      Bronchoscopy

    Correct Answer
    C. Blood gas analysis
    Explanation
    Blood gas analysis is not a morphologic pulmonary assessment tool because it measures the levels of oxygen and carbon dioxide in the blood, as well as other parameters such as pH and bicarbonate. It provides information about the respiratory function and acid-base balance, but it does not directly assess the physical structure or morphology of the lungs. Radiology, biopsy, and bronchoscopy, on the other hand, are all tools that can be used to visualize and examine the lungs and their structures.

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  • 14. 

    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

    Correct Answer(s)
    A. Expiratory reserve volume
    D. Inspiratory reserve volume
    Explanation
    The expiratory reserve volume and inspiratory reserve volume are measures of ventilation that involve breathing at rest. The expiratory reserve volume is the additional amount of air that can be forcefully exhaled after a normal exhalation, while the inspiratory reserve volume is the additional amount of air that can be forcefully inhaled after a normal inhalation. These measures are taken during normal breathing at rest, without any forced or maximum effort. On the other hand, the residual volume and forced vital capacity are measures that are not specifically related to breathing at rest.

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  • 15. 

    Which diseases would have normal FVC and FEV1?

    • A.

      COPD

    • B.

      Pneumoconioses

    • C.

      Asthma

    • D.

      Sarcoidosis

    Correct Answer(s)
    B. Pneumoconioses
    D. Sarcoidosis
    Explanation
    Pneumoconioses and sarcoidosis are the diseases that would have normal FVC (Forced Vital Capacity) and FEV1 (Forced Expiratory Volume in 1 second). In these conditions, the lung function tests, specifically FVC and FEV1, would not show any significant abnormalities. This means that the volume of air forcefully exhaled in 1 second and the total volume of air exhaled after maximum inhalation would be within the normal range. This is in contrast to COPD (Chronic Obstructive Pulmonary Disease) and asthma, where FVC and FEV1 are typically reduced due to airway obstruction and lung damage.

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  • 16. 

    Which would decrease diffusion capacity?

    • A.

      COPD

    • B.

      Asthma

    • C.

      Thinning of the aveolocapillary membrane

    • D.

      Loss of alveoli

    Correct Answer(s)
    A. COPD
    D. Loss of alveoli
    Explanation
    COPD (Chronic Obstructive Pulmonary Disease) is a progressive lung disease that causes obstruction in the airways, leading to difficulty in breathing. This obstruction can decrease the surface area available for gas exchange, thereby decreasing diffusion capacity. Loss of alveoli, which are the tiny air sacs in the lungs responsible for gas exchange, can also reduce the surface area available for diffusion, further decreasing diffusion capacity. Both COPD and loss of alveoli can impair the efficiency of oxygen and carbon dioxide exchange in the lungs, leading to decreased diffusion capacity.

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  • 17. 

    Normal SaO2 is

    • A.

      35-45 mmHg

    • B.

      80-100 mmHg

    • C.

      97%

    • D.

      7.35-7.45

    • E.

      22 - 26 mEq/L

    Correct Answer
    C. 97%
  • 18. 

    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

    Correct Answer
    B. Fluid collected in the pleural space
    Explanation
    Pleural effusion refers to the accumulation of fluid in the pleural space, which is the space between the two layers of the pleura (the membrane that covers the lungs). This condition can occur due to various reasons such as infection, inflammation, heart failure, or cancer. The fluid buildup in the pleural space can cause symptoms like shortness of breath, chest pain, and coughing. Treatment usually involves addressing the underlying cause and draining the fluid from the pleural space.

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  • 19. 

    Which does not have a preexisting pulmonary disease?

    • A.

      Secondary pneumothorax

    • B.

      Primary pneumothorax

    • C.

      Cor pulmonale

    • D.

      ARDS

    Correct Answer
    B. Primary pneumothorax
    Explanation
    A primary pneumothorax refers to the spontaneous collapse of a lung without any preexisting lung disease. It typically occurs in tall, thin individuals and is often caused by the rupture of small air sacs on the lung surface called blebs. Secondary pneumothorax, on the other hand, occurs in individuals with preexisting lung diseases such as chronic obstructive pulmonary disease (COPD) or cystic fibrosis. Cor pulmonale is a condition characterized by right-sided heart failure due to lung disease, and ARDS (acute respiratory distress syndrome) is a severe lung condition often caused by infection or injury.

