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Patho > Patho Test II > Flashcards

Patho Test II Flashcards

1
Q

Clubbing of the digits is a frequent finding in what?

A

ILD

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2
Q

Most common form of ILD is?

A

Sarcoidosis

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3
Q

What indicates that your pt who is having a severe asthma attack is at a greater risk for respiratory failure and needs mechanical ventilation?

A

Hx of prior intubation & Steroid dependence

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4
Q

ILD typically involves what areas of the lung?

A

All lobes

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5
Q

Your pt has been determined to have this stage (T1, N0, M0) in his lung cancer. What should be recommended?

A

Imaging and bronchoscopy to ascertain site and nature of the tumor

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6
Q

In ILD, damaged type I cells are replaced by?

A

Secretory type II cells

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7
Q

All of these are pulmonary factors that can predispose to pneumonia except:

a. Asthma
b. Bronchial obstruction by tumor
c. Smoking
d. Pulmonary hypertension

A

Pulmonary hypertension

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8
Q

Which of the following statements is true regarding the use of CT scan in ILD?

a. Normal CT examines slices of the tissue, 10mm thick
b. High-resolution CT scan increases the pts’s exposure to radiation
c. High-resolution CT uses 1mm thick “cuts” to examine the lung
d. All the above

A

All the above

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9
Q

Which of the following ventilator settings or measurements is most concerning to you during mechanical ventilation of a pt with acute asthma?

a. Plateau pressure of 45cmH20
b. Mechanical rate of 14/min
c. Tidal volume set at 6-8 mL/kg of IBW
d. Inspiratory flow of 50 L/min

A

Plateau pressure of 45 cmH20

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10
Q

What strategy during mechanical ventilation is often used to prevent barotraumas?

A

Permissive hypercapnia

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11
Q

During a routine asthma attack, what assessment technique is least useful for the pt. assessment?

A

Chest x-ray

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12
Q

What instrument should an asthma pt have at home to monitor their status and to help indicate when to call the doctor?

A

Peak flow meter

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13
Q

What is the first symptom of lung involvement in ILD?

A

Progressive dyspnea on exertion

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14
Q

Which of these organisms is not a cause of pneumonia?

a. Fungi
b. Algae
c. Viruses
d. Bacteria

A

Algae

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15
Q

Bronchoscopes can be used with all of the following appliances to extend their usefulness except?

a. Continuous suction
b. Needle
c. Brush
d. Forceps

A

Continuous suction

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16
Q

The clinical presentation of lung cancer depends on all of these except?

a. Location within lung
b. If the pt consumed filtered cigarettes
c. Immune status of pt
d. Cell type and growth rate

A

If the pt consumed filtered cigarettes

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17
Q

What can be said about the incidence of asthma and the death rate from asthma in the past decade or so?

A

Both Incidence and Death rate are Increasing

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18
Q

The goals of therapy in most cases of ILD are all of these except?

a. Reducing inflammation
b. Identifying offending agent
c. Reversing damage
d. Preventing futher exposure

A

Reversing damage

19
Q

Factors that suppress the immune system include all of the following except?

a. Leukemia
b. AIDS
c. Poor hand washing
d. Transplantation

A

Poor hand washing

20
Q

What may be the earliest evidence on a standard pulmonary function test of the presence of ILD

A

Abnormal DLCO

21
Q

Mechanical factors that guard the respiratory system from inhaled organisms include all of the following except?

a. Gag and cough reflexes
b. Ciliary movement
c. Filtration in the nose
d. Destruction by gastric acid

A

Destruction by gastric acid

22
Q

What interstitial lung diseases are of unknown etiology?

A

Sarcoidosis, Rheumatoid arthritis, and idiopathic pulmonary fibrosis

23
Q

The fact that the overall survival rate for pts presenting with lung cancer is about 10% reflects what fact?

A

The disease is already advanced at time of diagnosis

24
Q

What medication is most commonly used to suppress the inflammatory process associated with ILD?

A

Prednisone

25
Q

If a pt has a number of nodules in their lung with hilar lymphadenopathy, the findings are most suggestive of what?

A

Sarcoidosis

26
Q

What breath sound is most consistent with ILD?

A

Late-inspiratory crackles

27
Q

Pulmonary function studies typically reveal what in ILD?

A

A purely restrictive defect

28
Q

What pulmonary function test is most useful during an acute attack?

A

Peak flow

29
Q

What contributes to the increase in the work of breathing associated with an asthma attack?

A

Bronchospasm, Mucus plugging, Air trapping

30
Q

Lobar pneumonia is evidenced by all of the following except?

a. Unilateral chest expansion on involved side
b. Increased resonance to percussion
c. Increased tactile fremitus on involved side
d. Bronchial breath sounds

A

Increased resonance to percussion

31
Q

What are the common sites for extrathoracic spread?

A

Brain and spinal cord, Bone marrow, Liver

32
Q

Poor cough can compromise pts in what conditions

A

Drug overdose, NMD, Abdominal pain

33
Q

Amiodarone, a drug associated with ILD, is used to treat what group of disorders?

A

Cardiac dysrrhythmias

34
Q

What imaging studies are useful in diagnosing lung cancer?

A

MRI, chest radiograph, Chest CT scan

35
Q

Chest radiographs for pneumonia are needed when?

A

There is fever, tachpnea, and tachycardia at any age

36
Q

If pt. A is having an asthma attack with loud wheezing, paradoxical pulse, and normal sensorium. Pt B is also having an asthma attack but no audible wheezing, no paradoxical pulse, but is confused and slow to respond. Which patient(s) should be treated most aggressively?

A

Pt B

37
Q

What are major factors that make nosocomial pneumonia so hard to eradicate

A

Person-to-person spread, Abx resistance, numerous reservoirs for infection

38
Q

Which of the following physical examination findings is least associated with an asthma attack?

a. Retractions
b. Heavy use of accessory muscles
c. Polyphonic wheezing
d. Prolonged inspiratory time

A

Prolonged Inspiratory time

39
Q

What is the significance of increased immature WBCs(bands in the peripheral blood?

A

Bacterial infection stimulates the bone marrow and Worsening infection may necessitate younger “soldiers”

40
Q

What is the specific term for pneumonia that causes permanent damage to lung tissue?

A

Necrotizing

41
Q

Which of these is not a pathway for organisms to enter the lungs in the adult?

a. From the lymphatic system
b. From the blood
c. Aspiration
d. Inhalation

A

From the lymphatic system

42
Q

What is the most common form of lung cancer?

A

Adenocarcinoma

43
Q

What are the major histological types of bronchogenic carcinoma?

A

Adenocarcinoma, Small-cell Carcinoma, Squamous cell Carcinoma, Large-cell Carcinoma

44
Q

All of the following are risk factors for lung cancer except:

a. Exposure to side stream smoke
b. Positive family hx
c. Consumption of fatty foods
d. Asbestos exposure

A

Consumption of fatty foods

Patho (4 decks)

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