Deck 20: Pulmonary Embolism and Infarction

Question 1

MATCHING
The clinical scenarios associated with respiratory diseases result from the pathophysiologic mechanisms caused (or activated) by the anatomic alterations of the lungs associated with the disorder. Using the "Yes" or "No" items, match the major anatomic alterations of the lungs, listed below, that cause the clinical scenario associated with Pulmonary Embolism.
Excessive Bronchial Secretions Clinical Scenario

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Answer 1

NO-This is not associated with pulmonary embolism.

Question 2

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Alveolar consolidation

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Answer 2

YES-This is associated with pulmonary embolism.

Question 3

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Alveolar hyperinflation (air-trapping)

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Answer 3

NO-This is not associated with pulmonary embolism.

Question 4

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Interstitial edema

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 5

MATCHING
The clinical scenarios associated with respiratory diseases result from the pathophysiologic mechanisms caused (or activated) by the anatomic alterations of the lungs associated with the disorder. Using the "Yes" or "No" items, match the major anatomic alterations of the lungs, listed below, that cause the clinical scenario associated with Pulmonary Embolism.
Increased Alveolar-Capillary Membrane Thickness Clinical Scenario

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 6

MATCHING
The clinical scenarios associated with respiratory diseases result from the pathophysiologic mechanisms caused (or activated) by the anatomic alterations of the lungs associated with the disorder. Using the "Yes" or "No" items, match the major anatomic alterations of the lungs, listed below, that cause the clinical scenario associated with Pulmonary Embolism.
Atelectasis Clinical Scenario

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 7

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Fibrotic thickening of the alveoli (parenchymal fibrosis)

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 8

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Hyaline membrane formation

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 9

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Granulomas

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 10

MATCHING
The clinical scenarios associated with respiratory diseases result from the pathophysiologic mechanisms caused (or activated) by the anatomic alterations of the lungs associated with the disorder. Using the "Yes" or "No" items, match the major anatomic alterations of the lungs, listed below, that cause the clinical scenario associated with Pulmonary Embolism.
Distal Airway and Alveolar Weakening Clinical Scenario

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 11

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Blockage of pulmonary vascular system

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 12

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Distal airway and alveolar weakening

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 13

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Chronic dilation and distortion of bronchial airway

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 14

MATCHING
The clinical scenarios associated with respiratory diseases result from the pathophysiologic mechanisms caused (or activated) by the anatomic alterations of the lungs associated with the disorder. Using the "Yes" or "No" items, match the major anatomic alterations of the lungs, listed below, that cause the clinical scenario associated with Pulmonary Embolism.
Alveolar Consolidation Clinical Scenario

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 15

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Bronchospasm (smooth muscle constriction of bronchial airways)

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 16

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Atelectasis

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 17

MATCHING
The clinical scenarios associated with respiratory diseases result from the pathophysiologic mechanisms caused (or activated) by the anatomic alterations of the lungs associated with the disorder. Using the "Yes" or "No" items, match the major anatomic alterations of the lungs, listed below, that cause the clinical scenario associated with Pulmonary Embolism.
Bronchospasm Clinical Scenario

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 18

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Compression of great vessels and decreased cardiac return

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 19

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Destruction of pulmonary capillaries

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 20

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Pulmonary capillary congestion

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 21

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Permanent enlargement and deterioration of alveoli

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 22

Match the arterial blood gas changes that occur during extensive pulmonary embolism and infarction to the items listed below. Items may be used once, more than once, or not at all.
PaCO₂

A)Increases
B)Decreases
C)Normal

Question 23

Match the arterial blood gas changes that occur during extensive pulmonary embolism and infarction to the items listed below. Items may be used once, more than once, or not at all.
pH

A)Increases
B)Decreases
C)Normal

Question 24

Match what develops in the oxygen indices of a patient with a pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
_S/ _T

A)Normal
B)Decreases
C)Increases
D)Normal or decreased
E)Normal or increased

Question 25

Match what develops in the oxygen indices of a patient with a pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
O₂

A)Normal
B)Decreases
C)Increases
D)Normal or decreased
E)Normal or increased

Question 26

Match what develops in the oxygen indices of a patient with a pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
DO₂

