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PATH 370 – QUIZ 9 PRACTICE QUESTIONS Integrated Pathophysiology & Clinical
Scenarios – Advanced Review
SECTION 1: INTEGRATED CARDIOVASCULAR AND RESPIRATORY
PATHOPHYSIOLOGY
1. A patient with chronic obstructive pulmonary disease (COPD)
develops right-sided heart failure. This condition is best
described as:
A) Cardiomyopathy
B) Cor pulmonale
C) Myocarditis
D) Endocarditis
Answer: B
Rationale: Cor pulmonale is right ventricular failure secondary
to pulmonary disease (COPD causes chronic hypoxic pulmonary
vasoconstriction, increasing right heart workload).
2. Which of the following explains why patients with COPD
develop cor pulmonale?
A) Left ventricular failure
B) Chronic hypoxia causes pulmonary vasoconstriction and
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pulmonary hypertension
C) Systemic hypertension
D) Aortic stenosis only
Answer: B
Rationale: Chronic hypoxia in COPD causes pulmonary
vasoconstriction → increased pulmonary vascular resistance →
pulmonary hypertension → right heart failure (cor pulmonale).
3. A patient with asthma presents with wheezing, dyspnea, and
tachypnea. ABG shows pH 7.48, PaCO₂ 30 mm Hg. This acid-
base disturbance is:
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis
Answer: B
Rationale: Asthma causes hyperventilation, blowing off CO₂
(PaCO₂ < 35), raising pH → respiratory alkalosis.
4. A patient with severe asthma exacerbation is becoming
fatigued. ABG shows pH 7.32, PaCO₂ 55 mm Hg. This finding
indicates:
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A) Improvement
B) Impending respiratory failure (CO₂ retention)
C) Normal ventilation
D) Metabolic acidosis only
Answer: B
Rationale: Rising PaCO₂ in an asthmatic indicates exhaustion
and impending respiratory failure—a medical emergency.
5. A patient with chronic bronchitis is described as a "blue
bloater." This is due to:
A) Emphysematous changes only
B) Chronic hypoxemia (cyanosis) and right heart failure with
edema
C) Pink skin color
D) Weight loss only
Answer: B
Rationale: "Blue bloater": chronic bronchitis causes hypoxemia
(bluish) and right heart failure with fluid retention (bloated).
6. A patient with emphysema is described as a "pink puffer."
This is due to:
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A) Cyanosis and edema
B) Compensatory hyperventilation maintaining oxygenation
with minimal cyanosis, but marked dyspnea
C) Productive cough only
D) Heart failure only
Answer: B
Rationale: "Pink puffer": emphysema patients maintain
oxygenation through hyperventilation (pink) but have significant
dyspnea (puffer).
7. A patient with a pulmonary embolism has a ventilation-
perfusion (V/Q) mismatch primarily characterized by:
A) Areas ventilated but not perfused (dead space)
B) Areas perfused but not ventilated (shunt)
C) Normal V/Q matching
D) Increased lung compliance only
Answer: A
Rationale: PE blocks blood flow to ventilated alveoli, creating
dead space ventilation (V without Q).
8. A patient with atelectasis has a V/Q mismatch characterized
by:
PATH 370 – QUIZ 9 PRACTICE QUESTIONS Integrated Pathophysiology & Clinical
Scenarios – Advanced Review
SECTION 1: INTEGRATED CARDIOVASCULAR AND RESPIRATORY
PATHOPHYSIOLOGY
1. A patient with chronic obstructive pulmonary disease (COPD)
develops right-sided heart failure. This condition is best
described as:
A) Cardiomyopathy
B) Cor pulmonale
C) Myocarditis
D) Endocarditis
Answer: B
Rationale: Cor pulmonale is right ventricular failure secondary
to pulmonary disease (COPD causes chronic hypoxic pulmonary
vasoconstriction, increasing right heart workload).
2. Which of the following explains why patients with COPD
develop cor pulmonale?
A) Left ventricular failure
B) Chronic hypoxia causes pulmonary vasoconstriction and
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pulmonary hypertension
C) Systemic hypertension
D) Aortic stenosis only
Answer: B
Rationale: Chronic hypoxia in COPD causes pulmonary
vasoconstriction → increased pulmonary vascular resistance →
pulmonary hypertension → right heart failure (cor pulmonale).
3. A patient with asthma presents with wheezing, dyspnea, and
tachypnea. ABG shows pH 7.48, PaCO₂ 30 mm Hg. This acid-
base disturbance is:
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis
Answer: B
Rationale: Asthma causes hyperventilation, blowing off CO₂
(PaCO₂ < 35), raising pH → respiratory alkalosis.
4. A patient with severe asthma exacerbation is becoming
fatigued. ABG shows pH 7.32, PaCO₂ 55 mm Hg. This finding
indicates:
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A) Improvement
B) Impending respiratory failure (CO₂ retention)
C) Normal ventilation
D) Metabolic acidosis only
Answer: B
Rationale: Rising PaCO₂ in an asthmatic indicates exhaustion
and impending respiratory failure—a medical emergency.
5. A patient with chronic bronchitis is described as a "blue
bloater." This is due to:
A) Emphysematous changes only
B) Chronic hypoxemia (cyanosis) and right heart failure with
edema
C) Pink skin color
D) Weight loss only
Answer: B
Rationale: "Blue bloater": chronic bronchitis causes hypoxemia
(bluish) and right heart failure with fluid retention (bloated).
6. A patient with emphysema is described as a "pink puffer."
This is due to:
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A) Cyanosis and edema
B) Compensatory hyperventilation maintaining oxygenation
with minimal cyanosis, but marked dyspnea
C) Productive cough only
D) Heart failure only
Answer: B
Rationale: "Pink puffer": emphysema patients maintain
oxygenation through hyperventilation (pink) but have significant
dyspnea (puffer).
7. A patient with a pulmonary embolism has a ventilation-
perfusion (V/Q) mismatch primarily characterized by:
A) Areas ventilated but not perfused (dead space)
B) Areas perfused but not ventilated (shunt)
C) Normal V/Q matching
D) Increased lung compliance only
Answer: A
Rationale: PE blocks blood flow to ventilated alveoli, creating
dead space ventilation (V without Q).
8. A patient with atelectasis has a V/Q mismatch characterized
by:
