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Clinical Manifestations and Assessment of Respiratory Disease > Interstitial lung disease Ch 26 and ARDS Ch 28 > Flashcards

Interstitial lung disease Ch 26 and ARDS Ch 28 Flashcards

1
Q

All of the following are anatomic alterations of the lungs that may be found with the chronic stage of interstitial lung disease (ILD) EXCEPT:

a. honeycombing.
b. edema.
c. interstitial thickening.
d. granulomas.

A

b. edema.

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2
Q

What major pathologic and structural changes are associated with asbestosis?

  1. Fibrocalcific pleural plaques
  2. Excessive bronchial secretions
  3. Bronchospasm
  4. Mediastinal shift
A
  1. Fibrocalcific pleural plaques
  2. Excessive bronchial secretions
  3. Bronchospasm
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3
Q

All of the following are interstitial lung diseases EXCEPT:

a. asbestosis.
b. sarcoidosis.
c. Staphylococcus.
d. silicosis.

A

Staphylococcus.

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4
Q

Which of the following is the largest group of agents associated with drug-induced interstitial lung disease?

a. Anticancer agents
b. Cardiovascular agents
c. Antibiotics agents
d. Antiinflammatory agents

A

Anticancer agents

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5
Q

Which of the following organs are affected by systemic scleroderma?

  1. Skin
  2. Reproductive organs
  3. Lungs
  4. Brain
A
  1. Skin
  2. lungs

Systemic scleroderma causes fibrous degeneration of the connective tissue of the skin and lungs (and esophagus, digestive tract, and kidneys).

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6
Q

What is the most common pulmonary complication associated with systemic lupus erythematosus (SLE)?

A

Pleurisy

Pleurisy, with or without effusion, is the most common pulmonary complication associated with SLE.

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7
Q

Which of the following Americans would be the most likely to get sarcoidosis?

a. A 27-year-old African-American female
b. A 60-year-old African-American male
c. A 45-year-old Caucasian female
d. A 60-year-old Hispanic male

A

A 27-year-old African-American female

African-American women in the 20- to 30-year age group are the most likely people to get sarcoidosis.

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8
Q

Cryptogenic organizing pneumonia (COP) is associated with all of the following EXCEPT:

a. COPD.
b. connective tissue disease.
c. infection.
d. toxic gas inhalation.

A

COPD.

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9
Q

A patient has just been diagnosed with Wegener’s granulomatosis. Her long-term prognosis is:

a. excellent, with full recovery expected.
b. fair, with recovery expected after proper treatment.
c. guarded; recovery is possible after proper treatment.
d. poor; it is considered a fatal disease.

A

d. poor; it is considered a fatal disease.

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10
Q

What category of medications is commonly prescribed to manage interstitial lung disease?

a. Antibiotics
b. Mucolytics
c. Corticosteroids
d. Diuretics

A

Corticosteroids

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11
Q

Chest assessment findings in a patient with ILD would include:

  1. pleural friction rub.
  2. increased vocal fremitus.
  3. vesicular breath sounds.
  4. hyperresonant percussion note.
A
  1. pleural friction rub.

2. increased vocal fremitus

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12
Q

The diffusing capacity of a patient with coal worker’s pneumoconiosis or silicosis would be expected to be:

a. normal.
b. increased.
c. decreased.
d. variable based on the age of the patient.

A

decreased

In almost all cases of ILD, the diffusing capacity will be decreased because of pulmonary fibrosis and related problems.

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13
Q

Which of the following chest radiograph findings would be associated in a patient with ILD?

  1. Pleural effusion
  2. Honeycombing
  3. Cavity formation
  4. Increased translucency
A
  1. Pleural effusion
  2. Honeycombing
  3. Cavity formation
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14
Q

Which of the following are associated with an increased DLCO?

a. Goodpasture’s syndrome and idiopathic pulmonary hemosiderosis
b. Goodpasture’s syndrome and Churg-Strauss syndrome
c. Churg-Strauss syndrome and LAM
d. Idiopathic pulmonary hemosiderosis and COP

A

Goodpasture’s syndrome and idiopathic pulmonary hemosiderosis

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15
Q

All of the following are associated with lymphangioleiomyomatosis (LAM) EXCEPT:

a. recurrent chylothoraces and recurrent pneumothoraces.
b. increased airway obstruction.
c. postmenopausal women are primarily affected.
d. airway smooth muscle is affected.

A

postmenopausal women are primarily affected.

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16
Q

Which ILD is a smoking-related condition characterized by star-shaped nodules in the midlung?

a. PLCH
b. LIP
c. BOOP
d. CWP

A

PLCH

PLCH is a smoking-related ILD characterized by midlung-zone, star-shaped nodules with adjacent thin-walled cysts.

17
Q

What is another name for rheumatoid pneumoconiosis?

a. Goodpasture’s syndrome
b. Caplan’s syndrome
c. Churg-Strauss syndrome
d. Sjögren’s syndrome

A

Caplan’s syndrome

Rheumatoid pneumoconiosis is also known as Caplan’s syndrome and is most often seen in coalminers.