A)Normal
B)Decreases
C)Increases
D)Normal or decreased
E)Normal or increased

Question 27

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Frothy white (or pink) bronchial secretions

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 28

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
RAP

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 29

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Pulmonary infarction

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 30

Match what develops in the oxygen indices of a patient with a pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
O₂ER

A)Normal
B)Decreases
C)Increases
D)Normal or decreased
E)Normal or increased

Question 31

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Excessive thick, whitish bronchial secretions

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 32

Match the arterial blood gas changes that occur during a mild to moderate pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
pH

A)Increases
B)Decreases
C)Normal

Question 33

Match the arterial blood gas changes that occur during a mild to moderate pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
HCO₃^-

A)Increases
B)Decreases
C)Normal

Question 34

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Mucus plugging

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 35

Match what develops in the oxygen indices of a patient with a pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
C(a-v)

A)Normal
B)Decreases
C)Increases
D)Normal or decreased
E)Normal or increased

Question 36

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
CVP

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 37

Match the arterial blood gas changes that occur during a mild to moderate pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
PaCO₂

A)Increases
B)Decreases
C)Normal

Question 38

Match what develops in the oxygen indices of a patient with a pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
SvO₂

A)Normal
B)Decreases
C)Increases
D)Normal or decreased
E)Normal or increased

Question 39

Identify the major anatomic alterations of the lungs associated with pulmonary embolism.
Chronic inflammation and swelling of airways

A)YES-This is associated with pulmonary embolism.
B)NO-This is not associated with pulmonary embolism.

Question 40

Match the arterial blood gas changes that occur during extensive pulmonary embolism and infarction to the items listed below. Items may be used once, more than once, or not at all.
HCO₃^-

A)Increases
B)Decreases
C)Normal

Question 41

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
PA

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 42

The term syncope is defined as a loss of consciousness resulting from insufficient blood flow to the brain.

Question 43

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
CO

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 44

Blood clots are the most common source of pulmonary embolus.

Question 45

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
LVSWI

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 46

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
PVR

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 47

A large embolus that lodges in the bifurcation of the pulmonary artery is called a saddle embolus.

Question 48

An angiogram procedure generally poses no risk to a patient with a pulmonary embolus, unless the mean pulmonary artery pressure is greater than 25 mm Hg.

Question 49

One of the consequences of pulmonary embolism is the reduction of certain humoral agents, primarily serotonin and prostaglandin.

Question 50

As a result of the decreased systemic blood pressure associated with a pulmonary embolism, reflexes from the aortic and carotid sinus baroreceptors cause a decreased heart rate and a decreased ventilatory rate.

Question 51

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
SVI

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 52

A large pulmonary embolus causes the systemic blood pressure to decrease.

Question 53

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
SV

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 54

For a ventilation lung scan, the patient inhales a gas mixture containing a small amount of radioactive gas. This radioactive mixture is usually Xenon-133.

Question 55

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
CI

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 56

Heparin is a thrombolytic agent.

Question 57

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
SVR

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 58

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
PCWP

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 59

Match what hemodynamic indices develop in patients with an extensive pulmonary embolism to the items listed below. Items may be used once, more than once, or not at all.
RVSWI

A)Normal
B)Decreases
C)Increases
D)Decrease/normal
E)Increase/normal

Question 60

It is not the pulmonary embolism but rather the decreased / ratio that develops that causes the patient's PaO₂ to decrease.

Question 61

Which of the following is/are major mechanisms that contribute to the pulmonary hypertension commonly seen in the patients with pulmonary embolism?

A) I and III only
B) II and IV only
C) I, II, and IV only
D) I, II, III, and IV

Question 62

Which of the following thrombolytic agents is/are used to treat pulmonary embolism?

A) III only
B) IV only
C) II and IV only
D) I, II, and IV only

Question 63

Most patients with a pulmonary embolus have a mean pulmonary artery pressure in excess of:

A) 20 mm Hg.
B) 30 mm Hg.
C) 40 mm Hg.
D) 50 mm Hg.
E) 60 mm Hg.