,Table of Contents
Section 1 ................................................................................. 6
Section 2 ............................................................................... 34
Conclusion ......................................................................... 45
References ......................................................................... 47
2
, Section 1
1. A new patient was admitted and has been diagnosed with
pneumonia. The patient has an oxygen saturation of 87% on 2
L/min nasal cannula. Which of the following would cause the
patient to be hypoxemic?
1. Capillary shunting
2. Diffusion defect
3. Alveolar consolidation
4. Hypoventilation
Select all that apply:
A. 1 and 2
B. 2 and 3
C. 1 and 3
D. All of the above
To get this one right, you have to have a basic understanding of
pneumonia. For the TMC Exam, I want you to always remember
that consolidation is associated with pneumonia.
So automatically we know that alveolar consolidation is one of the
correct answers. Hypoxemia in pneumonia patients is also related
to capillary shunting as well. That is because, if the alveoli are filled
with fluid (consolidation), perfusion will not occur as the oxygen
passes through, causing hypoxemia.
A diffusion defect is found in patients with pulmonary fibrosis—
not pneumonia. Patients with pneumonia will show signs of
hyperventilation, not hypoventilation, so we can rule that one out
as well.
So by using what we know about pneumonia, as well as the
process of elimination, we know that the correct answer has to be
C.
The correct answer is: C. 1 and 3
3
, 2. A 16-year-old patient has been admitted and shows signs of
poor body development. Upon assessment, you also noted
digital clubbing, hyperresonance to percussion, and a
productive cough. It has also been reported that the patient
has foul-smelling stools. Which of the following conditions are
these findings consistent with?
A. Acute respiratory distress syndrome
B. Heart failure
C. Acute bronchitis
D. Cystic fibrosis
If you’ve studied up on your pathology, you should know right
away that this patient is showing signs of cystic fibrosis.
Cystic fibrosis patients typically show signs of poor body
development, malnourishment, and foul-smelling stools. They
usually have a productive cough with large amounts of secretions.
Digital clubbing is a sign of chronic hypoxemia, which can be seen
in cystic fibrosis as well.
Also, you should remember that cystic fibrosis is an obstructive
lung disease. We know that air trapping is a side effect of
obstructive diseases, and that is what causes the hyperresonant
percussion note to be heard.
None of the other answer choices make sense in this situation, so
we know that the correct answer has to be D.
The correct answer is: D. Cystic fibrosis
3. While reviewing the chest x-ray of a 57-year-old male patient,
you noted blunting of the left costophrenic angle. It also states
4
Section 1 ................................................................................. 6
Section 2 ............................................................................... 34
Conclusion ......................................................................... 45
References ......................................................................... 47
2
, Section 1
1. A new patient was admitted and has been diagnosed with
pneumonia. The patient has an oxygen saturation of 87% on 2
L/min nasal cannula. Which of the following would cause the
patient to be hypoxemic?
1. Capillary shunting
2. Diffusion defect
3. Alveolar consolidation
4. Hypoventilation
Select all that apply:
A. 1 and 2
B. 2 and 3
C. 1 and 3
D. All of the above
To get this one right, you have to have a basic understanding of
pneumonia. For the TMC Exam, I want you to always remember
that consolidation is associated with pneumonia.
So automatically we know that alveolar consolidation is one of the
correct answers. Hypoxemia in pneumonia patients is also related
to capillary shunting as well. That is because, if the alveoli are filled
with fluid (consolidation), perfusion will not occur as the oxygen
passes through, causing hypoxemia.
A diffusion defect is found in patients with pulmonary fibrosis—
not pneumonia. Patients with pneumonia will show signs of
hyperventilation, not hypoventilation, so we can rule that one out
as well.
So by using what we know about pneumonia, as well as the
process of elimination, we know that the correct answer has to be
C.
The correct answer is: C. 1 and 3
3
, 2. A 16-year-old patient has been admitted and shows signs of
poor body development. Upon assessment, you also noted
digital clubbing, hyperresonance to percussion, and a
productive cough. It has also been reported that the patient
has foul-smelling stools. Which of the following conditions are
these findings consistent with?
A. Acute respiratory distress syndrome
B. Heart failure
C. Acute bronchitis
D. Cystic fibrosis
If you’ve studied up on your pathology, you should know right
away that this patient is showing signs of cystic fibrosis.
Cystic fibrosis patients typically show signs of poor body
development, malnourishment, and foul-smelling stools. They
usually have a productive cough with large amounts of secretions.
Digital clubbing is a sign of chronic hypoxemia, which can be seen
in cystic fibrosis as well.
Also, you should remember that cystic fibrosis is an obstructive
lung disease. We know that air trapping is a side effect of
obstructive diseases, and that is what causes the hyperresonant
percussion note to be heard.
None of the other answer choices make sense in this situation, so
we know that the correct answer has to be D.
The correct answer is: D. Cystic fibrosis
3. While reviewing the chest x-ray of a 57-year-old male patient,
you noted blunting of the left costophrenic angle. It also states
4
