Cardiovascular Conditions and Respiratory Function
1. Which respiratory complication is most commonly associated with left-sided heart failure?
A. Pleural effusion
B. Pulmonary edema
C. Pneumothorax
D. Pulmonary embolism
Answer: B
Explanation: Left-sided heart failure causes pulmonary congestion and pulmonary edema due to increased pulmonary capillary pressure.
2. A patient with congestive heart failure (CHF) is experiencing dyspnea when lying flat but improves when sitting up. What is this symptom called?
A. Orthopnea
B. Platypnea
C. Trepopnea
D. Hyperpnea
Answer: A
Explanation: Orthopnea is difficulty breathing when lying flat, commonly seen in heart failure due to fluid redistribution.
3. Which of the following is a hallmark sign of pulmonary congestion in heart failure?
A. Hyperinflated lungs on chest X-ray
B. Kerley B lines on chest X-ray
C. Decreased lung compliance
D. Alveolar consolidation
Answer: B
Explanation: Kerley B lines indicate interstitial fluid overload, commonly seen in pulmonary congestion due to heart failure.
4. Which of the following is the primary cause of dyspnea in heart failure?
A. Airway obstruction
B. Fluid overload in the lungs
C. Increased lung compliance
D. Hyperventilation
Answer: B
Explanation: Dyspnea in heart failure is due to fluid overload, leading to impaired gas exchange and stiff lungs.
5. Which of the following findings is expected in a patient with cardiogenic pulmonary edema?
A. Decreased PCWP (Pulmonary Capillary Wedge Pressure)
B. Frothy pink sputum
C. Decreased venous return
D. Decreased systemic vascular resistance
Answer: B
Explanation: Pulmonary edema in heart failure leads to fluid leaking into alveoli, producing frothy pink sputum.
Renal Failure and Pulmonary Function
6. Which acid-base disorder is most commonly seen in chronic kidney disease (CKD)?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: C
Explanation: CKD causes metabolic acidosis due to decreased acid excretion by the kidneys.
7. Patients with renal failure are at increased risk of pulmonary edema due to:
A. Increased sodium and water retention
B. Decreased pulmonary vascular resistance
C. Increased alveolar surfactant production
D. Hypovolemia
Answer: A
Explanation: Renal failure causes fluid overload, increasing pulmonary capillary pressure and leading to pulmonary edema.
8. What is Kussmaul breathing, which is commonly seen in metabolic acidosis due to renal failure?
A. Rapid, deep breathing
B. Periodic cessation of breathing
C. Shallow, slow breathing
D. Labored breathing
Answer: A
Explanation: Kussmaul breathing is a compensatory hyperventilation to eliminate CO₂ in metabolic acidosis.
9. Which pulmonary complication is commonly associated with end-stage renal disease (ESRD)?
A. Pleural effusion
B. Bronchiectasis
C. Pulmonary embolism
D. Pulmonary fibrosis
Answer: A
Explanation: ESRD causes fluid overload, leading to pleural effusions.
10. Why do patients with uremia experience dyspnea?
A. Bronchial obstruction
B. Increased lung compliance
C. Uremic toxins affect respiratory drive
D. Increased alveolar perfusion
Answer: C
Explanation: Uremic toxins can depress the central respiratory centers, leading to dyspnea.
Neuromuscular Disorders and Respiratory Function
11. Which of the following neuromuscular diseases is most likely to cause respiratory failure?
A. Myasthenia gravis
B. Multiple sclerosis
C. Guillain-Barré syndrome
D. All of the above
Answer: D
Explanation: These neuromuscular diseases can weaken respiratory muscles, leading to respiratory failure.
12. In patients with neuromuscular disease, which respiratory function is usually affected first?
A. Tidal volume
B. Inspiratory muscle strength
C. Oxygen saturation
D. Diffusing capacity
Answer: B
Explanation: Inspiratory muscle weakness is an early sign of neuromuscular respiratory failure.
13. Which test is used to assess respiratory muscle weakness in neuromuscular disorders?
A. Peak expiratory flow rate (PEFR)
B. Maximum inspiratory pressure (MIP)
C. DLCO test
D. Arterial blood gas (ABG)
Answer: B
Explanation: MIP measures inspiratory muscle strength, which is reduced in neuromuscular diseases.
14. Which neuromuscular disorder is most associated with diaphragmatic paralysis?
A. Guillain-Barré syndrome
B. Parkinson’s disease
C. Huntington’s disease
D. Amyotrophic lateral sclerosis (ALS)
Answer: A
Explanation: Guillain-Barré syndrome can cause diaphragmatic weakness, leading to respiratory failure.
15. What is the most common cause of death in patients with advanced neuromuscular diseases?
A. Cardiac arrhythmias
B. Respiratory failure
C. Liver failure
D. Renal failure
Answer: B
Explanation: Respiratory failure is the leading cause of death in neuromuscular diseases due to muscle weakness.
More Questions
16. Which test helps differentiate cardiac from non-cardiac pulmonary edema?
A. D-dimer
B. B-type natriuretic peptide (BNP)
C. C-reactive protein (CRP)
D. Troponin
Answer: B
Explanation: BNP levels are elevated in cardiogenic pulmonary edema but not in non-cardiac causes like ARDS.
17. Which electrolyte imbalance in renal failure worsens muscle weakness and respiratory function?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: A
Explanation: Hyperkalemia can lead to muscle paralysis, including respiratory muscle weakness, increasing the risk of respiratory failure.
18. Which of the following is a sign of diaphragmatic weakness in neuromuscular disease?
A. Paradoxical breathing
B. Kussmaul respiration
C. Cheyne-Stokes breathing
D. Biot’s breathing
Answer: A
Explanation: Paradoxical breathing occurs when the diaphragm moves opposite to normal, often seen in diaphragmatic paralysis.
19. Why does renal failure increase the risk of pleural effusion?
A. Increased vascular resistance
B. Fluid overload and uremic inflammation
C. Increased cardiac output
D. Increased lung compliance
Answer: B
Explanation: Pleural effusion in renal failure occurs due to fluid retention and inflammation caused by uremic toxins.
20. Which neuromuscular disorder is most likely to cause chronic respiratory insufficiency?
A. Guillain-Barré syndrome
B. Myasthenia gravis
C. Amyotrophic lateral sclerosis (ALS)
D. Multiple sclerosis
Answer: C
Explanation: ALS causes progressive muscle weakness, including respiratory muscle failure, leading to chronic ventilatory insufficiency.
21. Which respiratory support is recommended for advanced neuromuscular diseases with nocturnal hypoventilation?
A. High-flow nasal cannula (HFNC)
B. Invasive mechanical ventilation
C. Bilevel positive airway pressure (BiPAP)
D. Simple oxygen therapy
Answer: C
Explanation: BiPAP is commonly used for nocturnal hypoventilation in neuromuscular disorders to reduce CO₂ retention.
22. What is the primary cause of hypoxemia in pulmonary edema due to heart failure?
A. Decreased diffusion capacity
B. Ventilation-perfusion mismatch
C. