Question 1

The presence of previous chronic obstructive pulmonary disease (COPD) reduces the diagnostic usefulness of scans in acute pulmonary embolism.

Accepted Answer

A) True 
 B)False

Question 2

A patient with pulmonary emboli has severe hypoxemia, acute right-sided heart failure, and shock. What treatment should be given at this time?

Accepted Answer

A)  Acetylcholine esterase 
B)  Heparin 
C)  Streptokinase 
D)  Warfarin 
A)  Acetylcholine esterase 
B)  Heparin 
C)  Streptokinase 
D)  Warfarin

Question 3

What IV infusion has been found to improve exercise capacity, hemodynamic variables, and survival in patients with severe IPAH?

Accepted Answer

A)  Bosentan 
B)  Epoprostenol 
C)  Methylprednisolone 
D)  Sildenafil 
A)  Bosentan 
B)  Epoprostenol 
C)  Methylprednisolone 
D)  Sildenafil

Question 4

Which of the following findings on a chest radiograph are consistent with pulmonary embolism?
1) Diffuse hyperinflation
2) Elevation of the diaphragm
3) Enlargement of the heart shadow
4) Pleural effusion

Accepted Answer

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

Question 5

What is the most frequent symptom found in patients with confirmed pulmonary emboli?

Accepted Answer

A)  Cough 
B)  Dyspnea 
C)  Leg swelling 
D)  Pleuritic pain 
A)  Cough 
B)  Dyspnea 
C)  Leg swelling 
D)  Pleuritic pain

Question 6

What is the main hemodynamic consequence of pulmonary emboli?

Accepted Answer

A)  Increased pulmonary vascular resistance 
B)  Increased systemic vascular resistance 
C)  Pulmonary instability 
D)  Pulmonary vasodilation 
A)  Increased pulmonary vascular resistance 
B)  Increased systemic vascular resistance 
C)  Pulmonary instability 
D)  Pulmonary vasodilation

Question 7

Which of the following conditions predispose a patient to venous thromboembolic disease?
1) Carcinoma
2) COPD
3) Trauma
4) Thrombocytosis

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 8

What is the initial event in the pathogenesis of idiopathic pulmonary artery hypertension (IPAH)?

Accepted Answer

A)  Insult to the pulmonary endothelium 
B)  Elevated level of serotonin 
C)  Monoclonal proliferation of endothelial cells 
D)  Vascular remodeling 
A)  Insult to the pulmonary endothelium 
B)  Elevated level of serotonin 
C)  Monoclonal proliferation of endothelial cells 
D)  Vascular remodeling

Question 9

What therapy has been proven to improve survival in patients with COPD and pulmonary hypertension?

Accepted Answer

A)  Bronchodilators 
B)  Oral vasodilators 
C)  Oxygen 
D)  Prostanoids 
A)  Bronchodilators 
B)  Oral vasodilators 
C)  Oxygen 
D)  Prostanoids

Question 10

What drug would be the treatment of choice for pulmonary emboli?

Accepted Answer

A)  Heparin 
B)  Streptokinase 
C)  Urokinase 
D)  Warfarin 
A)  Heparin 
B)  Streptokinase 
C)  Urokinase 
D)  Warfarin

Question 11

What is the most important factor contributing to the onset of pulmonary hypertension in the patient with COPD?

Accepted Answer

A)  Alveolar hypoxia 
B)  Compression of pulmonary vasculature 
C)  Left ventricular failure 
D)  Loss of vascular surface 
A)  Alveolar hypoxia 
B)  Compression of pulmonary vasculature 
C)  Left ventricular failure 
D)  Loss of vascular surface

Question 12

What treatment is initiated in patients suspected of pulmonary emboli, and continued until pulmonary emboli is ruled out?

Accepted Answer

A)  Antiarrhythmia 
B)  Anticoagulation 
C)  Corticosteroids 
D)  Diuretics 
A)  Antiarrhythmia 
B)  Anticoagulation 
C)  Corticosteroids 
D)  Diuretics

Question 13

A D-dimer test is performed in a patient in whom a pulmonary embolism is suspected. The value comes back at 379 mg/L. What does this suggest?