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  • 20. 

    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

    Correct Answer
    C. Atelectasis
    Explanation
    Atelectasis refers to a condition where there is either a complete or partial collapse of the lung or a portion of it. This collapse can be due to various factors such as airway obstruction, lung compression, or loss of surfactant. Atelectasis can be hereditary or acquired, and it is characterized by the inability of the affected lung tissue to properly inflate and exchange oxygen.

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  • 21. 

    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

    Correct Answer(s)
    A. Takes place in the larger airways
    C. Involves the parasympathetic nervous system
    E. Involves histamine
    Explanation
    Bronchoconstriction refers to the narrowing of the airways in the lungs. It primarily occurs in the larger airways rather than the smaller ones. The parasympathetic nervous system plays a role in bronchoconstriction by causing the smooth muscles in the airways to contract, leading to narrowing. Histamine is also involved in bronchoconstriction as it is released during allergic reactions and causes the airways to constrict. Therefore, the correct answer is that bronchoconstriction takes place in the larger airways, involves the parasympathetic nervous system, and involves histamine.

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  • 22. 

    Which of the following is not an obstructive pulmonary disease?

    • A.

      Pneumoconioses

    • B.

      Sarcoidosis

    • C.

      Bronchiectasis

    • D.

      Cystic fibrosis

    • E.

      Chronic bronchitis

    Correct Answer(s)
    A. Pneumoconioses
    B. Sarcoidosis
    Explanation
    Pneumoconioses and sarcoidosis are both non-malignant lung diseases that are not classified as obstructive pulmonary diseases. Pneumoconioses refer to a group of lung diseases caused by the inhalation of mineral dust particles, such as coal dust or silica, leading to scarring and inflammation in the lungs. Sarcoidosis is an inflammatory disease that can affect multiple organs, including the lungs, causing granulomas to form. On the other hand, bronchiectasis, cystic fibrosis, and chronic bronchitis are all obstructive pulmonary diseases characterized by airflow limitation and difficulty breathing.

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  • 23. 

    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

    Correct Answer(s)
    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
    Explanation
    The correct answer states that asthma results from overproduction of TH2 cells since TH1 cells weren't produced to fight the microbes of childhood illness. This aligns with the hygiene hypothesis, which suggests that reduced exposure to infectious agents in early childhood leads to an imbalance in the immune system, favoring TH2 responses over TH1 responses. This imbalance can contribute to the development of asthma. Additionally, the answer also mentions that asthma is caused by IgE antibodies responding to harmless substances instead of to helminths. This is consistent with the understanding that allergic reactions, mediated by IgE antibodies, play a role in asthma development.

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  • 24. 

    Which of the following are bronchospastic triggers of asthma?

    • A.

      GERD

    • B.

      Dust mites

    • C.

      Cold air

    • D.

      Viruses

    • E.

      Pollen

    Correct Answer
    C. Cold air
    Explanation
    Cold air is a bronchospastic trigger of asthma because when a person with asthma breathes in cold air, it can cause the airways in their lungs to narrow and become inflamed. This can lead to symptoms such as wheezing, coughing, and difficulty breathing. Cold air can also cause the muscles around the airways to tighten, further exacerbating the bronchospasm. Therefore, individuals with asthma are often advised to avoid exposure to cold air and to take precautions such as wearing scarves or masks over their mouths and noses during cold weather.

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  • 25. 

    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

    Correct Answer(s)
    B. Includes epithelial edema and injury
    C. May last for weeks
    Explanation
    The late phase response of asthma refers to a prolonged inflammatory reaction in the airways. It is caused by the release of chemical mediators from the mast cells, which leads to epithelial edema and injury. This response can persist for weeks, resulting in symptoms such as shortness of breath and wheezing.

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  • 26. 

    The typical patient is a male smoker.

    • A.

      Emphysema

    • B.

      Adenocarcinoma

    • C.

      Squamous cell carcinoma

    • D.

      Chronic bronchitis

    • E.

