Porth's Essentials of Pathophysiology Chapter 22 Exam Questions and Complete Solutions

Porth's Essentials of Pathophysiology Chapter 22 Exam Questions and Complete Solutions ? are the most frequent cause of respiratory tract infections - Ans: viruses Viral infections can damage ? epithelium that would normally clean the incoming air, ? airways making it hard to move gasses, and lead to secondary ? infections due to the static mucus providing a route for infection - Ans: bronchial, obstruct, bacterial The common cold is a viral infection of the ? respiratory tract - Ans: upper Outbreaks of colds due to ? are most common in early fall and late spring - Ans: rhinoviruses ? are popular over-the-counter treatments for colds because of their action in drying nasal secretions - Ans: antihistamines ? refers to inflammation of the nasal passages, and sinusitis is inflammation of the ? sinuses - Ans: rhinitis, paranasal The lower ? content in the sinuses facilitates the growth of organisms, impairs local defenses, and alters the function of immune celss - Ans: oxygen Host antibodies to ? and ? prevent or ameliorate infection by the influenza virus - Ans: hemagglutinin, neuraminidase The influenza viruses can cause three types of infections: an uncomplicated ? respiratory infections, ? pneumonia, and a respiratory viral infection followed by a ? infection - Ans: upper, viral, bacterial Because influenza is so highly contagious prevention relies primarily on ? - Ans: vaccination Avian strains of the influenza virus do not usually cause outbreaks of disease in humans unless a ? of the virus genome has occurred within an intermediate mammalian host such as a pig - Ans: reassortment The term ? describes inflammation of parenchymal structures of the lung, such as the alveoli and the bronchioles - Ans: pneumonia ? refers to consolidation of part or all of a lung lobe, and ? signifies a patchy consolidation involving more than one lobe - Ans: lobar pneumonia, bronchopenumonia Hospital-acquired, or ? pneumonia is defined as a lower respiratory tract infection that was not present or incubating on admission to the hospital - Ans: nosocomial The term ? host usually is applied to persons with a variety of underlying defects in host defenses - Ans: immunocompromised ? disease is a form of bronchopneumonia; infection normally occurs by acquiring the organism from the environment - Ans: Legionnaire The primary atypical pneumonias are caused by a variety of agents, the most common being ? pnemonia - Ans: mycoplasma ? is the world's foremost cause of death from a single infectious agent - Ans: tuberculosis Mycobacteria are similar to other bacterial organisms except for an outer ? cell wall that makes them more resistant to destruction - Ans: waxy ? tuberculosis is a form of the disease that develops in previously unexposed, and therefore unsensitized, persons - Ans: primary The most frequently used screening methods for pulmonary tuberculosis are the ? test and chest ? - Ans: tuberculin skin, x-rays ? is caused by the dimorphic fungus histoplasma capsulatum and is one of the most common fungal infections in the United States - Ans: histoplasmosis ? respiratory infections produce pulmonary manifestations that resemble tuberculosis - Ans: fungal The number of Americans who develop lung cancer is decreasing, primarily because of a decrease in ? - Ans: smoking Cigarette smoking causes more than ? of cases of lung cancer in those over 65 years of age - Ans: 60% ? are aggressive, locally invasive, and widely metastatic tumors that arise from the epithelial lining of major bronchi - Ans: Lung cancers The ? are small, round to oval cells that are approximately the size of a lymphocyte and grow in clusters that exhibit neither glandular nor squamous organization - Ans: small cell lung cancers (SCLCs) The ? include squamous cell carcinomas, adenocarcinomas, and large cell carcinomas - Ans: non-small cell lung cancers (NSCLCs) ? is characterized by inspiratory stridor, hoarseness, and a barking cough - Ans: Croup By the ? weeks of gestation, sufficient terminal air sacs are present to permit survival of the premature infant - Ans: 25th to 28th Audible crowing sound during inspiration is called? - Ans: Stridor Measures hypersensitivity to tubercle bacillus - Ans: Tuberculin skin test Results from infection by bacteria - Ans: Typical pnemonia Attachment protein that allows the influenza virus to enter epithelial cells in the respiratory tract - Ans: Hemagglutinin Symptoms that develop when substances released by some cancer cells disrupt the normal function - Ans: Paraneoplastic syndrome Viral and mycoplasma infection - Ans: Atypical pneumonia Facilitates influenza viral replication and release from the cell - Ans: Neuraminidase Fatty liver with encephalitis - Ans: Reye Syndrome Highly aggressive lung cancer - Ans: SCLCs Carcinoma is associated with paraneoplastic syndromes that produce hypercalcemia - Ans: Squamous cell How is lung cancer categorized? - Ans: squamous cell lung carcinoma adenocarcinoma small cell carcinoma large cell carincoma What causes the varied manifestations of