Question 1

In patients suspected of having pulmonary emboli in which noninvasive studies do not give a definite diagnosis, what diagnostic procedure is the test of choice?

Accepted Answer

A)  CT 
B)  MRI 
C)  Pulmonary angiography 
D)  scan 
A)  CT 
B)  MRI 
C)  Pulmonary angiography 
D)  scan

Question 2

At rest, what level does the mean pulmonary artery pressure need to reach before it is considered pulmonary hypertension?

Accepted Answer

A)  Greater than 10 mm Hg 
B)  Greater than 15 mm Hg 
C)  Greater than 20 mm Hg 
D)  Greater than 25 mm Hg 
A)  Greater than 10 mm Hg 
B)  Greater than 15 mm Hg 
C)  Greater than 20 mm Hg 
D)  Greater than 25 mm Hg

Question 3

Where do most pulmonary emboli originate?

Accepted Answer

A)  Deep veins of the arms 
B)  Deep veins of the legs 
C)  Thrombi from the right side of the heart 
D)  Veins of the thorax 
A)  Deep veins of the arms 
B)  Deep veins of the legs 
C)  Thrombi from the right side of the heart 
D)  Veins of the thorax

Question 4

What are the two most common findings on the electrocardiogram (ECG) in the patient with pulmonary embolism?

Accepted Answer

A)  Bradycardia and elevated ST segment 
B)  Inverted T waves and depressed ST segment 
C)  Large P waves and inverted T waves 
D)  Tachycardia and depressed ST segment 
A)  Bradycardia and elevated ST segment 
B)  Inverted T waves and depressed ST segment 
C)  Large P waves and inverted T waves 
D)  Tachycardia and depressed ST segment

Question 5

What ECG findings are typically seen in patients with idiopathic pulmonary artery hypertension?
1) Frequent premature ventricular complexes
2) Right-axis deviation
3) Right ventricular hypertrophy
4) Left bundle-branch block

Accepted Answer

A) 1, 2, and 4 only 
B) 2 and 3 only 
C) 4 only 
D) 2, 3, and 4 only 
A) 1, 2, and 4 only 
B) 2 and 3 only 
C) 4 only 
D) 2, 3, and 4 only

Question 6

Which of the following conditions contribute to the development of hypoxemia in a patient with pulmonary emboli?
1) Cardiogenic shock
2) Destruction of lung parenchyma
3) Intrapulmonary shunt
4) Mismatch

Accepted Answer

A) 1, 2, and 3 only 
B) 1 and 4 only 
C) 2 only 
D) 1, 3, and 4 only 
A) 1, 2, and 3 only 
B) 1 and 4 only 
C) 2 only 
D) 1, 3, and 4 only

Question 7

Which of the following risk factors are associated with an increase in the incidence of pulmonary embolism?
1) Advanced age
2) Immobilization
3) Multiple injuries from trauma
4) Positive smoking history

Accepted Answer

A) 2 and 3 only 
B) 1, 2, and 3 only 
C) 4 only 
D) 2, 3, and 4 only 
A) 2 and 3 only 
B) 1, 2, and 3 only 
C) 4 only 
D) 2, 3, and 4 only

Question 8

Approximately what percentage of patients with pulmonary embolism have a normal ECG?

Accepted Answer

A)  10% to 15% 
B)  25% to 30% 
C)  40% to 60% 
D)  70% to 75% 
A)  10% to 15% 
B)  25% to 30% 
C)  40% to 60% 
D)  70% to 75%

Question 9

What is the 5-year survival rate for patients with untreated idiopathic pulmonary artery hypertension (IPAH)?

Accepted Answer

A)  33% 
B)  44% 
C)  55% 
D)  66% 
A)  33% 
B)  44% 
C)  55% 
D)  66%

Question 10

What percentage of the pulmonary vascular bed must be occluded by emboli before pulmonary hypertension occurs?

Accepted Answer

A)  25% 
B)  33% 
C)  50% 
D)  75% 
A)  25% 
B)  33% 
C)  50% 
D)  75%

Question 11

In what type of IPAH patient is lung transplantation indicated?

Accepted Answer

A)  All pulmonary artery hypertension patients with clinically significant disease 
B)  Patients not responding to vasodilators with significant cardiac dysfunction 
C)  Patients with class II, class III, or class IV disease 
D)  Patients with refractory hypoxemia 
A)  All pulmonary artery hypertension patients with clinically significant disease 
B)  Patients not responding to vasodilators with significant cardiac dysfunction 
C)  Patients with class II, class III, or class IV disease 
D)  Patients with refractory hypoxemia

Question 12

Which of the following physical examination findings are found in patients with primary pulmonary hypertension?
1) Cyanosis
2) Diastolic heart murmur
3) Digital clubbing
4) Loud second heart sound (P2)

Accepted Answer

A) 2 and 4 only 
B) 1 and 3 only 
C) 1, 2, and 4 only 
D) 2, 3, and 4 only 
A) 2 and 4 only 
B) 1 and 3 only 
C) 1, 2, and 4 only 
D) 2, 3, and 4 only

Question 13

Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.

Accepted Answer

A) True 
 B)False

Question 14

Which of the following medications should be used in the hospital for prophylactic deep venous thrombosis therapy?