Accepted Answer

A)  Almost completely establishes the presence of pulmonary embolism. 
B)  Almost completely rules out pulmonary embolism. 
C)  Establishes roughly a 50/50 chance of pulmonary embolism. 
D)  Is indeterminate but highly suggestive of pulmonary embolism. 
A)  Almost completely establishes the presence of pulmonary embolism. 
B)  Almost completely rules out pulmonary embolism. 
C)  Establishes roughly a 50/50 chance of pulmonary embolism. 
D)  Is indeterminate but highly suggestive of pulmonary embolism.

Question 14

What are the two most common symptoms associated with primary pulmonary hypertension?

Accepted Answer

A)  Dry cough and dyspnea 
B)  Dyspnea and angina 
C)  Hemoptysis and dyspnea 
D)  Syncope and chest pain 
A)  Dry cough and dyspnea 
B)  Dyspnea and angina 
C)  Hemoptysis and dyspnea 
D)  Syncope and chest pain

Question 15

Which of the following radiographic findings is not typical for patients with primary pulmonary hypertension?

Accepted Answer

A)  Enlargement of the pulmonary artery 
B)  Enlargement of the right ventricle 
C)  Narrowing of the peripheral arteries 
D)  Pleural effusion 
A)  Enlargement of the pulmonary artery 
B)  Enlargement of the right ventricle 
C)  Narrowing of the peripheral arteries 
D)  Pleural effusion

Question 16

Approximately what percentage of patients who die from pulmonary embolism are not suspected before death?

Accepted Answer

A)  5% 
B)  20% 
C)  40% 
D)  70% 
A)  5% 
B)  20% 
C)  40% 
D)  70%

Question 17

Pulmonary artery hypertension (PAH) is not typically associated with which of the following conditions?

Accepted Answer

A)  Amyotrophic lateral sclerosis 
B)  Cirrhosis of the liver 
C)  Congenital heart disease 
D)  Human immunodeficiency virus infection 
A)  Amyotrophic lateral sclerosis 
B)  Cirrhosis of the liver 
C)  Congenital heart disease 
D)  Human immunodeficiency virus infection

Exam 28: Pulmonary Vascular Disease

The presence of previous chronic obstructive pulmonary disease (COPD) reduces the diagnostic usefulness of scans in acute pulmonary embolism.

A patient with pulmonary emboli has severe hypoxemia, acute right-sided heart failure, and shock. What treatment should be given at this time?

What IV infusion has been found to improve exercise capacity, hemodynamic variables, and survival in patients with severe IPAH?

Which of the following findings on a chest radiograph are consistent with pulmonary embolism? 1) Diffuse hyperinflation 2) Elevation of the diaphragm 3) Enlargement of the heart shadow 4) Pleural effusion

What is the most frequent symptom found in patients with confirmed pulmonary emboli?

What is the main hemodynamic consequence of pulmonary emboli?

Which of the following conditions predispose a patient to venous thromboembolic disease? 1) Carcinoma 2) COPD 3) Trauma 4) Thrombocytosis

What is the initial event in the pathogenesis of idiopathic pulmonary artery hypertension (IPAH)?

What therapy has been proven to improve survival in patients with COPD and pulmonary hypertension?

What drug would be the treatment of choice for pulmonary emboli?

What is the most important factor contributing to the onset of pulmonary hypertension in the patient with COPD?

What treatment is initiated in patients suspected of pulmonary emboli, and continued until pulmonary emboli is ruled out?

A D-dimer test is performed in a patient in whom a pulmonary embolism is suspected. The value comes back at 379 mg/L. What does this suggest?

What are the two most common symptoms associated with primary pulmonary hypertension?

Which of the following radiographic findings is not typical for patients with primary pulmonary hypertension?

Approximately what percentage of patients who die from pulmonary embolism are not suspected before death?

Pulmonary artery hypertension (PAH) is not typically associated with which of the following conditions?

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