      Large cell carcinoma

    Correct Answer(s)
    C. Squamous cell carcinoma
    D. Chronic bronchitis
    Explanation
    The given answer, squamous cell carcinoma and chronic bronchitis, is likely the correct answer because both conditions are commonly associated with smoking. Squamous cell carcinoma is a type of lung cancer that is strongly linked to smoking, particularly in male patients. Chronic bronchitis is a chronic inflammation of the bronchial tubes, often caused by smoking. Therefore, the combination of squamous cell carcinoma and chronic bronchitis suggests that the typical patient is a male smoker.

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  • 27. 

    This disease can be caused by an alpha-1 antitrypsin deficiency:

    • A.

      Cystic fibrosis

    • B.

      Emphysema

    • C.

      Chronic bronchitis

    • D.

      Asthma

    • E.

      Pulmonary embolism

    Correct Answer
    B. Emphysema
    Explanation
    Emphysema is a disease that can be caused by an alpha-1 antitrypsin deficiency. Alpha-1 antitrypsin is a protein that protects the lungs from damage caused by enzymes. When there is a deficiency of this protein, the enzymes are not properly regulated, leading to the destruction of lung tissue and the development of emphysema. Cystic fibrosis, chronic bronchitis, asthma, and pulmonary embolism are not directly caused by alpha-1 antitrypsin deficiency, making emphysema the correct answer.

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  • 28. 

    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

    Correct Answer
    B. Chronic bronchitis
    Explanation
    Chronic bronchitis is a respiratory condition characterized by inflammation and irritation of the bronchial tubes. This inflammation leads to excessive mucus production and narrowing of the airways, causing difficulty in breathing. In chronic bronchitis, the high levels of mucus can block the airways, preventing proper oxygen exchange. As a result, the reduced hemoglobin in the blood fails to come into contact with sufficient oxygen, leading to cyanosis, a bluish discoloration of the skin and mucous membranes due to low oxygen levels.

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  • 29. 

    A mutation in chromosome 7 is associated with:

    • A.

      Emphysema

    • B.

      Adenocarcinoma

    • C.

      Cystic fibrosis

    • D.

      Primary spontaneous pneumothorax

    Correct Answer
    C. Cystic fibrosis
    Explanation
    Cystic fibrosis is a genetic disorder caused by a mutation in the CFTR gene, which is located on chromosome 7. This mutation leads to the production of a defective protein that affects the movement of salt and water in and out of cells. As a result, thick and sticky mucus builds up in various organs, especially the lungs and digestive system, causing problems with breathing and digestion. Therefore, a mutation in chromosome 7 is associated with cystic fibrosis.

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  • 30. 

    Normal HCO3 is

    • A.

      35-45 mmHg

    • B.

      80-100 mmHg

    • C.

      97%

    • D.

      7.35-7.45

    • E.

      22-26 MEq/L

    Correct Answer
    E. 22-26 MEq/L
    Explanation
    The correct answer is 22-26 MEq/L. This range represents the normal levels of bicarbonate (HCO3) in the body. Bicarbonate is an important electrolyte involved in maintaining the acid-base balance in the blood. Any deviation from this range may indicate an underlying health condition, such as acidosis or alkalosis. Therefore, it is crucial to monitor bicarbonate levels to ensure proper functioning of the body's metabolic processes.

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  • 31. 

    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

    Correct Answer
    B. COPD from asthma
    Explanation
    Diffusion capacity testing measures the ability of the lungs to transfer gases from inhaled air into the bloodstream. In the case of COPD, the air sacs in the lungs become damaged, leading to reduced gas exchange. On the other hand, asthma is characterized by inflammation and narrowing of the airways, which can also affect gas exchange. Therefore, diffusion capacity testing can help differentiate between COPD and asthma by assessing the extent of gas transfer impairment in each condition.

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  • 32. 

    Interstitial lung diseases can also be called

    • A.

      Obstructive pulmonary diseases

    • B.

      COPD

    • C.

      Pulmonary fibrosis

    • D.

