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WorksheetsCh 5 Practice Q's
Total questions: 10
Worksheet time: 5mins
A 56-year-old man with a 40-pack-year smoking history presents with progressive dyspnea, a barrel-shaped chest, and diminished breath sounds. ABG shows PaO2 58 mmHg, PaCO2 52 mmHg, and pH 7.35. Which pathophysiologic change most directly explains his CO2 retention?
Increased respiratory drive from hypoxemia
Loss of elastic recoil reducing expiratory airflow and trapping gas
Increased surfactant production causing airway collapse
Impaired diffusion capacity from pulmonary embolism
A 3-year-old child presents with fever, drooling, inspiratory stridor, and sitting in a tripod position. Which immediate intervention is most critical before diagnostic testing?
Administer nebulized epinephrine
Obtain a throat culture
Secure the airway to prevent complete obstruction
Give IV corticosteroids
A patient presents with severe dyspnea, hypotension, and absent breath sounds on the right after a motor vehicle accident. Trachea is deviated to the left. Which mechanism is causing the hemodynamic instability?
Increased pulmonary vascular resistance
Increased intrathoracic pressure compressing vena cava and reducing preload
Decreased compliance from surfactant loss
V/Q mismatch from alveolar consolidation
A 48-year-old man with COPD develops worsening hypoxemia after starting high-flow supplemental oxygen. Which mechanism best explains this paradoxical drop in oxygenation?
Oxygen toxicity causing alveolar damage
Reduced hypoxic pulmonary vasoconstriction increasing V/Q mismatch
Increased oxygen binding affinity reducing tissue delivery
CO₂ displacement from hemoglobin increasing acidity
A 60-year-old woman develops acute respiratory distress syndrome (ARDS) after sepsis. Chest X-ray shows bilateral infiltrates. Which primary pathophysiologic event leads to her hypoxemia?
Bronchospasm narrowing small airways
Increased alveolar-capillary membrane permeability causing non-cardiogenic pulmonary edema
Alveolar destruction reducing surface area
Microthrombi obstructing pulmonary vessels
A patient with a history of tuberculosis presents with hemoptysis, night sweats, and weight loss. Which cellular process is primarily responsible for lung tissue destruction in this disease?
Neutrophil elastase release
Caseating granulomatous inflammation from T-cell–mediated macrophage activation
Apoptosis of type II alveolar cells
Surfactant inactivation by bacterial toxins
A 19-year-old man with cystic fibrosis presents with increased cough, purulent sputum, and fever. Which mechanism most directly contributes to his recurrent infections?
Loss of IgA secretion in respiratory tract
Increased elastase activity in alveolar macrophages
Defective chloride transport leading to thick, dehydrated mucus
Hypersensitivity reaction to bacterial antigens
A patient with pneumonia has a PaO2 of 55 mmHg despite receiving 100% oxygen. Which abnormality best explains this finding?
Low V/Q mismatch
Right-to-left shunt from alveoli completely filled with exudate
Dead space ventilation from embolism
Increased diffusion distance in alveolar walls
A 7‑year‑old child presents with wheezing, chest tightness, and cough triggered by pollen exposure. Which mediator is most responsible for his acute bronchoconstriction?
IL‑- 5
TNF - a
Histamine released from mast cells
Platelet-activating factor
A 52‑year‑old man presents with progressive exertional dyspnea. Pulmonary function tests show a restrictive pattern with reduced lung volumes. Which finding best distinguishes this from an obstructive disorder?
Decreased FEV₁/FVC ratio
Increased total lung capacity
Normal or increased FEV₁/FVC ratio
Increased residual volume
