Cardiopulmonary Pathophysiology Exam Preparation Guide
Course Introduction
Cardiopulmonary Pathophysiology explores the underlying mechanisms and functional changes associated with diseases affecting the heart and lungs. The course emphasizes an integrated understanding of normal and abnormal anatomy and physiology, examining how disruptions in cardiovascular and respiratory systems lead to clinical manifestations. Key topics include altered hemodynamics, gas exchange abnormalities, heart failure, obstructive and restrictive pulmonary diseases, and the interplay between cardiac and pulmonary conditions. Students learn to interpret diagnostic findings and understand how pathophysiologic changes guide therapeutic interventions, preparing them for advanced study or clinical practice in health-related fields.
Recommended Textbook
Respiratory Disease A Case Study Approach to Patient Care 3rd Edition by James R. Dexter
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20 Chapters
484 Verified Questions
484 Flashcards
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Chapter 1: Introduction to Patient Assessment
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) Your patient has bilateral wheezing.Which of the following conditions often causes this finding?
A)Asthma
B)Acute bronchitis
C)Congestive heart failure
D)All the above
Answer: D
Q2) Patients who are short of breath often complain of what other symptom?
A)Chest pain
B)Anxiety
C)Cough
D)Dizziness
Answer: B
Q3) Which of the following disorders is associated with a cough?
A)Asthma
B)Gastroesophageal reflux disease
C)Postnasal drip
D)All the above
Answer: D
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Page 3
Chapter 2: Introduction to Respiratory Failure
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Which of the following can contribute to diaphragm dysfunction and lead to ventilatory failure?
A)Emphysema
B)Malnutrition
C)Electrolyte abnormalities
D)All the above
Answer: D
Q2) Your patient is being weaned using IMV.He appears to be tolerating the wean,but labors during the spontaneous breaths because the endotracheal tube is probably too small.What could be done to overcome this problem?
A)Increase the tidal volume during IMV breaths
B)Add pressure support
C)Increase the flow rate during the IMV breaths
D)Give the patient a mild sedative
Answer: B
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4
Chapter 3: Asthma
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23 Flashcards
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Sample Questions
Q1) What instrument should the asthma patient have at home to monitor his/her status and to help indicate when to call the doctor?
A)Pulse oximeter
B)Densitometer
C)Peak flow meter
D)Blood pressure cuff
Answer: C
Q2) Which of the following conditions is least likely to mimic the symptoms of an asthma attack?
A)Congestive heart failure
B)Bronchitis
C)Acute respiratory distress syndrome
D)Acute upper airway obstruction
Answer: C
Q3) Which of the following is NOT associated with provoking an asthma attack?
A)Aspirin use
B)Exercise
C)Viral respiratory infection
D)Use of Atropine to increase heart rate
Answer: D
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Chapter 4: Chronic Obstructive Pulmonary Disease
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) Which of the following findings on the chest film is associated with hypertrophy of the airways due to heavy cigarette consumption?
A)Tram tracks
B)An enlarged right ventricle
C)Kerly B lines
D)Air bronchograms
Q2) Which of the following approaches to mechanical ventilation in the COPD patient is most likely to help avoid auto-PEEP?
A)Small tidal volumes
B)Reduced inspiratory flows
C)Minimal expiratory times
D)Use of IMV
Q3) What clinical laboratory data finding is suggestive of chronic hypoxemia in the COPD patient?
A)Hyperkalemia
B)Hyponatremia
C)Polycythemia
D)Elevation of total CO<sub>2</sub>
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Chapter 5: Cystic Fibrosis
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20 Flashcards
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Sample Questions
Q1) Which of the following upper airway problems is common in patients with cystic fibrosis?
A)Nasal polyps
B)Sinusitis
C)Deviated septum
D)A and B only
Q2) Your patient with cystic fibrosis is having frequent pulmonary infections and her doctor asks you for a suggestion on therapy that might help reduce the frequency of these exacerbations.What do you suggest?
A)Better hydration for the patient
B)Aerosolized tobramycin
C)Home chest physical therapy
D)A home humidifier
Q3) What finding on the chest radiograph is NOT typical for patients with cystic fibrosis?
A)Tram tracks
B)Hilar adenopathy
C)Enlarged heart
D)Atelectasis
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Chapter 6: Hemodynamic Monitoring and Shock
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20 Flashcards
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Sample Questions
Q1) What parameter is used to assess preload for the left ventricle?
A)CVP
B)PCWP
C)Systemic blood pressure
D)Pulmonary vascular resistance
Q2) What therapy is often needed for patients with cardiogenic shock?
A)Vasopressors
B)Bronchodilators
C)Positive inotropics
D)Fluids
Q3) What therapy is often needed for the patient with septic shock?
A)Vasopressors
B)Bronchodilators
C)Positive inotropics
D)Diuretics
Q4) Which of the following is not related to production of stroke volume?
A)Circulating blood volume
B)Vascular resistance
C)Cardiac contractility
D)Pulse pressure
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Chapter 7: Pulmonary Thromboembolic Disease
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) Which of the following findings in a patient with PTE would cause you to most likely consider using thrombolytic therapy?