      Bronchiectasis

    Correct Answer
    C. Pulmonary fibrosis
    Explanation
    Interstitial lung diseases are a group of lung disorders that primarily affect the interstitium, the tissue and space around the air sacs in the lungs. Pulmonary fibrosis is a specific type of interstitial lung disease characterized by the formation of scar tissue in the lungs, which leads to the thickening and stiffening of the lung tissue. This scarring can make it difficult for the lungs to expand and contract properly, resulting in breathing difficulties. Therefore, pulmonary fibrosis is a correct term to describe interstitial lung diseases.

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  • 33. 

    Pulmonary fibrosis can be caused by

    • A.

      A chromosome 7 mutation

    • B.

      Heparin

    • C.

      Inhalants

    • D.

      Sarcoidosis

    • E.

      Alpha-1 antitrypsin deficiency

    Correct Answer(s)
    C. Inhalants
    D. Sarcoidosis
    Explanation
    Pulmonary fibrosis is a condition characterized by scarring and thickening of the lung tissues, leading to difficulty in breathing. Inhalants, such as certain chemicals or pollutants, can cause inflammation and damage to the lungs, eventually leading to fibrosis. Sarcoidosis is another potential cause of pulmonary fibrosis, where tiny clumps of inflammatory cells form in different organs, including the lungs. These clumps can cause scarring and fibrosis over time. Chromosome 7 mutation and alpha-1 antitrypsin deficiency are not directly associated with causing pulmonary fibrosis.

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  • 34. 

    Symptoms of interstitial lung diseases include

    • A.

      Wheezing

    • B.

      Airway obstructive

    • C.

      Clubbing of nails

    • D.

      Productive cough

    • E.

      Slow and labored breathing

    Correct Answer
    C. Clubbing of nails
    Explanation
    Clubbing of nails is a symptom of interstitial lung diseases. Clubbing refers to the enlargement of the fingertips and the nails becoming rounded and curved. It is caused by the lack of oxygen in the blood, which can occur in lung diseases. This symptom is often seen in advanced stages of interstitial lung diseases and is a result of chronic low oxygen levels in the body. Therefore, the presence of clubbing of nails can be a sign of interstitial lung diseases.

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  • 35. 

    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

    Correct Answer(s)
    B. May be related to HLA genes
    C. Commonly affects the lungs, skin and eyes
    Explanation
    Sarcoidosis is a disease that commonly affects the lungs, skin, and eyes. This is supported by the statement that it commonly affects these specific organs. Additionally, the answer suggests that sarcoidosis may be related to HLA genes. This implies that certain genetic factors, specifically the HLA genes, may play a role in the development of sarcoidosis.

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  • 36. 

    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

    Correct Answer(s)
    C. Pulmonary embolism
    D. Pulmonary hypertension
    Explanation
    The V/Q ratio refers to the ventilation-perfusion ratio, which is a measure of how well oxygen is being delivered to the lungs and how well carbon dioxide is being removed. A V/Q ratio higher than 0.8 indicates that there is more ventilation (airflow) relative to perfusion (blood flow) in the lungs. Pulmonary embolism and pulmonary hypertension both involve a decrease in blood flow to the lungs, which can lead to a higher V/Q ratio. In contrast, emphysema and chronic bronchitis are both obstructive lung diseases that can cause a decrease in ventilation and a lower V/Q ratio.

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  • 37. 

    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

    Correct Answer
    C. Pulmonary embolism
    Explanation
    Pulmonary embolism is a condition where a blood clot blocks one or more arteries in the lungs. It can occur suddenly and without warning, leading to a lack of oxygen in the body. In some cases, there may be no noticeable signs or symptoms initially, but it can quickly become life-threatening. If left untreated, a pulmonary embolism can result in death within minutes. Therefore, pulmonary embolism is the correct answer as it matches the description given in the question.

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  • 38. 

    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

    Correct Answer(s)
    C. A cause of the increase in pulmonary vascular resistance is obstruction/destruction of the pulmonary vascular bed
    E. The hypoxic component is more important
    Explanation
    The correct answer suggests that the increase in pulmonary vascular resistance in cor pulmonale is primarily caused by obstruction or destruction of the pulmonary vascular bed. This means that there is a physical blockage or damage to the blood vessels in the lungs, which leads to increased resistance to blood flow. Additionally, the answer states that the hypoxic component is more important, indicating that low oxygen levels in the lungs play a significant role in causing vasoconstriction and further increasing pulmonary vascular resistance.

