Question 1

Why does hypercalcemia occur with bronchogenic carcinoma?
A) Invasion of the parathyroid gland by the tumor
B) Secretion of parathyroid or parathyroid like hormones by the tumor
C) Destruction of the ribs
D) Failure of the kidney to excrete calcium ions

Accepted Answer

Bronchogenic carcinoma can produce parathyroid hormone-related protein (PTHrP) which increases calcium levels in the blood by enhancing reabsorption of calcium in the kidneys, stimulating osteoclasts to break down bone, and increasing calcium absorption in the gut.

Question 2

Which of the following is typical of progressive emphysema?
A) Vital capacity increases.
B) Residual lung volume increases.
C) Forced expiratory volume increases.
D) Tidal volume increases.

Accepted Answer

Progressive emphysema typically leads to an increase in residual lung volume due to the destruction of alveoli and loss of lung elasticity. This results in less efficient oxygen exchange and difficulty breathing. Vital capacity (the maximum amount of air that can be forcibly exhaled after a maximum inhalation), forced expiratory volume (the amount of air forcibly exhaled in the first second of a forced breath), and tidal volume (the amount of air breathed in and out during normal breathing) may all decrease in progressive emphysema.

Question 3

What is a sign indicating total obstruction of the airway by aspirated material?
A) Hoarse cough
B) Rapid loss of consciousness
C) Dyspnea
D) Inflammation of the mucosa

Accepted Answer

Rapid loss of consciousness is a sign indicating total obstruction of the airway by aspirated material, as it means that there is no air passage left to sustain consciousness. Hoarse cough, dyspnea, and inflammation of the mucosa may be present in partial airway obstruction.

Question 4

What are typical pathological changes with bronchiectasis?
A) Bronchospasm and increased mucous secretion
B) Adhesions and fibrosis in the pleural membranes
C) Airway obstructions and weak, dilated bronchial walls
D) Fixation of the ribs in the inspiratory position

Accepted Answer

Bronchiectasis is characterized by weakening and destruction of the walls of the bronchi, resulting in dilated and thickened airways that are prone to infection and inflammation. Airway obstructions can also occur due to increased mucus production and accumulation. Adhesions and fibrosis in the pleural membranes are not typical changes with bronchiectasis, and fixation of the ribs in the inspiratory position is a feature of flail chest, not bronchiectasis. Bronchospasm may occur in response to inflammation or infection, but it is not a defining characteristic of bronchiectasis.

Question 5

Persistent thick mucus in the bronchioles of a child with cystic fibrosis may cause:
1) air trapping.
2) atelectasis.
3) repeated infections.
4) irreversible damage to lung tissue.
A) 1, 2
B) 2, 4
C) 1, 3, 4
D) 1, 2, 3, 4

Accepted Answer

The answer of Persistent thick mucus in the bronchioles of...

Question 6

Restrictive lung disorders may be divided into two groups based on:
A) patient history of obesity and exposure to other COPD.
B) smoking history and congenital defects.
C) previous lung disease and cardiovascular disorders.
D) anatomical abnormality and lung disease damage, impairing expansion.

Accepted Answer

Restrictive lung disorders result from anatomical abnormalities or lung disease damage that impairs lung expansion. These abnormalities may be congenital, acquired, or due to other diseases such as interstitial lung disease or sarcoidosis. Therefore, option D is the correct answer.

Question 7

What is a common indicator of cystic fibrosis in the newborn?
A) Infant respiratory distress syndrome
B) Failure to excrete meconium
C) Taste of ammonia on the skin
D) Lack of bile secretions

Accepted Answer

Failure to excrete meconium is a common indicator of cystic fibrosis in the newborn. Normally, a newborn will excrete meconium within the first 24 to 48 hours of life. However, babies with cystic fibrosis will often have difficulty passing meconium, indicating a blockage in the digestive tract.

Question 8

What cause the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema?
A) Air trapping and hyperinflation
B) Persistent coughing to remove mucus
C) Recurrent damage to lung tissues
D) Dilated bronchi and increased mucous secretions

Accepted Answer

The expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema is caused by air trapping and hyperinflation. The destruction of alveolar walls and loss of elastic recoil in emphysema leads to air being trapped in the lungs, causing them to become hyperinflated. This hyperinflation causes the chest to expand in all directions, including the A-P diameter, resulting in a characteristic barrel chest appearance.

