Question 1

Which of the following factors is considered a risk factor for deep venous thrombi?&#10;A)Obesity&#10;B)Use of estrogen-containing drugs&#10;C)Postpartum status&#10;D)All the above

Accepted Answer

All of these factors are considered risk factors for deep venous thrombi. Obesity can cause pressure on veins and slow down blood flow, estrogen-containing drugs can increase blood clotting factors, and postpartum status can cause changes in blood clotting factors and slowed blood flow.

Question 2

Which of the following is NOT responsible for causing hypoxemia in a patient with pulmonary embolism?&#10;A)Bronchospasm&#10;B)Atelectasis&#10;C)Deadspace ventilation&#10;D)Hypercapnia

Accepted Answer

Hypercapnia refers to increased levels of carbon dioxide in the blood and is not responsible for causing hypoxemia in a patient with pulmonary embolism. The other choices (A, B, and C) can all contribute to hypoxemia in this condition.

Question 3

What percent of the pulmonary vascular bed must be occluded by emboli before cardiac output drops and hypotension is present?&#10;A)10%&#10;B)25%&#10;C)50%&#10;D)75%

Accepted Answer

When approximately 50% of the pulmonary vascular bed is occluded by emboli, there is a reduction in cardiac output, which can cause hypotension. This is because the lungs play a crucial role in oxygenation, and when the pulmonary vascular bed is obstructed, the ability of the lungs to oxygenate blood is compromised, leading to a decrease in cardiac output and hypotension.

Question 4

When a larger pulmonary thromboembolism occurs in the lung,why does cardiac output drop?&#10;A)Decreased filling of the left ventricle&#10;B)Increased systemic vascular resistance&#10;C)Increased filling of the right ventricle&#10;D)Reduced contractility

Accepted Answer

Decreased filling of the left ventricle occurs because a large pulmonary thromboembolism obstructs blood flow through the lungs, reducing the amount of blood reaching the left heart, thereby decreasing cardiac output.

Question 5

When is thrombolytic therapy most useful?&#10;A)During the first five days after clot formation&#10;B)Only during the first 12 hours after clot formation&#10;C)One week after clot formation&#10;D)None of the above

Accepted Answer

Thrombolytic therapy is most useful during the first five days after clot formation because it can help to dissolve the clot and restore blood flow.

Question 6

What finding is most common in the ECG of the patient with pulmonary thromboembolism?&#10;A)Elevated ST segment&#10;B)Normal&#10;C)First degree block&#10;D)Frequent PVCs

Accepted Answer

The most common finding in the ECG of patients with pulmonary thromboembolism is a normal ECG. However, in some cases, there may be abnormalities such as sinus tachycardia, right ventricular strain pattern (T-wave inversion in leads V1 to V4), or new onset atrial fibrillation. Elevation of ST segments or frequent PVCs is less common in pulmonary thromboembolism. First-degree block may be present but is not the most common finding.

Question 7

What is the most common initial treatment for a patient with a small or moderate PTE?&#10;A)Oxygen&#10;B)Bronchodilators&#10;C)Heparin&#10;D)Streptokinase

Accepted Answer

The most common initial treatment for a patient with a small or moderate pulmonary embolism (PTE) is anticoagulation therapy, usually with intravenous heparin. This helps to prevent further clots from forming and reduces the risk of complications such as deep vein thrombosis and pulmonary infarction. Oxygen therapy may also be given to improve oxygenation, but it is not the most common initial treatment. Bronchodilators and streptokinase are not typically used in the treatment of PTE.

Question 8

Which of the following findings in a patient with PTE would cause you to most likely consider using thrombolytic therapy? A)PaO₂ 65 mmHg B)PaCO₂ 44 mmHG C)Blood pressure 80/45 mmHg D)Pulse rate = 110/min

Accepted Answer

Thrombolytic therapy is considered in patients with pulmonary thromboembolism (PTE) who are hemodynamically unstable, as indicated by hypotension (blood pressure 80/45 mmHg in this case), which suggests a more severe form of the disease requiring aggressive treatment.

