COMPREHENSIVE EXAM QUESTIONS WITH
ANSWERS GRADED A+
◉ What are the S&S of secondary pulmonary hypertension? Answer:
dyspnea and profound fatigue;
peripheral edema;
ascites;
signs of right heart failure (for pulmonale)
◉ How does a pulmonary embolism develop? Answer: a blood-
borne substance lodges in a branch of the pulmonary artery and
obstructs the flow
◉ What are the types of pulmonary embolism? Answer: thrombus-
venous blood clot;
fat- mobilized from the bone marrow after a fracture;
amniotic fluid- enters the maternal circulation after rupture of the
membranes at the time of delivery;
air
◉ What are the manifestations of pulmonary embolism? Answer:
sudden onset of dyspnea and tachypnea;
,sudden onset of anxiety;
sudden onset of flank or side pain;
cough;
hemoptysis (blood tinged sputum);
cyanosis
◉ What is pulmonary edema? Answer: accumulation of fluid in the
interstitium and alveoli of the lungs;
most commonly caused by left heart failure
◉ What does fluid in alveoli cause? Answer: lung stiffness;
difficult expansion;
impaired gas exchange
◉ What are the S&S of pulmonary edema? Answer: severe dyspnea
and air hunger (gasping for air);
cough productivity of frothy, blood tinged sputum;
tachypnea and tachycardia;
cold, clammy skin;
cyanosis;
extreme apprehension;
confusion, stupor
,◉ What is acute respiratory distress syndrome? Answer: disorder
caused by disseminated pulmonary inflammation and leads to
profound hypoxemia and increased work of breathing
◉ What is the cause of acute respiratory distress syndrome (ARDS)?
Answer: shock;
major trauma (with or without fat emboli);
sepsis secondary to pulmonary or nonpulmonary infections;
acute pancreatitis;
hematologic disorders;
aspiration;
reactions to drugs and toxins;
inhalation of toxins
◉ What is the pathology of ARDS? Answer: diffuse epithelial cell
injury;
increased permeability of alveolar- capillary membrane;
fluid collects in interstitium and alveoli;
surfactant (helps inflate the alveoli) inactivation (caused by
increased fluid);
hyaline membrane formation (collection of sloughed off cells and
tissue);
, increased work of breathing;
intrapulmonary shunting of blood (constriction of vessels in
damaged parts of the lungs to create more oxygen to the healthy
part of the lungs);
impaired gas exchange
◉ What are the manifestations of ARDS? Answer: profound hypoxia-
PO2 may be in 30s or 40s;
tachypnea;
severe dyspnea;
hypotension- has to do with shunting of the blood;
hypercapnia;
acidosis- can't get rid of CO2;
multiple organ failure;
mortality- 30-60%
◉ What is acute respiratory failure? Answer: state of disturbed gas
exchange;
PaO2 < 60 mmHg and PaCO2 > 50 mmHg;
may involve hypoxemia, hypercapnia;
high mortality rate- 30-50%