18
Q

All of the following materials will be found in the alveoli of a patient with ARDS EXCEPT:

a. leukocytes.
b. cellular debris.
c. fibrin.
d. hyaline membrane.

A

leukocytes.

19
Q

A patient has a prolonged case of ARDS. What changes would be expected in the patient’s alveolar cells?

a. Multiplication of the type I cells
b. Influx of macrophages
c. Hyperplasia and swelling of the type II cells
d. Development of emphysema

A

Hyperplasia and swelling of the type II cells

20
Q

Which of the following pulmonary changes are associated with ARDS?

  1. Abnormal surfactant
  2. Interstitial edema
  3. Decreased shunt
  4. Narrowing of the alveolar-capillary membrane
A
  1. Abnormal surfactant

2. Interstitial edema

21
Q

What is the reason for the elevated risk of developing ARDS associated with massive blood transfusions?

a. Shock (hypovolemia)
b. Receiving the wrong blood type
c. Fat emboli
d. Blockages in pulmonary blood vessels

A

Blockages in pulmonary blood vessels

With massive transfusions, aggregated cells in stored blood can occlude or damage the small pulmonary blood vessels

22
Q

ARDS can result from the inhalation of all of the following EXCEPT:

a. FIO2 >0.60 for prolonged exposure.
b. nitrogen dioxide.
c. very dry air.
d. chlorine gas.

A

very dry air.

23
Q

Which of the following are causes of ARDS?

  1. Liver failure
  2. Heroin abuse
  3. Septicemia
  4. Goodpasture’s syndrome
A
  1. Heroin abuse
  2. Septicemia
  3. Goodpasture’s syndrome
24
Q

Which of the following are recommended to treat alveolar consolidation and atelectasis associated with ARDS?

  1. Aerosolized bronchodilator medications
  2. Continuous positive airway pressure (CPAP)
  3. Chest percussion and postural drainage
  4. Positive end-expiratory pressure (PEEP)
A
  1. Continuous positive airway pressure (CPAP)
  2. Positive end-expiratory pressure (PEEP)

Lung expansion measures, including CPAP and PEEP, will help offset alveolar consolidation and atelectasis associated with ARDS.

25
Q

Which of the following are current ventilatory strategies in the treatment of ARDS?

  1. Large tidal volume
  2. Small tidal volume
  3. Rapid respiratory rates
  4. Slow respiratory rates
A
  1. Small tidal volume

3. Rapid respiratory rates

26
Q

What initial tidal volume setting on the ventilator would be recommended for a 70-kg adult male with ARDS?

a. 350 mL
b. 420 mL
c. 560 mL
d. 700 mL

27
Q

All of the following would be low–tidal volume ventilation goals in a patient with ARDS, EXCEPT:

a. decrease barotrauma.
b. maintain plateau pressure >30 cm H2O.
c. decrease high transpulmonary pressures.
d. reduce overdistention of the lungs.

A

maintain plateau pressure >30 cm H2O.

28
Q

Breath sounds associated with ARDS include:

  1. vesicular.
  2. bronchovesicular.
  3. crackles.
  4. bronchial.
A
  1. crackles.

4. bronchial.

29
Q

Which of the following clinical manifestations are associated with ARDS?

  1. Normal or decreased pulmonary capillary wedge pressure (PCWP)
  2. Increased CVP
  3. Intercostal retractions
  4. Cyanosis
A
  1. Normal or decreased pulmonary capillary wedge pressure (PCWP)
  2. Increased CVP
  3. Intercostal retractions
  4. Cyanosis
30
Q

The chest radiograph finding indicative of severe ARDS is:

a. “ground-glass” appearance of the lungs.
b. pleural effusion.
c. bilateral hyperinflation of the lungs.
d. tracheal deviation.

A

“ground-glass” appearance of the lungs.

31
Q

According to the Berlin definition of ARDS, what does a PaO2/FIO2 ratio of 150 mm Hg indicate for a patient on mechanical ventilation with a PEEP of 10 cm H2O?

a. Normal lungs
b. Mild ARDS
c. Moderate ARDS
d. Severe ARDS

A

Moderate ARDS

Moderate ARDS is present when the PaO2/FIO2 ratio falls between 100 and 199 mm Hg.

32
Q

What is the most common cause of ARDS?

a. Sepsis
b. Fat embolism
c. Inhalation of irritants
d. Aspiration of gastric contents

33
Q

When would symptoms of ARDS associated with a fat embolism from a long bone fracture be most likely to develop?

a. 2 to 4 hours following the fracture
b. 4 to 12 hours following the fracture
c. 12 to 48 hours following the fracture
d. 48 to 96 hours following the fracture

A

12 to 48 hours following the fracture

Between 12 and 48 hours after the fracture of a long bone, the symptoms of ARDS related to a fat embolism from the fracture would begin to appear.

Clinical Manifestations and Assessment of Respiratory Disease (4 decks)

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