Respiratory 102

Front 1

In chronic bronchitis:
I the bronchial walls are narrowed because od vasoconstriction
II the bronchial glands are enlarged
III the number of goblet cell is decreased
IV the number of cilia lining the tracheobronchial tree is increased

Back 1

II only

Front 2

Which of the following is/are believed to play a major role in chronic bronchitis?
I ozone
II nitrous oxide
III sulfur dioxide
IV nitrogen oxide

Back 2

I, III and IV

Front 3

Which of the following common bacteria are found in the tracheobronchial tree of patients with chronic bronchitis?
I Staphylococcus
II Haemophilus influenzae
III Klebsiella
IVStreptococcus

Back 3

II and IV only

Front 4

In chronic bronchitis, the patient commonly demonstrates which of the following:
I increased FVC
II decreased ERV
III increased VC
IV decreased RV

Back 4

II only

Front 5

The patient with severe chronic bronchitis usually has which of the following arterial blood gas values?
I decreased pH
II increased HCO3
III decreased Paco2
IVincreased Pao2

Back 5

II only

Front 6

Sympathomimetic agents commonly are prescribed for patients with chronic bronchitis to offset bronchial smooth muscle spasm. What is the trade name of the sympathomimetic agent albuterol?
I Proventil
II Ventolin
III Vanceril
IV Brethine

Back 6

I and II only

Front 7

The patient with severe chronic bronchitis commonly demonstrates which of the following oxygenation indices?
I decreased C(a-v)o2
II increased O2ER
III decreased Do2
IV increased Vo2

Back 7

II and III only

Front 8

The patient with severe chronic bronchitis commonly demonstrates which of the following hemodynamic indices?
I increased PCWP
II decreased RAP
III increased PA
IV decreased CO

Back 8

III only

Front 9

Parasympatholtic agents are often used to offset the bronchial smooth muscle constriction associated with chronic bronchitis. What is the trade name of the parasympatholytic agent ipratropium bromide?

Back 9

Atrovent

Front 10

Patients with severe chronic bronchitis may demonstrate which of the following?
I peripheral edema
II distended neck veins
III An elevated hemoglobin concentration
IV An enlarged liver

Back 10

I,II,III, and IV

Front 11

What type of emphysema creates an abnormal enlargement of all structures distal to the terminal bronchioles?

Back 11

Panlobular emphysema

Front 12

What is the normal level of a1-protease inhibitor?

Back 12

200-400mg/dl

Front 13

The diffusion capacity of patients with emphysema is:

Back 13

Decreased

Front 14

Patients with severe emphysema commonly demonstrate which of the following oxygenation indices?
I decreased Svo2
II increased O2ER
III decreased Do2
IV increased C(a-v)o2

Back 14

I, II, and III only

Front 15

Which phenotype is associated with the lowest serum concentration of a1-protease inhibitor?

Back 15

ZZ phenotype

Front 16

Which of the following pulmonary function study findings are associated with severe emphysema?
I increased FRC
II decreased PEFR
III increased RV
IV decreased FVC

Back 16

I,II,III, and IV

Front 17

The patient with severe emphysema commonly demonstrates which of the following hemodynamic indices?
I decreased CVP
II increased PA
III decreased RVSWI
IV increased PVR

Back 17

II and IV only

Front 18

Because acute ventilatory changes often are seen in patients with chronic ventatory failure, the respiratory care practitioner must be alert for this problem in patients with severe emphysema. Which of the following ABG findings represent acute alveolar hyperventilation superimposed on chronic ventilatory failure?
I increased pH
II increased Paco2
III increased HCO3
IV Pao2

Back 18

I,II, and III only

Front 19

The lung parenchyma in the chest radiograph of a patient with empysema appears:
I opaque
II white
III More translucent than normal
IV dark

Back 19

III and IV only

Front 20

What is the single most important etiologic factor in emphysema?

Back 20

cigarette smoking

Front 21

During an asthmatic episode, the smooth muscle of the bronchi may hypertrophy as much as:

Back 21

3 times normal size

Front 22

Asthma is associated with which of the following?
I increase in goblet cells
II decrease in cilia
III increase in bronchial gland size
IV decrease in eosinophils

Back 22

I,II and III only

Front 23

During an extrinsic-type asthma attack, the lymphoid tissue cells form which antibody?