A)PaO<sub>2</sub> 65 mmHg
B)PaCO<sub>2</sub> 44 mmHG
C)Blood pressure 80/45 mmHg
D)Pulse rate = 110/min
Q2) Which of the following statements is true about the use of "D-dimer" in evaluating the patient for PTE?
A)A value of >200 ng/mL is suggestive of PTE
B)Negative results are good evidence that PTE is not present
C)High values are proof of PTE
D)None of the above
Q3) Which of the following findings is/are typical for the chest radiograph in a patient with PTE?
A)Normal
B)Signs of volume loss
C)Westermark's sign
D)All the above
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Chapter 8: Heart Failure
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) Your patient develops severe pulmonary edema with severe hypoxemia and a PaCO<sub>2</sub> of 55 mmHg.What therapy would you recommend to the attending physician?
A)Oxygen via non-rebreathing mask
B)CPAP with FIO<sub>2</sub> of 1.0
C)CPAP with BiPAP and an FIO<sub>2</sub> of 1.0
D)Intubate and use blow-by at an FIO<sub>2</sub> of 0.50
Q2) What is the primary electrolyte and fluid balance problem associated with heart failure that results in reduced renal perfusion?
A)Potassium retention and excessive water elimination
B)Potassium loss and water retention
C)Sodium loss and water elimination
D)Sodium retention and water retention
Q3) What is the normal value for ejection fraction in a healthy heart?
A)40%
B)50%
C)60%
D)70%
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Chapter 9: Smoke Inhalation Injury and Burns
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24 Flashcards
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Sample Questions
Q1) Which of the following is/are a potential mechanism for the ARDS that accompanies some burns?
A)Surfactant dysfunction
B)Increased capillary permeability
C)Bacterial sepsis
D)All the above
Q2) Which of the following is most indicative of inhalation injury with organ damage?
A)Tachycardia
B)PaO<sub>2</sub> = 38 mmHg
C)Abnormal sensorium
D)pH below 7.30
Q3) Which of the following is NOT a cause of increased mortality among burn victims?
A)Greater total body surface (TBSA)involvement
B)Women ages 30 to 55
C)Significant smoke inhalation
D)None of the above
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Chapter 10: Near Drowning
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Sample Questions
Q1) Which of the following statements is NOT true regarding pathophysiology of drowning or near drowning?
A)Only a small percent of victims aspirate water into their lungs
B)Victims usually swallow large amounts of water
C)Cold water near drowning victims can survive longer submersion times
D)When fresh water is aspirated it is hypotonic to the blood and rapidly passes into the blood stream
Q2) About how many people drown in the United States each year?
A)1,200
B)3,400
C)6,000
D)8,500
Q3) Which of the following parameters would you assess to determine perfusion in a near drowning victim?
A)Capillary refill
B)Extremity temperature
C)Sensorium
D)All the above
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Chapter 11: Acute Respiratory Distress Syndrome
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) What plateau pressure should you accept while mechanically ventilating an ARDS patient to avoid barotrauma?
A)Below 20 cwp
B)Below 30 cwp
C)Below 40 cwp
D)Below 50 cwp
Q2) Which of the values below for f/Vt ratio during spontaneous breathing is most indicative of success?
A)>200
B)<100
C)<50
D)< or = 300-350
Q3) Which of the following measurements is obtainable only with a Swan-Ganz catheter?
A)PCWP
B)SaO<sub>2</sub>
C)CVP
D)None of the above (all are obtainable with a Swan-Ganz catheter)
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Chapter 12: Chest Trauma
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) All of the following are cardiac isoenzymes that are elevated in myocardial contusion except:
A)AST
B)LDH
C)CK
D)MAO
Q2) Which is the most common site of aortic rupture in chest trauma?
A)Descending aorta near its hiatus in the diaphragm
B)Ascending aorta just distal to its semilunar valve
C)Upper thoracic aorta,near the left subclavian artery
D)Arch of the aorta near the brachiocephalic artery
Q3) Which of the following statements is true regarding flail chest?
A)It is a common accompaniment of chest injury
B)It is,more times than not,a cosmetic rather than a serious medical or surgical problem
C)Paradoxical breathing can result from chest wall instability
D)Surgery is required in all cases once the patient becomes stable
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14
Chapter 13: Postoperative Atelectasis
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18 Flashcards
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Sample Questions
Q1) What physical examination finding suggests a more severe case of postoperative atelectasis?
A)Hypotension
B)Inspiratory wheezing
C)Bronchial breath sounds
D)Use of accessory muscles to breathe
Q2) What must also be applied to the patient with postoperative atelectasis due to mucus plugging who is being treated with positive pressure techniques?
A)Oxygen therapy
B)Bronchoscopy
C)Bronchial hygiene techniques
D)Frequent ambulation
Q3) What therapy is often very effective in treating lobar atelectasis in the postoperative patient?
A)A short,vigorous course of chest physical therapy
B)IPPB
C)CPAP with humidity therapy
D)Simulated coughing
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15
Chapter 14: Interstitial Lung Disease
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20 Flashcards
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Sample Questions
Q1) Which of the following statements is true regarding coal worker's pneumoconiosis?
