Question 1

A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would be expected?

Accepted Answer

B

Question 2

A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. This condition could cause:

Accepted Answer

Aspiration of gastric contents can lead to the development of pneumonitis and pneumonia as gastric acid and contents can cause inflammation and infection in the lungs.

Question 3

A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing. This condition is referred to as:

Accepted Answer

The respiratory abnormalities described in the scenario are characteristic of Cheyne-Stokes breathing, which is marked by alternating periods of deep and shallow breathing. This pattern of breathing is often associated with brain stem dysfunction, which can occur as a result of a severe head injury. Frank-Starling refers to the relationship between stroke volume and end-diastolic volume in the heart, and is not relevant to describing respiratory abnormalities. Apnea refers to periods of interrupted breathing, and orthopnea refers to difficulty breathing while lying down, neither of which describe the pattern of breathing seen in this scenario.

Question 4

A 10-year-old female develops pneumonia following a urinary tract infection. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. This condition is referred to as:

Accepted Answer

The symptoms described, including difficulty breathing and a feeling of not getting enough air, are characteristic of dyspnea, which is defined as labored or difficult breathing. Cyanosis refers to a bluish discoloration of the skin or mucous membranes due to decreased oxygenation, hyperpnea refers to an increase in the depth and rate of breathing, and orthopnea refers to shortness of breath that occurs when lying down and is relieved by sitting up. While the patient may have some of these symptoms, dyspnea is the most appropriate choice given the given information.

Question 5

A 20-year-old male presents to his physician complaining of difficulty breathing when lying down. This condition is referred to as:

Accepted Answer

Difficulty breathing when lying down is known as orthopnea. A: Dyspnea on exertion is difficulty breathing during physical activity. C: Apnea is the absence of breathing. D: Tachypnea is rapid breathing.

Question 6

The condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion is called:

Accepted Answer

Alveolar dead space occurs when alveoli are ventilated but not perfused, meaning there is adequate air reaching the alveoli but insufficient blood flow to exchange gases.

Question 7

A low ventilation-perfusion ratio results in:

Accepted Answer

A low ventilation-perfusion ratio means that there is relatively less air getting to a given area of the lung than blood flow, which can lead to shunting. Shunting occurs when blood is able to bypass the capillaries surrounding the alveoli, reducing oxygenation in the lungs.

Question 8

A 28-year-old male complains to his physician that he has had a cold for a week and is coughing up bloody secretions. This condition is referred to as:

Accepted Answer

Hemoptysis is the coughing up of blood or bloody sputum from the respiratory tract, and is a common symptom of respiratory diseases such as bronchitis, pneumonia, and lung cancer. Hematemesis refers to vomiting blood, while cyanosis is a bluish discoloration of the skin due to lack of oxygen. Rhinitis is inflammation of the nasal mucosa and does not involve coughing up of bloody secretions.

Question 9

A 45-year-old male undergoes lung transplantation. He now suffers from airway occlusion secondary to fibrosis. The most likely diagnosis is:

Accepted Answer

After lung transplantation, the most common cause of airway occlusion is bronchiolitis obliterans, which is characterized by progressive fibrosis and inflammation of the small airways. Compression atelectasis, bronchiectasis, and bronchiolitis may also occur after lung transplantation but are less likely to result in airway occlusion.

Question 10

A 47-year-old male is diagnosed with pulmonary edema. Which of the following would be expected with this condition?

Accepted Answer

Pulmonary edema is characterized by the accumulation of fluid in the lungs. The accumulation of fluid can lead to the development of frothy, pink sputum. Thick mucous secretions, hypocapnia, and wheezing are not typical findings in pulmonary edema.

Question 11

A 60-year-old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. A diagnosis of pleural effusion is made and a watery fluid is drained. This fluid is referred to as:

Accepted Answer

Pleural effusion in a patient with cirrhosis is most likely to be transudative in nature. This is because the increased pressure in the portal circulation due to cirrhosis can lead to the formation of ascites, which can in turn cause pleural effusion through the flow of fluid across the diaphragm. Exudative effusions are more commonly seen in conditions such as pneumonia or malignancy, and purulent or infected effusions would typically present with a more severe clinical picture.

Question 12

A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide levels. Which of the following is the most likely cause?

Accepted Answer

Hyperventilation leads to decreased carbon dioxide levels (respiratory alkalosis) due to excessive breathing and elimination of carbon dioxide from the lungs.

Question 13

A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. The most likely diagnosis is:

Accepted Answer

The presentation of hypotension, hypoxemia, and tracheal deviation to the left along with high pressure in the pleural cavity exceeding barometric pressure in the atmosphere suggests tension pneumothorax. With this condition, air accumulates in the pleural space and creates pressure, which can push the heart and other thoracic structures to the opposite side of the affected lung, causing tracheal deviation. This can lead to hypotension and hypoxemia and is a medical emergency requiring prompt treatment. Options A, C, and D are not consistent with the presentation and test results provided.

Question 14

The most common cause of pulmonary edema is:

Accepted Answer

The most common cause of pulmonary edema is left heart failure, which occurs when the left side of the heart is unable to pump blood effectively, leading to an accumulation of fluid in the lungs.

Question 15

A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. This condition is caused by:

Accepted Answer

The symptoms described are consistent with altitude sickness, which is caused by decreased inspired oxygen at high altitudes. Bronchoconstriction, hypoventilation, and diffusion abnormalities do not typically cause altitude sickness.

Question 16

A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. This condition is referred to as:

Accepted Answer

Cyanosis is characterized by bluish skin and mucous membranes due to decreased oxygen saturation in the blood. Hemoptysis and hematemesis refer to coughing up blood and vomiting blood, respectively. Ischemia refers to inadequate blood supply to a tissue or organ.

Question 17

Paroxysmal nocturnal dyspnea generally occurs with:

Accepted Answer

Paroxysmal nocturnal dyspnea is a symptom of left ventricular failure, also known as congestive heart failure. It is caused by an accumulation of fluid in the lungs, leading to difficulty breathing especially when lying down at night. Pulmonary fibrosis, asthma, and hypertension may all cause shortness of breath, but not specifically paroxysmal nocturnal dyspnea.

Question 18

A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations that can be characterized by:

Accepted Answer

Kussmaul respirations are characterized by a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause. This is the body's compensatory mechanism to reduce the excess acid in the bloodstream by exhaling more carbon dioxide. Audible wheezing or stridor (A) are not typical of Kussmaul respirations. Rapid respirations with periods of apnea (C) would not effectively compensate for metabolic acidosis. Very slow inhalations and rapid expirations (D) do not describe Kussmaul respirations.

Question 19

Reduced oxygenation of arterial blood is called:

Accepted Answer

Hypoxemia refers to low levels of oxygen in the blood, specifically in the arteries.

Question 20

A 26-year-old female recently underwent surgery and is now experiencing dyspnea, cough, fever, and leukocytosis. Tests reveal that she has a collapsed lung caused by removal of air from obstructed alveoli. This condition is called:

Accepted Answer

Absorption atelectasis occurs when air is removed from obstructed alveoli, leading to lung collapse.

Quiz 26: Alterations of Pulmonary Function