NSG 530 EXAM 3 SYSTEMIC PATHOPHYSIOLOGY LATEST QUESTIONS AND VERIFIED ANSWERS GRADED A+

What is the primary function of innate immunity? - Answer To provide a defense system that protects against all antigens and is present from birth. What are the two main types of immunity? - Answer Innate immunity and adaptive (acquired) immunity. What are examples of physical barriers in innate immunity? - Answer Skin and mucous membranes. What is innate humoral immunity? - Answer A form of innate immunity that includes the body's complement system and substances like interferon and interleukin-1. What happens if an antigen breaches the physical barriers of innate immunity? - Answer It is attacked and destroyed by other parts of the immune system. How is adaptive immunity developed? - Answer It is created in response to exposure to a foreign substance. What are the primary cells involved in adaptive immunity? - Answer B cells and T cells. What is the timing of the response in innate immunity? - Answer It provides a constant and immediate response. How does the timing of adaptive immunity differ from innate immunity? - Answer There is a delay between primary exposure to an antigen and the maximal response, but it is immediate against secondary exposure. What is the specificity of innate immunity? - Answer Broadly specific. What is the specificity of adaptive immunity? - Answer Very specific toward the antigen. What type of memory is involved in adaptive immunity? - Answer Specific immunologic memory by T and B lymphocytes. What are some active molecules involved in innate immunity? - Answer Defensins, cathelicidins, collectins, lactoferrin. What is the role of immunoglobulin E (IgE)? - Answer It is an antibody associated with allergic responses and provides defense against parasites. alveoli epithelial cells - Answer Type I alveolar cells (alveolar structure) Type II alveolar cells (surfactant production) 1.Which of the following is TRUE regarding the pulmonary system? A.Each lobe is divided into bronchi. B.The left lobe is divided into three lobes. C.The mediastinum contains the lungs and heart. D.The larynx connects the upper and lower airways. - Answer Correct Answer: D The larynx connects the upper and lower airways. The mediastinum is located between the lungs and contains the heart, great vessels, andesophagus. The right lung has three lobes, and the left lung has two. Each lobe is divided into segments and lobules Neurochemical control: Respiratory center - Answer •Dorsal and ventral respiratory groups •Pneumotaxic and apneustic centers Neurochemical control: Lung receptors - Answer •Irritant receptors •Stretch receptors Neurochemical control: Chemoreceptors: - Answer Central chemoreceptors Peripheral chemoreceptors Muscles of Breathing: Major muscles of inspiration - Answer Diaphragm External intercostals Muscles of Breathing: Accessory muscles of inspiration - Answer ØSternocleidomastoid muscle ØScalene muscles Mechanics of Breathing: Gas Transport - Answer Four steps ØVentilation of the lungs ØDiffusion of oxygen from the alveoli into the capillary blood ØPerfusion of systemic capillaries with oxygenated blood ØDiffusion of oxygen from systemic capillaries into the cells Diffusion of CO2 occurs in reverse order 1.A patient has bulbous enlargement of the distal segments of the fingers. Which disease is associated with this condition? A.Cystic fibrosis B.Acute pneumonia C.Sickle cell disease D.Acute myocardial infarction - Answer A This condition describes clubbing, in which there is enlargement of the distal segment of the finger. It is associated with conditions of decreased oxygenation such as bronchiectasis, cystic fibrosis, pulmonary fibrosis, lung abscess, and congenital heart disease. Open pneumothorax - Answer An open wound to the chest that allows air to enter the pleural space and cause lung collapse tension pneumothorax - Answer a pneumothorax with rapid accumulation of air in the pleural space causing severely high intrapleural pressures with resultant tension on the heart and great vessels. Spontaneous (primary) pneumothorax - Answer Occurs in the absence of a traumatic injury to the chest or a known lung disease secondary pneumothorax - Answer Underlying lung disease leads to weakened small airways which collapse with respirations. Pleural effusion - Answer fluid in pleural space ØTransudative (watery) ØExudative (WBCs and plasma proteins) ØHemothorax (blood) ØEmpyema (pus) Chylothorax (chyle) Acute respiratory distress syndrome (ARDS) - Answer ØAcute lung inflammation and diffuse alveolocapillary injury that results from injury or severe inflammation •Bilateral infiltrates on chest radiograph •Low ratio of PaO2 to FiO2 ØThree phases: •Exudative (within 72 hours) •Proliferative (4 to 21 days) •Fibrotic (14 to 21 days) 2.Which of the following is TRUE regarding acute respiratory distress syndrome (ARDS)? A.It is caused by injury to the bronchioles. B.It can cause severe pulmonary edema. C.It is most commonly caused by exposure to inhaled irritants. D.Macrophages are not involved in response. - Answer Correct Answer: B Acute respiratory distress syndrome (ARDS) is characterized by damage that is done to the alveolar capillary membrane and causes severe pulmonary edema. The most common cause of ARDS is either sepsis or multiple trauma. Macrophages, neutrophils, complement, and endotoxins are all important mediators. Asthma - Answer ØChronic inflammation of the airways ØCauses bronchial hyperresponsiveness, constriction of airways, and reversible airflow obstruction ØPulsus paradoxus, status asthmaticus ØSymptoms include expiratory wheezing, dyspnea, and tachypnea ØPeak flow meters, corticosteroids, beta agonist inhalers, and anti-inflammatories used to treat Obstructive Lung Diseases: Emphysema - Answer ØAbnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis ØInherited deficit of α1-antitrypsin ØLoss of elastic recoil ØAir trapping 3.Which of the following is TRUE regarding the pathophysiology of asthma? A.IgA is the major factor. B.There is decreased vascular permeability. C.Inflammation results in hyperresponsiveness. D.The inflammatory process is caused by the loss of bronchial smooth muscle spasm. - Answer Correct Answer: C Asthma is caused by increased bronchial smooth muscle spasm and increased vascular permeability. IgE is the major factor. There is increased capillary permeability. Inflammatory mediators cause vasodilation, increased capillary permeability, mucosal edema, bronchial smooth muscle contraction (bronchospasm), and mucus secretion from mucosal goblet cells with narrowing of the airways and obstruction to airflow. Acute bronchitis - Answer ØAcute infection or inflammation of the airways or bronchi ØCommonly follows a viral illness ØAcute bronchitis causes symptoms similar tothose of pneumonia but does not demonstrate pulmonary consolidation and chest infiltrates Pneumonia - Answer ØLower respiratory tract infection ØCaused by bacteria, viruses, fungi, protozoa, or parasites ØTypes: •Community acquired (CAP) Streptococcus pneumoniae Influenza •Healthcare acquired (HCAP) •Ventilator-associated (VAP) Lung cancer - Answer ØNearly 80% caused by cigarette smoking •Smokers with COPD have even greater risk ØEnvironmental, occupational, and genetic risk factors are also associated ØTypes: •Non-small cell cancer: Squamous cell carcinoma Adenocarcinoma Large cell carcinoma •Small cell lung carcinoma—from neuroendocrine tissue 4.A patient has right ventricular enlargement secondary to pulmonary hypertension. Which of the following would be the most likely diagnosis? A.Cor pulmonale B.Acute bronchitis C.Pulmonary embolism D.Pulmonary thromboembolism - Answer Correct Answer: A Cor pulmonale consists of right ventricular enlargement and failure. Acute bronchitis is an acute infection or inflammation of the airways. Pulmonary embolism is occlusion of a portion of the pulmonary vascular bed by an embolus. Pulmonary thromboembolism is obstruction of a pulmonary vessel by a thrombus. 1.A child is born prematurely and requires respiratory support. The child experiences neonatal lung injury...