Question 9

What is an early sign of bronchogenic carcinoma?
A) Air trapping and overinflation of the lung
B) Weight loss
C) Bone pain
D) Chronic cough

Accepted Answer

A chronic cough is one of the earliest and most common symptoms of bronchogenic carcinoma, even before the appearance of other symptoms like chest pain, dyspnea, or hemoptysis. Weight loss and bone pain are more commonly seen in advanced stages of the disease, while air trapping and overinflation of the lung are associated with other respiratory conditions such as chronic obstructive pulmonary disease (COPD).

Question 10

Which of the following are significant signs of bronchiectasis?
A) Persistent nonproductive cough, dyspnea, and fatigue
B) Persistent purulent nasal discharge, fever, and cough
C) Chronic cough, producing large quantities of purulent sputum
D) Wheezing and stridor

Accepted Answer

Chronic cough, producing large quantities of purulent sputum, is a significant sign of bronchiectasis. Other symptoms may include episodes of fever, weight loss, and hemoptysis (coughing up blood). Wheezing and stridor may be present in some cases, but are not as specific to bronchiectasis. Persistent nonproductive cough, dyspnea, and fatigue are more commonly seen in conditions such as asthma or chronic obstructive pulmonary disease (COPD). Persistent purulent nasal discharge is a symptom of chronic sinusitis, which may be associated with bronchiectasis, but is not as specific to the condition.

Question 11

Destruction of alveolar walls and septae is a typical change in:
A) chronic bronchitis.
B) acute asthma.
C) emphysema.
D) asbestosis.

Accepted Answer

Destruction of alveolar walls and septae is a characteristic feature of emphysema. Chronic bronchitis may cause inflammation and narrowing of the airways. Acute asthma may cause bronchospasm and airway obstruction. Asbestosis is a type of pneumoconiosis caused by exposure to asbestos fibers.

Question 12

What is the cause of chronic bronchitis?
A) Chronic irritation, inflammation, and recurrent infection of the larger airways
B) A genetic defect causing excessive production of mucus
C) Hypersensitivity to parasympathetic stimulation in the bronchi
D) Deficit of enzymes, preventing tissue degeneration

Accepted Answer

Chronic bronchitis is caused by chronic irritation, inflammation, and recurrent infection of the larger airways, typically from smoking or exposure to air pollution. This leads to increased mucus production and narrowing of the airways, resulting in chronic cough, sputum production, and difficulty breathing.

Question 13

During an acute asthma attack, how does respiratory obstruction occur?
1) Relaxation of bronchial smooth muscle
2) Edema of the mucosa
3) Increased secretion of thick, tenacious mucus
4) Contraction of elastic fibers
A) 1, 2
B) 1, 3
C) 2, 3
D) 2, 4

Accepted Answer

During an acute asthma attack, respiratory obstruction occurs due to edema of the mucosa and increased secretion of thick, tenacious mucus. These factors cause narrowing of the airways, making it difficult to breathe. Contraction of elastic fibers and relaxation of bronchial smooth muscle are not primary causes of respiratory obstruction during an asthma attack.

Question 14

Why does cor pulmonale develop with chronic pulmonary disease?
A) The right ventricle pumps more blood than the left ventricle.
B) Pulmonary fibrosis and vasoconstriction increase vascular resistance.
C) Demands on the left ventricle are excessive.
D) Blood viscosity is increased, adding to cardiac workload.

Accepted Answer

Chronic pulmonary disease, such as pulmonary fibrosis and vasoconstriction, causes an increase in vascular resistance in the lungs. This increased resistance puts extra strain on the right ventricle, which pumps blood through the pulmonary circulation. Over time, this can lead to the development of cor pulmonale, which is a condition where the right ventricle becomes enlarged and weakened due to the increased workload.

Question 15

Which of the following is typical of chronic bronchitis?
A) Decreased activity of the mucous glands
B) Fibrosis of the bronchial wall
C) Overinflation of bronchioles and alveoli
D) Formation of blebs or bullae on the lung surface

Accepted Answer

Chronic bronchitis is characterized by an inflammation and thickening of the bronchial walls, which can lead to fibrosis over time. This can cause narrowing of the airways and difficulty breathing. Decreased activity of the mucous glands (choice A) would actually be detrimental in chronic bronchitis, as excess mucus production is a hallmark of the condition. Overinflation of bronchioles and alveoli (choice C) is more typical of emphysema, another type of COPD. Formation of blebs or bullae on the lung surface (choice D) is also more typical of emphysema.

Question 16

A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called:
A) mesothelioma.
B) COPD.
C) CF.
D) MD.

