NR507
NR 507 ADVANCED PATHOPHYSIOLOGY
MIDTERM STUDY GUIDE EXAM NEWEST
ACTUAL QUESTIONS AND ANSWERS
2025
Asthma - Correct Ans-Chronic disease due to bronchoconstriction and an excessive
inflammatory response in the bronchioles
What are 5 s/s of asthma - Correct Ans-coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - Correct Ans--airway inflammation, bronchial hyper-
reactivity and smooth muscle spasm
-excess mucus production and accumulation
-hypertrophy of bronchial smooth muscle
-airflow obstruction
-decreased alveolar ventilation
Bronchioles - Correct Ans-smaller passageways that originate from the bronchi that
become the alveoli
3 layers of the bronchioles - Correct Ans-innermost layer
middle layer - lamina propria
outermost layer
lamina propria - Correct Ans-the middle layer of the bronchioles
structure of the lamina propria - Correct Ans-embedded with connective tissue cells and
immune cells
purpose of the lamina propria - Correct Ans-white blood cells are present to help protect
the airways
How does the lamina propria effect the lungs in regards to asthma - Correct Ans-the
WBCs protective feature goes into overdrive causing an inflammatory response that
damages host tissue
NR507
,NR507
What does the innermost layer of the bronchioles contain - Correct Ans-columnar
epithelial ells and mucus producing goblet cells
What does the outermost layer of the bronchioles contain - Correct Ans-smooth muscle
cells
what does the outermost layer of the bronchioles do - Correct Ans-control the airways
ability to constrict and dilate
alveolar hyperinflation - Correct Ans-When air is unable to move out of the alveolar like
it should due to bronchial walls collapsing around possible mucus plug thus trapping air
inside
how does hyperinflation occur? - Correct Ans-the ongoing inflammatory process of
asthma produces mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - Correct Ans--expanded thorax and hypercapnia
(retention of CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - Correct Ans-tiotropium and
ipratropium
What do anticholinergics do in the lungs? - Correct Ans-These drugs block the effects of
the parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - Correct Ans-the parasympathetic system is
stimulated by the vagal nerve to release acetylcholine which binds to the cholinergic
receptors of the respiratory tract to cause bronchial constriction = decreased airflow
- blocking the cholinergic receptors prevents acetylcholine binding preventing the
bronchial constriction
bronchitis - Correct Ans-inflammation of the bronchial tubes
3 characteristics of bronchitis - Correct Ans-bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive
years
Perfusion - Correct Ans-The supply of oxygen to and removal of wastes from the cells
and tissues of the body as a result of the flow of blood through the capillaries.
results of chronic bronchitis/ low perfusion - Correct Ans-cyanosis
right to left shunting
NR507
, NR507
chronic hypoxemia
Why is there cyanosis with chronic bronchitis - Correct Ans-there is hypoxia due to
unfavorable conditions for gas exchange
Right to left shunting - Correct Ans-when blood passes from the right ventricle through
the lungs and to the left ventricle without perfusion
Causes of bronchitis - Correct Ans--long term exposure to environmental irritants
-repeated episodes of acute infection (RSV infection in early infancy)
-Factors affecting gestational childhood lung development (preterm birth)
Pathogenesis of bronchitis - Correct Ans--Exposure to airborne irritants
- Irritant activates bronchial smooth muscle constriction and mucus secretion
- Triggers release of inflammatory mediators from immune cells located in the lamina
propria
most common irritant with bronchitis is? - Correct Ans-tobacco product smoke
what does long term exposure to irritants promote in bronchitis? (5) - Correct Ans--
smooth muscle hypertrophy
- hypertrophy and hyperplasia of goblet cells
- epithelial cell metaplasia
- migration of more WBC to site
- thickening and rigidity of bronchial basement membrane
What does smooth muscle hypertrophy do in lungs? - Correct Ans-causes increased
bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials - Correct Ans-
promotes hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - Correct Ans-squamous cells
become nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - Correct Ans-increases
inflammation of the cite and causes fibrosis in the bronchial wall
How does the thickening and rigidity of bronchial basement membranes effect the
lungs? - Correct Ans-leads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - Correct Ans-respiratory
acidosis
how does chronic bronchitis lead to respiratory acidosis? - Correct Ans-hyperinflation of
the alveoli causes CO2 retention
NR507
NR 507 ADVANCED PATHOPHYSIOLOGY
MIDTERM STUDY GUIDE EXAM NEWEST
ACTUAL QUESTIONS AND ANSWERS
2025
