1.
Dyspnea is associated with diseases or situations that decrease gas exchange through the lungs.
Correct Answer
A. True
Explanation
Dyspnea, or shortness of breath, is indeed associated with diseases or situations that decrease gas exchange through the lungs. When gas exchange is impaired, it becomes difficult for oxygen to enter the bloodstream and carbon dioxide to be removed. This can occur in conditions such as chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and pulmonary embolism, among others. As a result, individuals may experience difficulty breathing, which is known as dyspnea. Therefore, the statement "Dyspnea is associated with diseases or situations that decrease gas exchange through the lungs" is true.
2.
Which statements regarding a cough are FALSE?
A. A reflex sudden expulsion of air initiated by afferent nerves in the respiratory mucosa.
B. It is a loss of lung volume due to inadequate expansion of airspaces.
C. It can be a response to irritants.
Correct Answer
B. B
Explanation
A cough is not a loss of lung volume due to inadequate expansion of airspaces. Instead, it is a reflex sudden expulsion of air initiated by afferent nerves in the respiratory mucosa. It can also be a response to irritants.
3.
Atelectasis is significant because it leads to shunting of blood that is not oxygenated into the pulmonary veins which result in hypoxia.
Correct Answer
A. True
Explanation
Atelectasis is a condition where the alveoli in the lungs collapse or become filled with fluid, leading to a decrease in the surface area available for gas exchange. This can result in a decrease in oxygen levels in the blood, leading to hypoxia. The shunting of blood that is not oxygenated into the pulmonary veins exacerbates this hypoxia. Therefore, atelectasis is indeed significant as it can cause hypoxia due to the shunting of deoxygenated blood.
4.
Which of the following terms is defined INCORRECTLY?
A. Hemothorax = purulent fluid in the pleural space
B. Empyema = Blood in the pleural space
C. Pleural effusion = fluid in the pleural space
D. Pneumothorax = air or other gases in the pleural space due to a lung rupture.
Correct Answer
E. A and B only
Explanation
Hemothorax is defined as blood in the pleural space, not purulent fluid. Empyema is also defined as purulent fluid in the pleural space, not blood. Therefore, options A and B are defined incorrectly. Option C correctly defines pleural effusion as fluid in the pleural space, and option D correctly defines pneumothorax as air or other gases in the pleural space due to a lung rupture.
5.
Which of the following terms is defined CORRECTLY?
A. Tidal volume = Volume of air moved in and out during normal easy breathing
B. Vital capacity = Volume of air moved during a maximal inhalation followed by maximal exhalation
C. Total lung capacity = The amount of air exhaled in the first second of the FVC procedure
Correct Answer
D. A and B only
Explanation
Option C: FEV1 = The amount of air exhaled in the first second of the FVC procedure
6.
Which of the following statements is FALSE?
A. FEV1/FVC is normal in obstructive lung diseases
B. A current theory regarding asthma is that bronchial inflammation is what leads to hyperresponsiveness.
C. Intrinsic Asthma is more common in children and they often outgrow it.
D. Treatment of asthma includes albuterol, epinephrine, MC stabilizers and leukotriene inhibitors.
Correct Answer
B. A and C only
Explanation
The statement A is false because in obstructive lung diseases, the FEV1/FVC ratio is reduced. The statement C is false because intrinsic asthma is not more common in children and they do not often outgrow it.
7.
The treatment of COPD is similar to and uses most of the same medications as in asthma, with the notable exception of allergy shots, and often the addition of oxygen on a chronic basis.
Correct Answer
A. True
Explanation
The statement is true because the treatment of COPD (chronic obstructive pulmonary disease) does indeed involve using similar medications as in asthma. Both conditions involve inflammation and narrowing of the airways, so medications such as bronchodilators and corticosteroids are commonly used for both. However, allergy shots, which are used to treat allergies, are not typically used in the treatment of COPD. Additionally, because COPD can cause low oxygen levels in the blood, oxygen therapy may be prescribed on a chronic basis to help improve oxygen levels.
8.
Like asthma, COPD is almost totally reversible.
Correct Answer
B. False
Explanation
This statement is false. Unlike asthma, Chronic Obstructive Pulmonary Disease (COPD) is not reversible. COPD is a progressive lung disease characterized by airflow limitation that is not fully reversible. It is typically caused by long-term exposure to irritating gases or particles, such as cigarette smoke. The damage to the airways and lung tissue in COPD is not reversible and can lead to symptoms such as shortness of breath, coughing, and wheezing. Treatment for COPD focuses on managing symptoms and slowing the progression of the disease, but it cannot fully reverse the damage that has already occurred.
