Question 1

Bronchospasm may happen after a pulmonary embolism. Which of the following can lead to this bronchospasm?
1) Localized hypoxemia
2) Localized hypercapnia
3) Localized hypocapnia
4) Release of cellular mediators from platelets

Accepted Answer

A pulmonary embolism can result in hypocapnia and hypoxemia in the local alveoli. In addition, there is the release of cellular mediators from platelets. All of these can cause bronchospasm.

Question 2

Which of the following fibrinolytic agents is/are used to treat a pulmonary embolism?
1) Urokinase
2) Vitamin K
3) Heparin
4) Streptokinase

Accepted Answer

C

Question 3

All of the following are associated with the formation of a deep vein thrombosis (DVT) EXCEPT:

Accepted Answer

While age greater than 40 years is a risk factor for DVT, it is not directly associated with the formation of a DVT. Blood vessel injury, hypercoagulability, and venous stasis are the three factors known as Virchow's triad, which are the primary contributors to the development of a DVT.

Question 4

The sudden onset of which of the following signs and symptoms indicate a pulmonary embolism:
1) wheezing.
2) coughing out blood-streaked sputum.
3) cyanosis.
4) sudden shortness of breath.

Accepted Answer

The answer of The sudden onset of which of the...

Question 5

Your patient is suspected of having one or more pulmonary emboli. He is tested by inhaling a radioactive gas and receiving an intravenous injection of radiolabeled particles. Which test results on his ventilation-perfusion lung scans will prove he has a pulmonary embolism?
1) Normal blood flow through the lungs
2) Decreased blood flow through the lungs
3) Normal ventilation through the lungs
4) Decreased ventilation through the lungs

Accepted Answer

A pulmonary embolism is indicated by decreased blood flow (perfusion) with normal ventilation, which is a mismatch seen in option 2 and 3.

Question 6

The duplex venous ultrasonography test is used to:

Accepted Answer

Duplex venous ultrasonography is used to diagnose a blood clot behind the knee or thigh. It combines two types of ultrasound, B-mode imaging and Doppler flow measurement, to produce images of the veins and detect any abnormalities in blood flow. It is a noninvasive and safe diagnostic tool for deep vein thrombosis (DVT).

Question 7

All of the following are preventative measures taken with patients at high risk for thromboembolic disease EXCEPT:

Accepted Answer

Dangling your legs over the edge of the bed before getting up can actually increase the risk of thromboembolic disease by causing blood to pool in the legs. Therefore, all other options (drinking water, walking frequently, wearing compression stockings) are preventative measures that can help reduce the risk of thromboembolic disease.

Question 8

Your patient's D-dimer blood test results show a value of 250 ng/mL. How should these results be interpreted?

Accepted Answer

A D-dimer level of 250 ng/mL is typically considered within the normal range, suggesting that it is unlikely the patient has a pulmonary embolism or deep vein thrombosis. However, it does not definitively rule out these conditions.

Question 9

Predisposing factors of pulmonary emboli include:
1) varicose veins.
2) smoking.
3) obesity.
4) congestive heart failure.

Accepted Answer

All of the listed options, and other factors, can predispose a person to having pulmonary emboli.

Question 10

A pulmonary angiogram is usually ordered:

Accepted Answer

A pulmonary angiogram is considered an invasive and potentially risky procedure, so it is generally reserved for cases where other less invasive tests such as a CT scan or V/Q scan have been inconclusive or there is a high suspicion for pulmonary embolism but non-invasive tests are negative.

Question 11

Which of the following is/are major mechanism(s) that contribute to the pulmonary hypertension commonly seen in a patient with a pulmonary embolism?
1) Decreased cross-section area of the pulmonary vascular system
2) Vasoconstriction induced by alveolar hypoxia
3) Reflexes from the aortic and carotid sinus baroreceptors
4) Vasoconstriction induced by humoral agents

Accepted Answer

Pulmonary embolism can cause a decrease in the cross-sectional area of the pulmonary vascular system due to obstruction by the thromboembolic material, leading to an increase in pulmonary vascular resistance and subsequently pulmonary hypertension. Alveolar hypoxia caused by the ventilation-perfusion mismatch can lead to vasoconstriction and further increase pulmonary vascular resistance. Humoral agents such as serotonin, thromboxane, and endothelin-1 are released in response to the thromboembolic material and cause vasoconstriction. However, reflexes from the aortic and carotid sinus baroreceptors are not major mechanisms in the development of pulmonary hypertension in pulmonary embolism.

Question 12

The death of lung tissue that may result from an obstruction of the pulmonary artery is called a:

Accepted Answer

The death of lung tissue that may result from an obstruction of the pulmonary artery is called a pulmonary infarction. This is caused by a pulmonary embolism, which is a blockage in the pulmonary artery that carries blood from the heart to the lungs. Pleural effusion is the buildup of fluid between the layers of tissue that line the lungs and chest cavity, while pulmonary empyema is a collection of pus within the lung tissue. Neither of these conditions result in the death of lung tissue.

Question 13

A pulmonary embolism causes which of the following major pathologic and structural changes in the lungs?
1) Alveolar consolidation
2) Mucosal edema
3) Alveolar atelectasis
4) Pleural friction rub

Accepted Answer

A pulmonary embolism can cause alveolar atelectasis, which is the collapse of the small air sacs in the lungs (alveoli) due to lack of blood flow. This can lead to ventilation-perfusion mismatch and hypoxia. It can also cause alveolar consolidation, which is the filling of the alveoli with fluid, blood, or other material, leading to decreased gas exchange and impaired lung function. Mucosal edema and pleural friction rub are not commonly associated with pulmonary embolisms.

Question 14

Your patient is now fully recovered from the condition that caused her to have a pulmonary embolism. As a precaution, the physician will have her take which of the following anticoagulant medications for a few months at home?

Accepted Answer

Warfarin is an oral anticoagulant that is used to prevent and treat blood clots. It is often used after a pulmonary embolism to prevent the formation of new clots.

Question 15

The best test for diagnosing a suspected pulmonary embolism is a/an:

Accepted Answer

Spiral computerized tomography (CT) scan is considered the best test for diagnosing a suspected pulmonary embolism. This test provides a detailed picture of the blood vessels in the lungs and can detect blockages caused by blood clots. Pulmonary function tests, electrocardiograms, and chest radiographs may provide useful information in evaluating patients with respiratory symptoms, but they are not specific for diagnosing pulmonary embolism.

Quiz 20: Pulmonary Embolism

Bronchospasm may happen after a pulmonary embolism. Which of the following can lead to this bronchospasm? 1) Localized hypoxemia 2) Localized hypercapnia 3) Localized hypocapnia 4) Release of cellular mediators from platelets

Which of the following fibrinolytic agents is/are used to treat a pulmonary embolism? 1) Urokinase 2) Vitamin K 3) Heparin 4) Streptokinase