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  • 39. 

    Causes of pulmonary edema include:

    • A.

      ARDS

    • B.

      Left ventricular failure

    • C.

      Cancer

    • D.

      Infection

    Correct Answer
    B. Left ventricular failure
    Explanation
    Left ventricular failure is a known cause of pulmonary edema. When the left ventricle of the heart is unable to pump blood effectively, it can lead to a buildup of fluid in the lungs. This can occur due to conditions such as congestive heart failure or myocardial infarction. The increased pressure in the left side of the heart causes fluid to leak into the pulmonary capillaries and eventually into the air sacs of the lungs, leading to pulmonary edema. This condition can result in symptoms like shortness of breath, coughing, and difficulty breathing.

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  • 40. 

    Symptoms in the early stages include dyspnea on exertion

    • A.

      Pulmonary edema

    • B.

      Emphysema

    • C.

      Pulmonary embolism

    • D.

      Interstitial lung disease

    Correct Answer(s)
    A. Pulmonary edema
    B. Emphysema
    D. Interstitial lung disease
    Explanation
    The given symptoms in the early stages include dyspnea on exertion, pulmonary edema, emphysema, and interstitial lung disease. Pulmonary edema refers to the accumulation of fluid in the lungs, causing difficulty in breathing. Emphysema is a chronic lung condition characterized by the destruction of the air sacs in the lungs, leading to shortness of breath. Interstitial lung disease refers to a group of lung disorders that cause inflammation and scarring of the lung tissue, resulting in breathing difficulties. Therefore, the correct answer includes pulmonary edema, emphysema, and interstitial lung disease as symptoms in the early stages.

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  • 41. 

    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

    Correct Answer(s)
    B. Is the most common type
    E. Selectively affects the respiratory bronchioles and alveolar ducts
    Explanation
    The given correct answer for this question is "is the most common type" and "selectively affects the respiratory bronchioles and alveolar ducts". This means that centriacinar emphysema is the most commonly seen type of emphysema and it specifically affects the respiratory bronchioles and alveolar ducts. This type of emphysema is characterized by the destruction of the walls of these small airways and the enlargement of the air spaces within the lungs. It is often associated with smoking and chronic obstructive pulmonary disease (COPD).

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  • 42. 

    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

    Correct Answer(s)
    C. Extrinsic disorders lead to hypercapnic failure
    E. Hypercapnea always implies hypoxemia
    Explanation
    Extrinsic disorders, such as chest wall abnormalities or neuromuscular diseases, can lead to hypercapnic failure, which is characterized by an inability to effectively remove carbon dioxide from the body. On the other hand, hypoxemia refers to low levels of oxygen in the blood, which can occur in various conditions, including acute respiratory failure. While hypercapnia can sometimes lead to hypoxemia, it is not always the case. Therefore, the statement "hypercapnea always implies hypoxemia" is not true.

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  • 43. 

    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

    Correct Answer(s)
    A. States that partial pressure of all the alveolar or arterial blood gases adds up to atmospheric pressure of 760 mmHg
    C. Implies that when PCO2 increases, PO2 decreases
    Explanation
    The gas rule states that the partial pressure of all the alveolar or arterial blood gases adds up to the atmospheric pressure of 760 mmHg. This implies that when the partial pressure of CO2 (PCO2) increases, the partial pressure of oxygen (PO2) decreases. This is because as PCO2 increases, it can displace or compete with oxygen, leading to a decrease in the amount of oxygen available. Therefore, an increase in PCO2 is associated with a decrease in PO2.

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  • 44. 

    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

    Correct Answer
    C. The cause is shunting
    Explanation
    When the cause of the A-a gradient is shunting, it means that there is a portion of the blood bypassing the alveoli and not participating in gas exchange. In this situation, the oxygen in the blood is not corrected by the inspired oxygen because it does not come into contact with the alveoli where gas exchange occurs. As a result, the A-a gradient remains elevated.

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  • 45. 

    If alveolar ventilation is halved, PCO2

    • A.

      Will half

    • B.

