August 2003, Volume 33 Number 8 , p 75 - 77
Check your knowledge of pathophysiology and challenge your assessment skills by taking this quiz .
1. A 65-year-old patient with COPD has a sudden onset of unilateral pleuritic chest pain that worsens when he coughs, along with severe shortness of breath. You also note that his chest wall movement is asymmetric. When you listen to his lungs, which finding is most significant in establishing the diagnosis?
a. crackles in both lung bases
b. significantly decreased breath sounds on the symptomatic side
c. expiratory wheezing
2. A patient who has a 40-pack/year history of smoking is found to have cor pulmonale, which is best described as
a. hypertrophy of the right ventricle.
b. hypertrophy of the left ventricle.
c. ventilation/perfusion mismatch.
3. A 76-year-old patient with a history of heart failure is admitted with pulmonary edema. What pathophysiologic process is occurring?
a. Perfusion to the lungs is interrupted by a pulmonary embolus.
b. Ventilation to the lungs is decreased because of a mucus plug.
c. Increased hydrostatic pressure in the capillaries causes fluid to leak into the interstitial spaces, causing the alveoli to collapse.
4. When myocardial cells are hypoxic, they signal the body to produce epinephrine and norepinephrine, which cause the heart to beat harder and faster (thus increasing blood flow to the cells). Why is this compensatory mechanism sometimes harmful?
a. It increases oxygen demand in the heart.
b. It depletes the myocardial cells of calcium.
c. It diverts blood to the extremities.
5. A patient with chronic heart failure caused by aortic stenosis begins to have symptoms of abdominal pain and nausea. Physical examination reveals an enlarged liver. What's the most likely cause of these new signs and symptoms?