UNIT FOUR: ALTERATIONS IN PULM
FUNCTION EDAPT EXAM
QUESTIONS AND ANSWERS
the number one cause of chronic bronchitis is -ANScigarette smoking
can be: cigarette, pipe, cigar or second-hand exposure.
COPD can also be caused by: -ANS* Airborne irritants such as air pollutants, chemical
fumes or dust
* anything that affects the lung growth during gestation such as smoking, antibiotic use,
preterm birth, and air pollution
* genetics (alpha-antitrypsin gene)
COPD patients have difficulty in fully expiring air from the lungs (decreased FVC) due to
expiratory airway obstruction caused by mucus, edema, and loss of elastic recoil, which
causes the airway to collapse. -ANSbarrel chest
hypoventilation and hypercapnia
bronchoconstriction --> bronchodilators
What systemic effects can this chronic inflammation from COPD have? -ANSweight loss
muscle weakness
increased susceptibility to infection
COPD PFTs reveal: -ANSdecreased FEV1 % predicted
FEV1/ FVC ration < 70%
GOLD Classification: Stage 1: -ANSMild
FEV1 >/= 80%
GOLD Classification: Stage 2: -ANSModerate 50% </= FEV1 < 80%
GOLD Classification: Stage 3: -ANSSevere 30% </= FEV1 < 50%
GOLD Classification: Stage 4: -ANSVery severe <30% FEV1
,Chronic bronchitis is a disease characterized by bronchial inflammation, hypersecretion
of mucus, and chronic productive cough that persists for at least how many consecutive
months for at least 2 successive years? -ANS3 months
What is chronic bronchitis caused by? -ANS* long-term exposure to environmental
irritants
*repeated episodes of acute bronchitis (infection)
* factors affecting gestational or childhood lung development (pre-term birth and/or
Respiratory Syncytial Virus (RSV) infection in early infancy)
The result of chronic bronchitis is excess mucus production and accumulation,
hypertrophy of bronchial smooth muscles, hypertrophy and hyperplasia of bronchial
mucus-producing cells, airflow obstruction and decreased alveolar ventilation -ANS
What are the most common presenting symptoms of chronic bronchitis? -
ANSproductive and purulent cough
copious sputum production
dyspnea
wheezing
rhonchi
cyanosis of the skin and mucus membranes
peripheral edema
What is lamina propria? -ANSbronchial smooth muscle
long-term exposure to airborne irritants that promote:
1. Smooth muscle hypertrophy that leads to bronchoconstriction
2. Hypertrophy and hyperplasia of goblet cells that lead to the hypersecretion of mucus
3. Epithelial cell metaplasia that creates non-ciliated squamous cells
4. Migration of more white blood cells (WBC) to the site which leads to inflammation and
fibrosis in the bronchial wall
5. Thickening and rigidity of bronchial basement membrane which leads to narrowing of
bronchial passageways -ANS
Smooth muscle constriction, bronchial wall inflammation and mucus plugs lead to
alveolar hyperinflation. -ANS
The term "blue bloater" is used to describe a patient with: -ANSCOPD
V/Q mismatch
Poor ventilation leads to decreased perfusion which causes right to left shunting. This is
the phenomenon where deoxygenated blood passes from the right ventricle to the left
ventricle with adequate perfusion (gas exchange).
, In response to the chronic low oxygen level of the blood, the kidneys compensate by
increasing secretion of erythropoietin. Pts with chronic bronchitis exhibit: -ANSelevated
Hct & can develop secondary polycythemia vera
increased strain on pulm & cardiovas systems
The increased blood volume combined with the vasoconstriction caused by chronic
hypoxia leads to: -ANSpulm HTN
this results in cardiac hypertrophy and right-sided heart failure or cor pulmonale
Which of the following are common clinical manifestations of chronic bronchitis?
productive cough
dyspnea
wheezing
history of smoking
barrel chest
prolonged expiration
cyanosis
chronic hypoventilation
polycythemia
cor pulmonale -ANSCommon:
* hx of smoking
* cyanosis
* chronic hypoventilation
* polycythemia
* cor pulmonale
productive cough- classic sign
dyspnea- late in course
wheezing- intermittent
barrel chest- occasional
prolong expiration- always present
Which of the following are common clinical manifestations of emphysema?
productive cough
dyspnea
wheezing
history of smoking
barrel chest
prolonged expiration
cyanosis
FUNCTION EDAPT EXAM
QUESTIONS AND ANSWERS
the number one cause of chronic bronchitis is -ANScigarette smoking
can be: cigarette, pipe, cigar or second-hand exposure.