      Will divide by 4

    • C.

      Will double

    • D.

      Will quadruple

    Correct Answer
    C. Will double
    Explanation
    If alveolar ventilation is halved, it means that the amount of fresh air reaching the alveoli in the lungs is reduced by half. As a result, the removal of carbon dioxide (CO2) from the body is also reduced. This leads to an accumulation of CO2 in the bloodstream, causing an increase in its partial pressure. According to the principles of gas exchange, an increase in CO2 partial pressure will result in a proportional increase in PCO2. Therefore, if alveolar ventilation is halved, PCO2 will double.

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  • 46. 

    Hemoglobin binds oxygen more strongly in

    • A.

      Acidosis

    • B.

      Alkalosis

    • C.

      An increased amount of CO2

    • D.

      A decreased amount of CO2

    Correct Answer(s)
    B. Alkalosis
    D. A decreased amount of CO2
    Explanation
    In alkalosis, the pH of the blood becomes more basic, which causes hemoglobin to bind oxygen more strongly. This is because the basic environment promotes the release of hydrogen ions from hemoglobin, allowing more oxygen to bind. Additionally, a decreased amount of CO2 also causes hemoglobin to bind oxygen more strongly. When CO2 levels are low, the blood becomes more alkaline, which further enhances the binding of oxygen to hemoglobin.

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  • 47. 

    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

    Correct Answer
    C. Release of oxygen into tissue capillaries
    Explanation
    The steep section of the OxyHb dissociation curve represents the release of oxygen into tissue capillaries. This is because at higher PO2 concentrations, hemoglobin is still highly saturated, meaning that it is already bound to oxygen and cannot bind more. Therefore, any increase in PO2 does not lead to a significant increase in oxygen binding. Instead, the steep section of the curve reflects a small transfer of oxygen to tissues with a large drop in PO2, indicating the release of oxygen from hemoglobin to meet the oxygen demands of the tissues.

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  • 48. 

    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

    Correct Answer
    C. 87 mmHg
    Explanation
    In a semicomatose patient with disorientation and lethargy, a high level of PCO2 could be hypothesized. This is because an increase in PCO2, also known as hypercapnia, can cause symptoms such as confusion, lethargy, and altered mental status. Therefore, the correct answer is 87 mmHg, as it represents a high level of PCO2 that could be associated with the given symptoms.

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  • 49. 

    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

    Correct Answer
    C. A two dimensional diagram using a coordinate system other than Cartesian
    Explanation
    A nomogram is a two-dimensional diagram that uses a coordinate system other than Cartesian. Unlike Cartesian coordinates, which use perpendicular axes, a nomogram may use curves or other non-linear scales to represent relationships between variables. Nomograms are often used in engineering, mathematics, and other fields to quickly solve equations or perform calculations without the need for complex mathematical formulas. They provide a visual representation of the relationships between variables, making them a useful tool for problem-solving and decision-making.

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  • 50. 

    Respiratory alkalosis =

    • A.

      Hypercapnea

    • B.

      Hypocapnia

    • C.

      Alveolar hypoventilation

    • D.

      Alveolar hyperventilation

    Correct Answer(s)
    B. Hypocapnia
    D. Alveolar hyperventilation
    Explanation
    Respiratory alkalosis refers to a condition where there is an increase in blood pH due to a decrease in carbon dioxide (CO2) levels. This can occur through two mechanisms - hypocapnia and alveolar hyperventilation. Hypocapnia refers to reduced levels of CO2 in the blood, which can cause respiratory alkalosis. Alveolar hyperventilation refers to an increase in the rate and depth of breathing, leading to the elimination of more CO2 from the body, resulting in hypocapnia. Therefore, both hypocapnia and alveolar hyperventilation are correct explanations for respiratory alkalosis.

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Day4517 |MedicalEducation |
Jessica, a seasoned Physician Associate with a decade of clinical expertise, seamlessly integrates over five years of teaching experience. Her unique background in journalism adds a distinctive dimension to her multifaceted approach to healthcare and education, creating a rich and diverse professional profile.

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  • Current Version
  • Mar 22, 2023
    Quiz Edited by
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  • Sep 27, 2009
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    Day4517
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