Question 9

Which of the following is NOT considered one of the three main factors associated with the formation of deep venous thrombi?&#10;A)Venous status&#10;B)Hypercoagulability&#10;C)Thrombocytopenia&#10;D)Damage to venous blood vessels

Accepted Answer

The three main factors associated with the formation of deep venous thrombi are venous status (e.g. immobility, varicose veins), hypercoagulability (e.g. factor V Leiden mutation), and damage to venous blood vessels (e.g. from surgery or injury). Thrombocytopenia, which is a decrease in the number of platelets in the blood, is not considered one of the main factors.

Question 10

In which of the following patients would thrombolytic therapy be contraindicated?&#10;A)The patient with COPD&#10;B)The patient who just gave birth&#10;C)The patient with pneumonia&#10;D)The patient with heart failure

Accepted Answer

Thrombolytic therapy is contraindicated in patients who have recently given birth because of the increased risk of bleeding. Thrombolytic therapy dissolves blood clots and can increase the risk of bleeding complications, which can be dangerous for postpartum patients who may already have increased bleeding. Thrombolytic therapy may be used in patients with COPD, pneumonia or heart failure if considered appropriate and after weighing the risks and benefits.

Question 11

Which of the following is least useful for detecting a PTE?&#10;A)   scan&#10;B)Pulmonary angiography&#10;C)CAT scan in contrast&#10;D)Apical-lordotic chest radiograph

Accepted Answer

The answer of Which of the following is least useful...

Question 12

Which of the following findings is/are typical for the chest radiograph in a patient with PTE?&#10;A)Normal&#10;B)Signs of volume loss&#10;C)Westermark's sign&#10;D)All the above

Accepted Answer

The answer of Which of the following findings is/are typical...

Question 13

Where do most deep venous thrombi originate?&#10;A)The heart&#10;B)The upper extremities&#10;C)The lower extremities and pelvic region&#10;D)Below the knees

Accepted Answer

The answer of Where do most deep venous thrombi originate?&#10;A)The...

Question 14

What test is used to monitor oral anticoagulation therapy?&#10;A)PTT&#10;B)PT&#10;C)Platelet count&#10;D)Sedimentation rates

Accepted Answer

The answer of What test is used to monitor oral...

Question 15

In which of the following conditions is pulmonary infarction more likely when a pulmonary embolism occurs?&#10;A)Left ventricular failure&#10;B)COPD&#10;C)Both A and B&#10;D)None of the above

Accepted Answer

The answer of In which of the following conditions is...

Question 16

Your patient has a fairly large pulmonary thromboembolism.What physical exam finding(s)is/are expected?&#10;A)Loud P2&#10;B)Jugular venous distention&#10;C)Hypotension&#10;D)All the above

Accepted Answer

The answer of Your patient has a fairly large pulmonary...

Question 17

How long is the patient with recurrent clots treated with anticoagulant therapy?&#10;A)Three months&#10;B)Six months&#10;C)One year&#10;D)Lifetime

Accepted Answer

The answer of How long is the patient with recurrent...

Question 18

What is the classic finding on the   scan for the patient with PTE?&#10;A)Matching ventilation and perfusion defects&#10;B)Decreased ventilation with normal perfusion in a localized area&#10;C)Decreased perfusion with normal ventilation in a localized area&#10;D)Diffuse ventilation and perfusion defects

Accepted Answer

The answer of What is the classic finding on the...

Question 19

What is the most common symptom associated with pulmonary thromboembolism?&#10;A)Transient acute dyspnea&#10;B)Pleuritic chest pain&#10;C)Hemoptysis&#10;D)Cough

Accepted Answer

The answer of What is the most common symptom associated...

Question 20

Which of the following statements is true about the use of &#34;D-dimer&#34; in evaluating the patient for PTE?&#10;A)A value of >200 ng/mL is suggestive of PTE&#10;B)Negative results are good evidence that PTE is not present&#10;C)High values are proof of PTE&#10;D)None of the above

Accepted Answer

The answer of Which of the following statements is true...

Question 21

Which of the following has proven useful in preventing future clots from developing?&#10;A)Low-dose heparin&#10;B)Warfarin&#10;C)Venous compression devices&#10;D)All the above

Accepted Answer

The answer of Which of the following has proven useful...

Deck 7: Pulmonary Thromboembolic Disease