Back 23

IgE

Front 24

When chemical mediators from mast cells are released:
I bronchial dilation occurs
II bronchial gland hypersecretion occurs
III blood vessels constrict
Iv tissue edema occurs

Back 24

II and IV only

Front 25

Which of the following are associated with intrinsic asthma?
I NSAIDs
II respiratory syncytial virus
III gastroesophageal reflux
IV bisulfites

Back 25

I,II,III,and IV

Front 26

When pulsus paradoxus appears during an asthma attack:
I left ventricle filling is increased duringinspiration
II cardiac output decreases during expiration
III left ventricle filling increases during expiration
IV cardiac output increases during inspiration

Back 26

III only

Front 27

During an asthmatic episode, which of the following abnormal lung volume and capacity findings are found?
I increased FRC
II decreased ERV
III increased FEV1
IV decreased RV

Back 27

I and II only

Front 28

During mast cell degranulation, which of the following chemical mediators are released?
I NCF
II ECF-A
III histamine
IV leukotrienes

Back 28

I,II,III, and IV

Front 29

Patients commonly exhibit which of the following ABG during an acute asthmatic episode?
I increased pH
II increased Paco2
III decreased HCO3
IV Pao2

Back 29

I,III,and IV only

Front 30

The onset of intrinsic asthma usually occurs after which age?

Back 30

40 years old

Front 31

Pathologic alterations of the lungs are absentbetween moderate asthmatic episodes.
t or f

Back 31

true

Front 32

A patient with extrinsic asthma generally demonstrates symptoms after 30 years of age:
t or f

Back 32

false

Front 33

An antigen-antibody reaction generally is absent in intrinsic asthma.
t or f

Back 33

true

Front 34

Extrinsic asthma is also considered an allergic disorder.
t or f

Back 34

true

Front 35

A partial Beta-blockade may be responsible for the occurrence of asthma in some individuals.
t or f

Back 35

true

Front 36

During an asthmatic attack, wheezing occurs more frequently during expiration.
t or f

Back 36

true

Front 37

Vanceril

Back 37

Beclomethasone

Front 38

Alupent

Back 38

Metaproterenol

Front 39

Spiriva

Back 39

Tiotropium

Front 40

Serevent

Back 40

Salmeterol

Front 41

Atrovent

Back 41

Ipratroprium bromide

Front 42

Proventil

Back 42

Albuterol

Front 43

Xopenex

Back 43

Levalbuterol

Front 44

Beclovent

Back 44

Beclomethasone

Front 45

Brethine

Back 45

Terbutaline

Front 46

Metaprel

Back 46

Metaproterenol

Front 47

Foradil

Back 47

Formoterol

Front 48

Ventolin

Back 48

Albuterol

Front 49

Intal

Back 49

Cromolyn sodium

Front 50

In which of the following forms of bronchiectasis are bronchi dilated and constricted in an irregular fashion?
I fusiform
II Saccular
III varicose
IV cylindrical

Back 50

I and III only

Front 51

Which of the following are common causes of acquied bronchiectasis?
I hypogammaglobulinemia
II pulmonary tuberculosis
III Kartagener's syndrome
IV cystic fibrosis

Back 51

II only

Front 52

In the primarily obstructive form of bronchiectasis, the patient commonly demonstrates which of the following?
I decreased FRC
II increased FEF
III decreased PEFR
IV V max 50

Back 52

III only

Front 53

Mucolytic agents are commonly used to enhance the mobilization of secretions in patients with bronchiectasis. which of the following is/are classified as a mucolytic agent(s)?
I acetylcysteine
II cromolyn sodium
III beclomethasone
IV rhDNase

Back 53

I and IV only

Front 54

What is considered the hallmark of bronchiectasis?

Back 54

chronic cough and large quantities of foul-smelling sputum.