lung cancer? - Ans: Due to involvement of the lung and adjacent structures The effects of local spread and metastasis nonmetastatic paraneoplastic manifestations involving endocrine, neurologic, and connective tissue function What is the result of the absence of surfactant in premature infants? - Ans: Pulmonary immaturity with surfactant deficiency leads to alveolar collapse A 23-year-old woman goes to the drugstore to buy a medication to east the symptoms of her cold. Her friends have told her to buy a medication with an antihistamine in it to help dry up her runny nose and make it easier to breathe. The woman talks with the pharmacist, who has known her many years. The pharmacist recommends that this young women not buy a cold medication with a decongestant in it. Why would he do that? A. The client has a history of hyperthyroidism B. The client has a history of hypotension C. The client has a history of type I diabetes mellitus D. The client has a history of juvenile rheumatoid arthritis - Ans: A. The client has a history of hyperthroidism The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections? A. Slow onset of upper respiratory symptoms B. Rapid onset of profound malaise C. Slow onset of fever and chills D. Rapid onset of productive cough - Ans: B. Rapid onset of profound malaise Influenza A subtype H5N1 has been documented in poultry in both East and Southeast Asia Countries. This form of aviation flu is highly contagious from bird to bird but rarely is passed from human to human. There is a large amount of concern that the H5N1 strain might mutate, making it easier to be passed from human to human, carrying with it high mortality rate. What is the main concern if the H5N1 strain does mutate? A. An epidemic in Southeast Asia B. Inability to develop a vaccine for the newly infected poultry C. Initiation of a pandemic D. Several small pockets of infection so widespread it will be difficult to control them - Ans: C. initiation of a pandemic Community-acquired pneumonia can be categorized according to several indexes. What are these indexes? (select all) A. Radiologic findings B. Serologic findings C. Age D. Presence of coexisting disease E. Need for hospitalization in long-term care facility - Ans: A, C, D An immunocompromised host is open to pneumonia from all types of organisms. There is, however, a correlation between specific types of immunologic deficits and specific invading organisms. What organism is most likely to cause pneumonia in an immunocompromised host with neutropenia and impaired granulocyte function? A. beta-hemolytic streptococcus B. gram-postive bacilli C. Eosinophilic bacillus substillis D. Staphylococcus aureus - Ans: D. Staphylococcus aureus Elderly people are very susceptible to pneumonia in all its varieties. The symptoms the elderly exhibit can be very different than those of other age groups who have pneumonia. What signs and symptoms are elderly people with pneumonia less likely to experience than people with pneumonia in other age groups? A. Marked elevation in temperature B. Loss of appetite C. Deterioration in mental status D. Pleuritic pain - Ans: A. Marked elevation in temperatue Tuberculosis is a highly destructive disease because the tubercle bacillus activates a tissue hypersensitivity to the tubercular antigens. What does that destructive nature of tuberculosis cause in a previously unexposed immunocompetent person? A. Cavitation and rapidly progressing pulmonary lesions B. Caseating necrosis and cavitation C. Rapidly progressing lesions and purulent necrosis D. Caseating necrosis and purulent pulmonary lesions - Ans: B. Caseating necrosis and cavitation Coccidioidomycosis is a pulmonary fungal infection resembling tuberculosis. Less severe forms of the infection are treated with oral anti-fungal medications. For persons with progressive disease, what is the drug of choice? A. IV fluconazole B. IV BCG C. IV amphotericin B D. IV rifampin - Ans: C. IV amphotericin B non-small cell lung cancers mimic small cell lung cancers through their abilities to do what? A. Synthesize bioactive products and produce pan-neoplastic syndromes B. Neutralize bioactive products, which produce paraneoplastic syndromes C. Produce paraneoplastic syndromes and synthesize adrenocorticotrophic hormone (ACTH) D. Synthesize bioactive products and produce paraneoplastic syndromes - Ans: D. Synthesize bioactive products and produce paraneoplastic syndromes Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. What are the signs and symptoms of BPD? A. Rapid and shallow breathing and chest retractions B. Weight loss and barrel chest C. Tachycardia and slow shallow breathing D. A barrel chest and rapid weight gain - Ans: A. Rapid and shallow breathing and chest retractions Which of the following is/are a lower airway disease (select all) A. Epiglottitis B. Acute bronchiolitis C. Asthma D. Spasmodic croup E. Laryngotracheobronchitis - Ans: B, C What is the underlying cause of respiratory failure in a child with bronchiolitis? A. Obstructive process B. Impaired gas exchange C. Ischemia D. Metabolic acidosis - Ans: B. Impaired gas exchange