9.
Which of the following characteristics apply to patients with Emphysema?
A. They can be referred to as blue bloaters
B. They appear barrel-chested
C. They are thin and not significantly hypoxic
Correct Answer
E. B and C only
Explanation
Patients with emphysema can be referred to as blue bloaters, as they often have a bluish discoloration of the skin due to inadequate oxygenation. They also appear barrel-chested, which is a characteristic physical finding in emphysema. However, they are not thin and are often significantly hypoxic, so option A is incorrect. Therefore, the correct characteristics that apply to patients with emphysema are B and C only.
10.
Which of the following statements does NOT apply to Chronic Bronchitis?
A. Defined as a persistent, productive cough for three consecutive months of at least two consecutive years.
B. The leading cause is cigarette smoke
C. Like emphysema, there is no retention of CO2 and hypoxia.
D. These patients are often obese and edematous
Correct Answer
C. C
Explanation
As opposed to emphysema, with chronic bronchitis there is often retention of CO2 and hypoxia. The classic patient here is obese, hypoxic, cyanotic and edematous (CHF) and is referred to as a "blue bloater".
11.
Which of the following statements is FALSE regarding restrictive lung disease?
A. There is usually a decrease in total lung capacity (TLC)
B. A decrease in diffusion of oxygen across the lung tissue occurs,
C. ARDS - is an extremely severe situation with mortality rates still about 50%
Correct Answer
D. All of the above are true
Explanation
Restrictive lung disease is characterized by a decrease in lung volume and capacity, leading to decreased total lung capacity (TLC). This is stated in option A. Option B is also true as restrictive lung disease can result in a decrease in the diffusion of oxygen across the lung tissue. Option C is also true, as Acute Respiratory Distress Syndrome (ARDS) is a severe form of restrictive lung disease with high mortality rates. Therefore, the correct answer is that all of the above statements are true.
12.
Pulmonary fibrosis is a poorly understood problem. The cause is often idiopathic.
Correct Answer
A. True
Explanation
Pulmonary fibrosis is indeed a poorly understood problem, meaning that the exact cause of this condition is often unknown or idiopathic.
13.
Which organism is the cause of the most common type of community-acquired pneumonia?
A. Streptococcus pneumonia
B. Haemophilus influenza
C. Staph aureus
D. Klebsiella pneumonia
Correct Answer
A. A
Explanation
The correct answer is A, Streptococcus pneumonia. Streptococcus pneumoniae is a common cause of community-acquired pneumonia, particularly in adults. It is a bacteria that can infect the lungs and cause symptoms such as cough, fever, and difficulty breathing. It is important to identify the causative organism in order to determine the appropriate treatment for pneumonia.
14.
Which organism is common in children and also adults who have COPD?
A. Streptococcus pneumonia
B. Haemophilus influenza
C. Staph aureus
D. Klebsiella pneumonia
Correct Answer
B. B
Explanation
Haemophilus influenza is the correct answer because it is a common organism found in both children and adults with COPD. COPD, or chronic obstructive pulmonary disease, is a lung disease that commonly affects adults and can also occur in children due to factors such as genetic predisposition or exposure to secondhand smoke. Haemophilus influenza is a bacteria that can cause respiratory infections, including pneumonia, which can be more severe in individuals with COPD. Therefore, it is important to be aware of this organism when diagnosing and treating respiratory infections in both children and adults with COPD.
15.
Which organism is an important cause of secondary pneumonia following viral respiratory infections?
A. Streptococcus pneumonia
B. Haemophilus influenza
C. Staph aureus
D. Klebsiella pneumonia
Correct Answer
C. C
Explanation
Staph aureus is an important cause of secondary pneumonia following viral respiratory infections. This bacterium is commonly found in the respiratory tract and can cause pneumonia when it enters the lungs after a viral infection weakens the immune system. Staph aureus pneumonia can be severe and is often associated with high mortality rates.
16.
Which organism is the most frequent cause of gram-negative pneumonia?
A. Streptococcus pneumonia
B. Haemophilus influenza
C. Staph aureus
D. Klebsiella pneumonia
Correct Answer
D. D
Explanation
Klebsiella pneumoniae is the most frequent cause of gram-negative pneumonia. This bacterium is commonly found in the respiratory tract and can cause severe pneumonia, especially in individuals with weakened immune systems or underlying health conditions. Klebsiella pneumoniae is known for its ability to produce a thick, sticky capsule that helps it evade the immune system and adhere to respiratory tissues, leading to infection. Its gram-negative nature indicates that it has an outer membrane that can make it more resistant to certain antibiotics.