Front 55

Which of the following is/are commonly cultured in the sputum of patients with bronchiectasis?
I staphylococcus aureus
II pseudomonas aeruginosa
III haemophilus influenzae
IV klebsiella

Back 55

I,II,and III only

Front 56

When the pathophysiology of bronchiectasis is primarily obstructive in nature, the patient demonstrates which of the following clinical manifestations?
I decreased tactile and vocal fremitus
II bronchial breth sounds
III dull percussion note
IV crackles/rhonchi/wheezing

Back 56

I and IV only

Front 57

Which of the following diagnostic procedures is/are used to diagnose bronchiectasis?
I ABG
II bronchography
III oxygenation indices
IV computed tomography

Back 57

II and IV only

Front 58

Which of the following is/are congenital causes of bronchiectasis?
I petussis
II cystic fibrosis
III chickenpox
IV measles

Back 58

II only

Front 59

Which of the following hemodynamic indices is/are associated with bronchiectasis?
I decreased CVP
II increased PA
III decreased RVSWI
IV increased RAP

Back 59

II and IV only

Front 60

What is also known as Friedlander's bacillus?

Back 60

Klebsiella

Front 61

Of the six types of Haemophilus influenzae, which type is most frequently pathogenic?

Back 61

Type B

Front 62

What disease is also associated with Q fever?

Back 62

Rickettsia

Front 63

Mendelson's syndrome is associated with which of the following?
a lipoid pneumonitis
b rubella
c varicella
d aspiration pneumonia
e rickettsia

Back 63

d aspiration pneumonia

Front 64

Which of the follow is are commonly seen in patients with AIDS?
I aspergillus
II cryptococcus
III pneumocystis carinii
IV cytomegalovirus

Back 64

I,II,III, and IV

Front 65

Ribavirin aerosol has been shown to be effective in treating children with:

Back 65

respiratory syncytial virus

Front 66

What is almost always the cause of acute epiglottitis?

Back 66

Haemophilus influenzae B

Front 67

______ is most associated with "croup"?

Back 67

parainfluenza pneumoniae

Front 68

In the absence of a secondary bacterial infection, lung inflammation caused by the aspiration of gastric fluids usually becomes insignificant in approximately how many days?

Back 68

3

Front 69

Which of the following is associated with pneumonia?
I decreased tactile and vocalfremitus
II increased C(a-v)o2
III decreased PEFR
IV increased VC

Back 69

III only

Front 70

What is the first stage of tuberculosis known as?
I reinfection tuberculosis
II Primary tuberculosis
III secondary tuberculosis
IV primary infection stage

Back 70

II and IV only

Front 71

What is the nameof the protective cell wall that surrounds and encases lung tissue infected with tuberculosis?

Back 71

granuloma

Front 72

The tubercule bacillus is:
I highly aerobic
II Acid-fast
III capable of surviving for months outside the body
IV rod-shoped

Back 72

I,II,III,and IV

Front 73

At which size wheal is a tuberculin skin test considered to be positive?

Back 73

greater than 10mm

Front 74

What is often prescribed as a daily dose for 1 year in individuals who have been exposed to the tuberculosis bacilli?

Back 74

Isoniazid

Front 75

Pleural space complications such as empysema and pneumothorax are common in patients with tuberculosis.
t or f

Back 75

true

Front 76

A positive reaction to the tuberculin skin test confirms that a patient has active tuberculosis.
t or f

Back 76

false

Front 77

Tuberculosis commonly develops in the apices of the lungs.
t or f

Back 77

true

Front 78

The tuberculin skin test measures the delayed hypersensitivity that follows exposure to the tubercule bacillus.
t or f

Back 78

true

Front 79

Military tuberculosis presents as a small, isolated tubercule lesion.
t or f

Back 79

false

Front 80

In pulomary edema, fluid first moves into the:
I alveoli
II pervascular interstitial space
III bronchioles
IV peribronchial intersititial space

Back 80

II and IV only

Front 81

What is the normal hydrostatic pressure in the pulmonary capillaries?

Back 81

10 to 15mmHg

Front 82

What is the normal oncotic pressure of the blood?