COPD can also be caused by: -ANS* Airborne irritants such as air pollutants, chemical
fumes or dust
* anything that affects the lung growth during gestation such as smoking, antibiotic use,
preterm birth, and air pollution
* genetics (alpha-antitrypsin gene)
COPD patients have difficulty in fully expiring air from the lungs (decreased FVC) due to
expiratory airway obstruction caused by mucus, edema, and loss of elastic recoil, which
causes the airway to collapse. -ANSbarrel chest
hypoventilation and hypercapnia
bronchoconstriction --> bronchodilators
What systemic effects can this chronic inflammation from COPD have? -ANSweight loss
muscle weakness
increased susceptibility to infection
COPD PFTs reveal: -ANSdecreased FEV1 % predicted
FEV1/ FVC ration < 70%
GOLD Classification: Stage 1: -ANSMild
FEV1 >/= 80%
GOLD Classification: Stage 2: -ANSModerate 50% </= FEV1 < 80%
GOLD Classification: Stage 3: -ANSSevere 30% </= FEV1 < 50%
GOLD Classification: Stage 4: -ANSVery severe <30% FEV1
,Chronic bronchitis is a disease characterized by bronchial inflammation, hypersecretion
of mucus, and chronic productive cough that persists for at least how many consecutive
months for at least 2 successive years? -ANS3 months
What is chronic bronchitis caused by? -ANS* long-term exposure to environmental
irritants
*repeated episodes of acute bronchitis (infection)
* factors affecting gestational or childhood lung development (pre-term birth and/or
Respiratory Syncytial Virus (RSV) infection in early infancy)
The result of chronic bronchitis is excess mucus production and accumulation,
hypertrophy of bronchial smooth muscles, hypertrophy and hyperplasia of bronchial
mucus-producing cells, airflow obstruction and decreased alveolar ventilation -ANS
What are the most common presenting symptoms of chronic bronchitis? -
ANSproductive and purulent cough
copious sputum production
dyspnea
wheezing
rhonchi
cyanosis of the skin and mucus membranes
peripheral edema
What is lamina propria? -ANSbronchial smooth muscle
long-term exposure to airborne irritants that promote:
1. Smooth muscle hypertrophy that leads to bronchoconstriction
2. Hypertrophy and hyperplasia of goblet cells that lead to the hypersecretion of mucus
3. Epithelial cell metaplasia that creates non-ciliated squamous cells
4. Migration of more white blood cells (WBC) to the site which leads to inflammation and
fibrosis in the bronchial wall
5. Thickening and rigidity of bronchial basement membrane which leads to narrowing of
bronchial passageways -ANS
Smooth muscle constriction, bronchial wall inflammation and mucus plugs lead to
alveolar hyperinflation. -ANS
The term "blue bloater" is used to describe a patient with: -ANSCOPD
V/Q mismatch
Poor ventilation leads to decreased perfusion which causes right to left shunting. This is
the phenomenon where deoxygenated blood passes from the right ventricle to the left
ventricle with adequate perfusion (gas exchange).
, In response to the chronic low oxygen level of the blood, the kidneys compensate by
increasing secretion of erythropoietin. Pts with chronic bronchitis exhibit: -ANSelevated
Hct & can develop secondary polycythemia vera
increased strain on pulm & cardiovas systems
The increased blood volume combined with the vasoconstriction caused by chronic
hypoxia leads to: -ANSpulm HTN
this results in cardiac hypertrophy and right-sided heart failure or cor pulmonale
Which of the following are common clinical manifestations of chronic bronchitis?
productive cough
dyspnea
wheezing
history of smoking
barrel chest
prolonged expiration
cyanosis
chronic hypoventilation
polycythemia
cor pulmonale -ANSCommon:
* hx of smoking
* cyanosis
* chronic hypoventilation
* polycythemia
* cor pulmonale
productive cough- classic sign
dyspnea- late in course
wheezing- intermittent
barrel chest- occasional
prolong expiration- always present
Which of the following are common clinical manifestations of emphysema?
productive cough
dyspnea
wheezing
history of smoking
barrel chest
prolonged expiration
cyanosis