Accepted Answer

COPD (Chronic Obstructive Pulmonary Disease) is a group of respiratory disorders that includes chronic bronchitis and emphysema, both of which involve tissue degeneration and respiratory obstruction. Mesothelioma is a rare form of cancer caused by exposure to asbestos. CF (Cystic Fibrosis) is a genetic disorder that affects the lungs and other organs, but does not typically involve tissue degeneration. MD (Muscular Dystrophy) is a genetic disorder that affects the muscles, not the respiratory system.

Question 17

Which of the following predisposes to postoperative aspiration?
A) Reduced pressure of the abdominal organs on the diaphragm
B) Depression of the vomiting center by anesthetics and analgesics
C) Vomiting caused by drugs or anesthesia
D) Lack of food intake for the previous 24 hours

Accepted Answer

Vomiting caused by drugs or anesthesia can increase the risk of postoperative aspiration by allowing stomach contents to enter the lungs. Reduced pressure of the abdominal organs on the diaphragm (A) would actually decrease the risk of aspiration. Depression of the vomiting center (B) would also decrease the risk of vomiting and aspiration. Lack of food intake (D) may increase the risk of aspiration due to a decrease in gastric emptying and a potentially fuller stomach at the time of surgery, but it is not as significant a risk factor as vomiting caused by drugs or anesthesia.

Question 18

Which statement does NOT apply to emphysema?
A) The surface area available for gas exchange is greatly reduced.
B) A genetic defect may lead to breakdown of elastic fibers.
C) The ventilation/perfusion ratio remains constant.
D) Expiration is impaired.

Accepted Answer

The ventilation/perfusion ratio is not constant in emphysema. The destruction of alveolar walls results in unevenly sized and shaped air spaces, altering the ratio and reducing efficiency of gas exchange.

Question 19

What is the pathophysiology of an acute attack of extrinsic asthma?
A) Gradual degeneration and fibrosis
B) Continuous severe attacks unresponsive to medication
C) A hypersensitivity reaction involving release of chemical mediators
D) Hyperresponsive mucosa

Accepted Answer

An acute attack of extrinsic asthma is a hypersensitivity reaction involving the release of chemical mediators such as histamine, leukotrienes, and prostaglandins, which lead to bronchospasm, increased mucus secretion, and edema of the airways. This results in airway obstruction and difficulty breathing.

Question 20

Cigarette smoking predisposes to malignant neoplasms because smoking:
A) can cause metaplasia and dysplasia in the epithelium.
B) promotes malignant changes in all types of benign tumors in the lungs.
C) causes paraneoplastic syndrome.
D) increases exposure to carbon monoxide in the lungs.

Accepted Answer

Cigarette smoking can cause metaplasia (change of one type of cell into another) and dysplasia (abnormal growth and development of cells) in the epithelium (the lining of the respiratory tract). These changes can lead to the development of cancer. Smoking does not promote malignant changes in all types of benign tumors in the lungs (B), cause paraneoplastic syndrome (C), or increase exposure to carbon monoxide in the lungs (D) which is a different health concern associated with smoking.

Quiz 13: Respiratory System Disorders

Why does hypercalcemia occur with bronchogenic carcinoma?

Which of the following is typical of progressive emphysema?

What is a sign indicating total obstruction of the airway by aspirated material?

What are typical pathological changes with bronchiectasis?

Persistent thick mucus in the bronchioles of a child with cystic fibrosis may cause: 1) air trapping. 2) atelectasis. 3) repeated infections. 4) irreversible damage to lung tissue.

Restrictive lung disorders may be divided into two groups based on:

What is a common indicator of cystic fibrosis in the newborn?

What cause the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema?

What is an early sign of bronchogenic carcinoma?

Which of the following are significant signs of bronchiectasis?

Destruction of alveolar walls and septae is a typical change in:

What is the cause of chronic bronchitis?

During an acute asthma attack, how does respiratory obstruction occur? 1) Relaxation of bronchial smooth muscle 2) Edema of the mucosa 3) Increased secretion of thick, tenacious mucus 4) Contraction of elastic fibers

Why does cor pulmonale develop with chronic pulmonary disease?

Which of the following is typical of chronic bronchitis?

A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called:

Which of the following predisposes to postoperative aspiration?

Which statement does NOT apply to emphysema?

What is the pathophysiology of an acute attack of extrinsic asthma?

Cigarette smoking predisposes to malignant neoplasms because smoking: