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Pulmonary Embolism Quiz

Total questions: 34

Worksheet time: 17mins

Name
Class
Date
1.

What is a common symptom of pulmonary embolism that appears suddenly and worsens with physical activity?

a)

Chest pain

b)

Shortness of breath

c)

Fainting

d)

Lightheadedness

2.

Which of the following is a symptom of pulmonary embolism that may feel like a heart attack and is often sharp and felt deeply?

a)

Chest pain

b)

Rapid heartbeat

c)

Leg swelling

d)

Dizziness

3.

What is the term used to describe fainting due to a sudden drop in heart rate or blood pressure in pulmonary embolism patients?

a)

Cyanosis

b)

Syncope

c)

Dyspnea

d)

Embolus

4.

Pulmonary embolism can be caused by which of the following apart from thrombus?

a)

Air, fat, or tumor

b)

Bacteria, virus, or fungus

c)

Excessive sweating

d)

Rapid heartbeat

5.

Pulmonary embolism can be caused by which of the following apart from thrombus?

a)

Air, fat, or tumor

b)

Bacteria, virus, or fungus

c)

Excessive sweating

d)

Rapid heartbeat

6.

Which veins are most commonly associated with thrombus formation leading to pulmonary embolism?

a)

Arm veins

b)

Pelvic and leg veins

c)

Neck veins

d)

Abdominal veins

7.

What is the term for the obstruction of the pulmonary artery by a clot that originates from another part of the body?

a)

Cyanosis

b)

Embolus

c)

Syncope

d)

Dyspnea

8.

Which of the following is NOT a symptom of pulmonary embolism?

a)

Excessive sweating and fever

b)

Clammy or discolored skin

c)

Sudden weight gain

d)

Rapid or irregular heartbeat

9.

What is the spectrum of disease ranging from DVT to pulmonary embolism called?

a)

Venous thromboembolism (VTE)

b)

Pulmonary edema

c)

Syncope

d)

Cyanosis

10.

What is the estimated annual incidence of pulmonary embolisms in Germany?

a)

200,000

b)

280,000

c)

350,000

d)

400,000

11.

At what age does the incidence of pulmonary embolism become 8 times higher?

a)

> 50 years

b)

> 60 years

c)

> 70 years

d)

> 80 years

12.

Which cardiovascular disease is the second most frequent cause of cardiac arrest after myocardial infarction?

a)

Stroke

b)

Pulmonary embolism

c)

Hypertension

d)

Aortic aneurysm

13.

What is Virchow's triad in the context of pulmonary embolism?

a)

Venous stasis, endothelial injury, hypercoagulability

b)

Venous stasis, hypertension, hypercoagulability

c)

Endothelial injury, stroke, hypertension

d)

Hypercoagulability, myocardial infarction, stroke

14.

What can cause endothelial injury, increasing the risk of pulmonary embolism?

a)

Prolonged immobility

b)

Major trauma or surgery

c)

Cancer

d)

Hypertension

15.

What is the effect of increased pressure in the small circulatory system?

a)

Decrease in pulmonary artery pressure

b)

Increase in pulmonary artery pressure and right ventricular afterload

c)

Decrease in pulmonary vascular resistance

d)

Increase in oxygenation levels

16.

What happens to pulmonary artery pressure during pulmonary embolism when more than 50% of the pulmonary artery tract is occluded?

a)

Pulmonary artery pressure decreases due to vasodilation.

b)

Pulmonary artery pressure remains unchanged.

c)

Pulmonary artery pressure increases due to pulmonary vasoconstriction.

d)

Pulmonary artery pressure increases due to reduced blood flow.

17.

Which part of the heart is highly sensitive to pressure (PAP; afterload) but not very sensitive to volume (preload)?

a)

Left atrium

b)

Right ventricle

c)

Left ventricle

d)

Right atrium

18.

What is the result of increased right ventricular afterload on the heart's function?

a)

Increased right ventricular ejection

b)

Reduced right ventricular ejection leading to acute right heart failure

c)

Increased systemic blood pressure

d)

Improved coronary perfusion pressure

19.

