ETP- pulmonology quiz Flashcards
(5 cards)
A 72-year-old woman with a 34 pack-year history of smoking and a 10 year history of COPD presents to the emergency room with worsening dyspnea and fatigue. Her symptoms have been getting progressively worse over the past 3 days, and she notes that her cough has become more frequent and has changed in character to productive of higher quantities of more yellow-coloured sputum. Vitals signs are: respiratory rate 24 breaths/min, heart rate 110 beats/min, blood pressure 146/92, oxygen saturation 91%, temperature 38.1 Celsius.
What are the general diagnostic criteria for chronic bronchitis?
Question 1 Answer
a.
Persistent cough with sputum production for at least 3 months for 2 consecutive years
b.
Persistent cough with sputum production for at least 6 weeks for 3 consecutive years
c.
X-ray or CT evidence of apical blebbing and/or hyperinflation at the lung bases
d.
Spirometry on two separate occasions at least 1 month apart that shows decreased vital capacity and increased residual volume
a.
Persistent cough with sputum production for at least 3 months for 2 consecutive years
A 72-year-old woman with a 34 pack-year history of smoking and a 10 year history of COPD presents to the emergency room with worsening dyspnea and fatigue. Her symptoms have been getting progressively worse over the past 3 days, and she notes that her cough has become more frequent and has changed in character to productive of higher quantities of more yellow-coloured sputum. Vitals signs are: respiratory rate 24 breaths/min, heart rate 110 beats/min, blood pressure 146/92, oxygen saturation 91%, temperature 38.1 Celsius.
You choose not to give this woman supplemental oxygen because the Haldane effect can result in serious acute acidosis. What is the Haldane effect?
Question 2 Answer
a.
Increased carbon dioxide content in the blood causes the hemoglobin curve for oxygen to shift to the right
b.
Increased arterial oxygen content causes the hemoglobin curve for oxygen to shift to the left
c.
Increased arterial oxygen content causes carbon dioxide to dissociate from hemoglobin and dissolve in the serum
d.
Decreased blood pH causes hemoglobin to bind to carbon dioxide with greater affinity
c.
Increased arterial oxygen content causes carbon dioxide to dissociate from hemoglobin and dissolve in the serum
A 35 year-old woman reports acute onset of shortness of breath and cough productive of a small amount of bloody sputum. The cough is associated with well-localized sharp chest pain over the upper aspect of the left anterior chest. She reports feeling lightheaded moving from sitting to standing. Her vitals are: respiratory rate 24 breaths/min, heart rate 120 beats/min, blood pressure 84/62 mm Hg, oxygen saturation 94%, temperature 37.6 Celsius. A CT scan confirms the presence of a pulmonary embolus in a large branch of the left pulmonary artery.
What category of shock does a pulmonary embolus cause?
Question 3 Answer
a.
Hypovolemic
b.
Cardiogenic
c.
Obstructive
d.
Distributive
c.
Obstructive
A 35 year-old woman reports acute onset of shortness of breath and cough productive of a small amount of bloody sputum. The cough is associated with well-localized sharp chest pain over the upper aspect of the left anterior chest. She reports feeling lightheaded moving from sitting to standing. Her vitals are: respiratory rate 24 breaths/min, heart rate 120 beats/min, blood pressure 84/62 mm Hg, oxygen saturation 94%, temperature 37.6 Celsius. A CT scan confirms the presence of a pulmonary embolus in a large branch of the left pulmonary artery.
What type of V/Q abnormality does a pulmonary embolus cause?
Question 4 Answer
a.
An increase in dead space
b.
A shift from zone 1 blood flow to zone 3 blood flow
c.
Atelectasis
d.
A shunt
a.
An increase in dead space
A 63 year-old man with a previous occupation as a shipbuilder and a significant history of asbestos exposure presents with progressive dyspnea and cough. He also has a 25 pack-year history of tobacco smoking, and has noted that in the past 2 months he sometimes coughs up small amounts of blood.
Chronic lung disease can cause a particular type of heart failure - what is it, and why does it occur?
Question 5 Answer
a.
Left ventricular failure - caused by the increased oxygen requirement of the left ventricle over the right ventricle in a setting of chronic hypoxemia
b.
Right ventricular failure - caused by chronic decreased oxygenation of the right ventricle over the left due to physiologic shunting of the bronchial artery
c.
Right ventricular failure - caused by decreased oxygen tensions in the lung leading to pulmonary vasoconstriction and increased right ventricular afterload
d.
Left ventricular failure - caused by decreased oxygen tensions in the lung leading to pulmonary vasoconstriction and decreased left ventricular preload
c.
Right ventricular failure - caused by decreased oxygen tensions in the lung leading to pulmonary vasoconstriction and increased right ventricular afterload