Asthma - Correct Ans-Chronic disease due to bronchoconstriction and an excessive
inflammatory response in the bronchioles
What are 5 s/s of asthma - Correct Ans-coughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - Correct Ans--airway inflammation, bronchial hyper-
reactivity and smooth muscle spasm
-excess mucus production and accumulation
-hypertrophy of bronchial smooth muscle
-airflow obstruction
-decreased alveolar ventilation
Bronchioles - Correct Ans-smaller passageways that originate from the bronchi that
become the alveoli
3 layers of the bronchioles - Correct Ans-innermost layer
middle layer - lamina propria
outermost layer
lamina propria - Correct Ans-the middle layer of the bronchioles
structure of the lamina propria - Correct Ans-embedded with connective tissue cells and
immune cells
purpose of the lamina propria - Correct Ans-white blood cells are present to help protect
the airways
How does the lamina propria effect the lungs in regards to asthma - Correct Ans-the
WBCs protective feature goes into overdrive causing an inflammatory response that
damages host tissue
NR507
,NR507
What does the innermost layer of the bronchioles contain - Correct Ans-columnar
epithelial ells and mucus producing goblet cells
What does the outermost layer of the bronchioles contain - Correct Ans-smooth muscle
cells
what does the outermost layer of the bronchioles do - Correct Ans-control the airways
ability to constrict and dilate
alveolar hyperinflation - Correct Ans-When air is unable to move out of the alveolar like
it should due to bronchial walls collapsing around possible mucus plug thus trapping air
inside
how does hyperinflation occur? - Correct Ans-the ongoing inflammatory process of
asthma produces mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - Correct Ans--expanded thorax and hypercapnia
(retention of CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - Correct Ans-tiotropium and
ipratropium
What do anticholinergics do in the lungs? - Correct Ans-These drugs block the effects of
the parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - Correct Ans-the parasympathetic system is
stimulated by the vagal nerve to release acetylcholine which binds to the cholinergic
receptors of the respiratory tract to cause bronchial constriction = decreased airflow
- blocking the cholinergic receptors prevents acetylcholine binding preventing the
bronchial constriction
bronchitis - Correct Ans-inflammation of the bronchial tubes
3 characteristics of bronchitis - Correct Ans-bronchial inflammation
hypersecretion of mucus
chronic productive cough for at least 3 consecutive months for at least 2 successive
years
Perfusion - Correct Ans-The supply of oxygen to and removal of wastes from the cells
and tissues of the body as a result of the flow of blood through the capillaries.
results of chronic bronchitis/ low perfusion - Correct Ans-cyanosis
right to left shunting
NR507
, NR507
chronic hypoxemia
Why is there cyanosis with chronic bronchitis - Correct Ans-there is hypoxia due to
unfavorable conditions for gas exchange
Right to left shunting - Correct Ans-when blood passes from the right ventricle through
the lungs and to the left ventricle without perfusion
Causes of bronchitis - Correct Ans--long term exposure to environmental irritants
-repeated episodes of acute infection (RSV infection in early infancy)
-Factors affecting gestational childhood lung development (preterm birth)
Pathogenesis of bronchitis - Correct Ans--Exposure to airborne irritants
- Irritant activates bronchial smooth muscle constriction and mucus secretion
- Triggers release of inflammatory mediators from immune cells located in the lamina
propria
most common irritant with bronchitis is? - Correct Ans-tobacco product smoke
what does long term exposure to irritants promote in bronchitis? (5) - Correct Ans--
smooth muscle hypertrophy
- hypertrophy and hyperplasia of goblet cells
- epithelial cell metaplasia
- migration of more WBC to site
- thickening and rigidity of bronchial basement membrane
What does smooth muscle hypertrophy do in lungs? - Correct Ans-causes increased
bronchoconstriction
Hypertrophy and hyperplasia of goblet cells do what in the bronchials - Correct Ans-
promotes hypersecretion of mucus
What are characteristics of epithelial cell metaplasia? - Correct Ans-squamous cells
become nonciliated and are less protective; allow passage of toxins and WBCs
What does the migration of WBCs to the bronchials do? - Correct Ans-increases
inflammation of the cite and causes fibrosis in the bronchial wall
How does the thickening and rigidity of bronchial basement membranes effect the
lungs? - Correct Ans-leads to further narrowing of the bronchial passageways
What acid-base disorder is seen in chronic bronchitis? - Correct Ans-respiratory
acidosis
how does chronic bronchitis lead to respiratory acidosis? - Correct Ans-hyperinflation of
the alveoli causes CO2 retention
NR507