What is the Bernheim effect in the context of increased pressure in the right ventricle?

a)

The right ventricle shifts to the left side, improving left ventricular function.

b)

The right ventricle shifts to the left side, causing severe diastolic dysfunction of the left ventricle.

c)

The left ventricle shifts to the right side, reducing systemic blood pressure.

d)

The left ventricle shifts to the right side, increasing cardiac output.

20.

What happens to coronary perfusion pressure due to increased pressure in the right atrium?

a)

Coronary perfusion pressure increases, improving heart function.

b)

Coronary perfusion pressure decreases, aggravating right heart failure.

c)

Coronary perfusion pressure remains unchanged.

d)

Coronary perfusion pressure decreases, improving systemic blood pressure.

21.

Which of the following is NOT a risk factor for thromboembolism?

a)

Heart failure

b)

Obesity

c)

Nephrotic syndrome

d)

Regular exercise

22.

What is the main risk factor for thromboembolism in women of childbearing age?

a)

Obesity

b)

Oral contraception ("pill")

c)

Nicotine abuse

d)

Increased blood viscosity

23.

At what percentage of pulmonary arterial vasculature occlusion does pulmonary arterial (PA) pressure start to increase?

a)

10-20%

b)

20-30%

c)

30-50%

d)

50-70%

24.

What systolic blood pressure level is considered a sign of hemodynamic instability in patients with pulmonary embolism (PE)?

a)

Less than 120 mmHg

b)

Less than 100 mmHg

c)

Less than 90 mmHg

d)

Less than 80 mmHg

25.

What is the recommended range of isotonic crystalloid volume to administer cautiously in hypotensive patients with suspected PE?

a)

100-200 ml

b)

200-300 ml

c)

250-400 ml

d)

400-500 ml

26.

What is the target mean arterial pressure (MAP) to maintain in patients with suspected PE?

a)

MAP ≥ 55 mmHg

b)

MAP ≥ 60 mmHg

c)

MAP ≥ 65 mmHg

d)

MAP ≥ 70 mmHg

27.

What is the Bernheim effect?

a)

A condition where the left ventricle enlarges due to increased blood flow.

b)

A phenomenon where right ventricular pressure rises, causing the interventricular septum to bow toward the left ventricle.

c)

A decrease in pulmonary arterial pressure due to reduced cardiac output.

d)

A condition where the right ventricle fails to pump blood effectively.

28.

Which of the following is a parenteral anticoagulant used for the initial treatment of acute pulmonary embolism (PE)?

a)

Rivaroxaban

b)

Enoxaparin

c)

Apixaban

d)

Warfarin

29.

What is the preferred agent for the initial treatment of most hemodynamically stable PE patients?

a)

Unfractionated Heparin (UFH)

b)

LMWH and Fondaparinux

c)

Oral Factor Xa Inhibitors

d)

Warfarin

30.

Why is Unfractionated Heparin (UFH) preferred in high-risk or unstable clinical situations?

a)

It has a long half-life.

b)

It requires minimal monitoring.

c)

It has a rapid onset and short half-life, allowing for quick reversal.

d)

It is cleared primarily by the kidneys.

31.

Which anticoagulant is safer for patients with severe renal failure?

a)

LMWH

b)

Fondaparinux

c)

Unfractionated Heparin (UFH)

d)

Rivaroxaban

32.

What is the rationale for using UFH in critically ill patients in the ICU?

a)

It is cleared by the kidneys.

b)

It allows for minute-to-minute dose adjustments.

c)

It has a long half-life.

d)

It is preferred for stable PE patients.

33.

Which oral anticoagulants are used in stable patients for the initial treatment of acute PE?

a)

Enoxaparin and Dalteparin

b)

Fondaparinux and UFH

c)

Rivaroxaban and Apixaban

d)

Warfarin and Heparin

34.

What is the primary reason LMWH and Fondaparinux are harder to reverse compared to UFH?

a)

They have a longer half-life.

b)

They are cleared by the liver.

c)

They require intensive monitoring.

d)

They are used only in unstable patients.