A)It develops in approximately 40-50% of exposed workers
B)It is usually associated with people known to have other allergies
C)It occurs in <0.5% of those regularly exposed to coal dust
D)When present,it rarely is a cause of significant functional impairment or disability
Q2) Pulmonary function studies typically reveal which of the following in ILD?
A)A predominantly obstructive ventilatory defect
B)A purely restrictive defect
C)Normal flow rates and volumes initially
D)None of the above
Q3) Which of the following statements is true regarding the use of CT scan in ILD?
A)Normal CT examines slices of the tissue,10 mm thick
B)High-resolution CT scan increases the patient's exposure to radiation
C)High-resolution CT uses 1 mm thick "cuts" to examine the lung
D)All the above
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16
Chapter 15: Neuromuscular Diseases
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28 Flashcards
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Sample Questions
Q1) What type of sleep apnea may play a role in sudden infant death syndrome?
A)Central
B)Obstructive
C)Both A and B
D)Mixed
Q2) Which of the following disorders represents a classic example of a disease that affects the neuromuscular junction?
A)Myasthenia gravis
B)Guillain-Barré syndrome
C)Polio
D)Amyotrophic lateral sclerosis
Q3) Tracheostomy is most likely indicated in the neuromuscular patient with which of the following disorders?
A)Myasthenia gravis
B)T3 spinal injury
C)High cervical spine fracture
D)Guillain-Barré syndrome
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Chapter 16: Bacterial Pneumonia
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20 Flashcards
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Sample Questions
Q1) Criteria for a poor sputum sample include all of the following except
A)Many squamous epithelial cells surround the flora on the microscope slide
B)Sample was obtained from mouth in such a way as to suggest patient was merely clearing throat or spitting
C)No or very few WBCs are present in the sample
D)The sample was aspirated aseptically and taken to the lab promptly
Q2) Lobar pneumonia is evidenced by all of the following except:
A)Unilateral chest expansion on involved side
B)Increased tactile fremitus on involved side
C)Bronchial breath sounds
D)Increased resonance to percussion
Q3) What is the significance of increased immature WBCs (bands)in the peripheral blood?
A)Bacterial infection stimulates the bone marrow
B)Worsening infection may necessitate younger "soldiers"
C)A and B are correct
D)Significant only if all other blood cell types are elevated
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18
Chapter 17: Pneumonia in the Immunocompromised Patient
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Sample Questions
Q1) What treatment is initially given to the immunocompromised patient with fungal pneumonia?
A)Amphotericin B
B)High-dose steroids
C)Sulfa antibiotics
D)Amoxicillin
Q2) What cells are the major constituent of pus?
A)Dead and alive neutrophils
B)Dead and alive macrophages
C)Dead and alive eosinophils
D)Dead and alive lymphocytes
Q3) All of the following laboratory findings are indicative of immunosuppression except A)Lymphocytopenia
B)Neutropenia
C)Reduced CD4+ cells
D)Increased WBCs
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Chapter 18: Sleep Disordered Breathing
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Sample Questions
Q1) Contraindications for using CPAP to treat obstructive sleep apnea include all the following except:
A)Uncontrolled emesis
B)Hypotension with hypovolemia
C)Pneumothorax
D)Left heart failure
Q2) During the sleep study your patient moves air during sleep but the amount is below what is needed to maintain homeostasis.What term is applied to this type of breathing problem during sleep?
A)Apnea
B)Eupnea
C)Hypopnea
D)Platypnea
Q3) Your patient has an apnea/hypopnea index of 36.How severe is the problem in this case?
A)Mild
B)Moderate
C)Severe
D)Very severe
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Page 20
Chapter 19: Tuberculosis
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Sample Questions
Q1) Which of the following is true regarding the use of laboratory data in the evaluation of a patient with TB?
A)The WBC count is usually elevated
B)A mild anemia is seen in chronic TB
C)Immature white cell counts usually decrease with TB
D)An anion gap is often seen
Q2) What arterial blood gas findings are typical for the patient with dormant TB lung infection?
A)Moderate hypoxemia
B)Mild hypercapnia
C)Metabolic acidosis
D)None of the above
Q3) Once the initial site of infection in the lung heals from the patient's immune system,which of the following is not true?
A)Pockets of bacteria may lie dormant for many years
B)The bacteria are all dead and can no longer cause disease
C)The patient will have a positive skin test at this point
D)Clinically,there is no evidence of disease
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Chapter 20: Lung Cancer
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Sample Questions
Q1) Which of these are clues to metastatic disease?
A)Chest wall pain
B)Seizures and stroke
C)Weight loss
D)All the above
Q2) All of these are major histological types of bronchogenic carcinoma except:
A)Small-cell
B)Hamartoma
C)Large-cell
D)Squamous cell
Q3) Magnetic resonance imaging (MRI)has this advantage over CT for evaluating pulmonary nodules or mediastinal metastases
A)Better for seeing chest wall invasion
B)Uses less ionizing radiation
C)Is less expensive than CT
D)Is more available to the patient
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