17.
Which organism is the most common cause of pneumonia in debilitated, malnourished people, in particular in alcoholics?
A. Streptococcus pneumonia
B. Haemophilus influenza
C. Staph aureus
D. Klebsiella pneumonia
Correct Answer
D. D
Explanation
Klebsiella pneumoniae is the most common cause of pneumonia in debilitated, malnourished people, especially in alcoholics. This bacterium is often found in the respiratory and gastrointestinal tracts and can cause severe infections in individuals with weakened immune systems. It is known to cause a specific type of pneumonia called Klebsiella pneumonia, which is characterized by a sudden onset of symptoms such as high fever, cough, and thick, bloody sputum.
18.
Which of the following statements regarding atypical pneumonia is FALSE?
A. With these infections, there is less sputum production, less elevation in the WBC count, and higher fever
B. Penicillins and cephalosporins are the first line of defense in treating atypical pneumonia
C. This type of pneumonia is particularly common in older children and young adults.
Correct Answer
D. A and B only
Explanation
The correct answer is A and B only. This means that both statements A and B are false. Statement A states that with atypical pneumonia, there is less sputum production, less elevation in the white blood cell count, and higher fever. However, in atypical pneumonia, there is typically more sputum production, a higher white blood cell count, and a lower fever. Statement B states that penicillins and cephalosporins are the first line of defense in treating atypical pneumonia. However, atypical pneumonia is typically caused by bacteria that are resistant to these antibiotics, so they are not the first line of treatment.
19.
Pneumonia is defined as infection below the carina and limited to the mucosa.
Correct Answer
B. False
Explanation
When there is the involvement of the alveoli and septa it is called pneumonia When the infection is limited to the mucosa this is bronchitis.
20.
Which of the following statements regarding pneumonia is FALSE?
A. Bacterial invasion of the lungs leads to a hemorrhagic, purulent exudative response
B. Bronchopneumonia involves part or all of one lobe.
C. Treatment of pneumonia includes antibiotics, oxygen, and respiratory support.
Correct Answer
B. B
Explanation
Bronchopneumonia involves a patchy distribution of infection generally affecting more than one lobe.
21.
Which of the following lung statements regarding Tuberculosis is TRUE?
A. It is a chronic granulomatous disease typically caused by an acid-fast bacillus
B. Only a small fraction of people infected with TB actually develop any active disease.
C. The infection may be reactivated by systemic steroids and then referred to as Reactivation TB
D. The infection can spread by way of the bloodstream and create a miliary form
Correct Answer
A. All of the above are true
Explanation
All of the statements regarding Tuberculosis are true. Tuberculosis is a chronic granulomatous disease typically caused by an acid-fast bacillus. Only a small fraction of people infected with TB actually develop any active disease. The infection may be reactivated by systemic steroids and then referred to as Reactivation TB. The infection can also spread by way of the bloodstream and create a miliary form. Therefore, all of the above statements are true.
22.
Coccidioidomycosis is commonly referred to as Valley Fever and is endemic in the San Joaquin Valley. In most cases, it results in a minor respiratory infection.
Correct Answer
A. True
Explanation
It can be life threatening in Philipino people
23.
Pneumocystis carinii is an organism that commonly affects older children and adults. It causes fever, dry cough, dyspnea and hypoxia.
Correct Answer
B. False
Explanation
It commonly affects the lungs of immune compromised people, like AIDS patients
24.
Which of the following statements regarding lung tumors is FALSE?
A. Bronchogenic carcinoma accounts for 15% of primary lung tumors
B. It is uncommon in industrialized countries.
C. There are four types of bronchogenic carcinomas: Squamous cell CA, Adenocarcinoma, Large cell CA and Small Cell CA
D. With small cell CA there is a very poor prognosis
Correct Answer
A. A and B only
Explanation
The correct answer is A and B only. This means that statements A and B are both false. Statement A states that bronchogenic carcinoma accounts for 15% of primary lung tumors, which is incorrect as it is the most common type of primary lung tumor. Statement B states that lung tumors are uncommon in industrialized countries, which is also false as lung cancer is one of the leading causes of cancer-related deaths worldwide, including in industrialized countries. Therefore, both statements A and B are false, making the answer A and B only.