Back 82

25 to 30mmHg

Front 83

Which of the following are causes of cardiogenic pulmonary edema?
I excessive fluid administration
II right ventricular failure
III mitral valve disease
IV pulmonary embolus

Back 83

I,III and IV only

Front 84

As a result of pulmonary edema, the patient's:
I RV is decreased
II FRC is increased
III VC is increased
IV TLC is increased

Back 84

I only

Front 85

Morphine sulfate induces venodilation.
t or f

Back 85

true

Front 86

Patients with pulmonary edema frequently recieve 30% to 50% aerosolized alcohol.
t or f

Back 86

true

Front 87

A patient is said to have orthopnea if dyspnea increases when the patient is in the upright postion.
t or f

Back 87

false

Front 88

Kerley B lines on the chest X-ray films are believed to originate from edematous interlobar septa.
t or f

Back 88

true

Front 89

Hypoproteinemia reduces oncotic pressure.
t or f

Back 89

true

Front 90

An agent used to increase the patient's oncotic pressure to counteract the increased hydrostatic forces associated with cardiogenic pulmonary edema is ___________.

Back 90

albumin

Front 91

Most pulmonary emboli orginate from thrombi in the:
I lungs
II right heart
III leg and pelvic veins
IV pulmonary veins

Back 91

C leg and pelvic veins

Front 92

The aortic and cartoid sinus barroreceptors initate which of the following in response to a decrease systemic blood pressure?
I increased heart rate
II increased ventilatory rate
III decreased heart rate
IV ventilatory rate is not affected by the aortic and carotid sinus barrorecptors

Back 92

I and II only

Front 93

What is the upper limit of the normal mean pulmonary artery pressure?

Back 93

15mmHg

Front 94

Pulmonary hypertension develops in pulmonary embolism because of which of the follwing?
I increased cross-setional area of the pulmonary vascular system
II vasoconstriction caused by humoral agent release
III vasoconstriction induced by decreased arterial oxygen pressure Pao2
IV vasocontriction induced by decreased alveolar oxygen pressure (Pao2

Back 94

II and IV only

Front 95

IN severe pulmonary embolism, which of the following hemodynamic indices is/are commonly seen?
I decreased PVR
II increased PA
III decreased CVP
IV increased PCWP

Back 95

II only

Front 96

When humoral agents such as serotonin are released into the pulmonary circulation, which of the following occurs?
I the bronchial smooth muscles dilate.
II the V/Q ratio decreases
III the bronchial smooth muscles constrict
IV th V/Q ratio increases

Back 96

II and III only

Front 97

Which of the following is a thrombolytic agent?
I urokinase
II Heprin
III Warfarin
IV streptokinase

Back 97

I and IV only

Front 98

What is the most prominent source of pulmonary emboli?

Back 98

blood clots

Front 99

Which of the following organisms is/are commonly found in the tracheobronchial tree secretions of patients with cystic fibrosis?
I staphylococcus
II haemophilus influenzae
III strepococcus
IV pseudomanas aeruginosa

Back 99

I,II and IV only

Front 100

When two carriers of cystic fibrosis produce children, there ia a :

Back 100

25% chance the baby will be normal and a 25% chance the baby will have cystic fibrosis.

Front 101

The cystic fibrosis gene is located on which chromosome?

Back 101

7

Front 102

In cystic fibrosis the patient commonly demonstrates which of the following?
I increase FEV
II decreased MVV
III increased RV
IV decreased FEV/FVC ratio

Back 102

II,III and IV only

Front 103

During advanced stages of cystic fibrosis, the patient generally demonstrates which of the following?
I bronchial breath sounds
II dull percussion notes
III diminished breath sounds
IV hyperresonant percussion notes

Back 103

III and IV only

Front 104

Approximately 80% of all patients with cystic fibrosis demonstrate a deficiency in which of the following vitamins?
I A
II B
III D
IV E
V K

Back 104

I, III, IV, V only

Front 105

In children, ______ sweat chloride concentration values is diagnostic of cystic fibrosis.

Back 105

60mEq/L

Front 106

Which of the following is/are a mucolytic agent(s)?
I N-acetylcystine
II aristocort
III rhDNase
IV aldactone

Back 106

I and III only

Front 107

In regards to the secretion of sodium and chloride, the sewat glands of patients with cystic fibrosis secrete up to:

Back 107

5 times the normal amount

Front 108

Which of the following clinical manifestations are associated with severe cystic fibrosis?
I decrease hemoglobin concentration
II increase central venous pressure
III decrease breath sounds
IV increased pulmonary vascular resistance

Back 108

II,III,and IV only