Accepted Answer

A)  Acetylcholine esterase 
B)  Albuterol 
C)  Aspirin 
D)  Heparin 
A)  Acetylcholine esterase 
B)  Albuterol 
C)  Aspirin 
D)  Heparin

Question 15

Which of the following pathophysiologic changes in the lung is not typically associated with pulmonary embolism?

Accepted Answer

A)  Bronchoconstriction 
B)  Decreased ciliary mobility 
C)  Increased dead space ventilation 
D)  Reduced surfactant production 
A)  Bronchoconstriction 
B)  Decreased ciliary mobility 
C)  Increased dead space ventilation 
D)  Reduced surfactant production

Question 16

What is the most important noninvasive diagnostic test for evaluation of a patient with idiopathic pulmonary artery hypertension (IPAH)?

Accepted Answer

A)  Posteroanterior chest radiograph 
B)  Physical examination 
C)  Pulmonary function testing 
D)  scan 
A)  Posteroanterior chest radiograph 
B)  Physical examination 
C)  Pulmonary function testing 
D)  scan

Question 17

Where in the lung is pulmonary embolism most frequently observed?

Accepted Answer

A)  Right lower lobe 
B)  Lingula 
C)  Left lower lobe 
D)  Right middle lobe 
A)  Right lower lobe 
B)  Lingula 
C)  Left lower lobe 
D)  Right middle lobe

Question 18

What is the critical value for mean pulmonary arterial pressure, above which the right ventricle fails and death may ensue?

Accepted Answer

A)  30 mm Hg 
B)  40 mm Hg 
C)  50 mm Hg 
D)  60 mm Hg 
A)  30 mm Hg 
B)  40 mm Hg 
C)  50 mm Hg 
D)  60 mm Hg

Question 19

Death from massive pulmonary embolism is the result of:

Accepted Answer

A)  cardiovascular collapse. 
B)  respiratory failure. 
C)  renal complications. 
D)  massive blood loss. 
A)  cardiovascular collapse. 
B)  respiratory failure. 
C)  renal complications. 
D)  massive blood loss.

Question 20

What is the most common pulmonary function abnormality found in patients with idiopathic pulmonary artery hypertension (IPAH)?

Accepted Answer

A)  Reduced diffusing capacity of the lungs (DLCO) 
B)  Reduced forced vital capacity (FV
C)  
C)  Reduced forced expiratory flow (FEF25% to 75%) 
D)  Reduced lung compliance (CL) 
A)  Reduced diffusing capacity of the lungs (DLCO) 
B)  Reduced forced vital capacity (FV
C)  
C)  Reduced forced expiratory flow (FEF25% to 75%) 
D)  Reduced lung compliance (CL)

Exam 28: Pulmonary Vascular Disease

In patients suspected of having pulmonary emboli in which noninvasive studies do not give a definite diagnosis, what diagnostic procedure is the test of choice?

At rest, what level does the mean pulmonary artery pressure need to reach before it is considered pulmonary hypertension?

Where do most pulmonary emboli originate?

What are the two most common findings on the electrocardiogram (ECG) in the patient with pulmonary embolism?

What ECG findings are typically seen in patients with idiopathic pulmonary artery hypertension? 1) Frequent premature ventricular complexes 2) Right-axis deviation 3) Right ventricular hypertrophy 4) Left bundle-branch block

Which of the following conditions contribute to the development of hypoxemia in a patient with pulmonary emboli? 1) Cardiogenic shock 2) Destruction of lung parenchyma 3) Intrapulmonary shunt 4) Mismatch

Which of the following risk factors are associated with an increase in the incidence of pulmonary embolism? 1) Advanced age 2) Immobilization 3) Multiple injuries from trauma 4) Positive smoking history

Approximately what percentage of patients with pulmonary embolism have a normal ECG?

What is the 5-year survival rate for patients with untreated idiopathic pulmonary artery hypertension (IPAH)?

What percentage of the pulmonary vascular bed must be occluded by emboli before pulmonary hypertension occurs?

In what type of IPAH patient is lung transplantation indicated?

Which of the following physical examination findings are found in patients with primary pulmonary hypertension? 1) Cyanosis 2) Diastolic heart murmur 3) Digital clubbing 4) Loud second heart sound (P2)

Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.

Which of the following medications should be used in the hospital for prophylactic deep venous thrombosis therapy?

Which of the following pathophysiologic changes in the lung is not typically associated with pulmonary embolism?

What is the most important noninvasive diagnostic test for evaluation of a patient with idiopathic pulmonary artery hypertension (IPAH)?

Where in the lung is pulmonary embolism most frequently observed?

What is the critical value for mean pulmonary arterial pressure, above which the right ventricle fails and death may ensue?

Death from massive pulmonary embolism is the result of:

What is the most common pulmonary function abnormality found in patients with idiopathic pulmonary artery hypertension (IPAH)?

History of Respiratory Care

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Physical Principles of Respiratory Care

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Filters

Which of the following physical examination findings are found in patients with primary pulmonary hypertension? 1) Cyanosis 2) Diastolic heart murmur 3) Digital clubbing 4) Loud second heart sound (P₂)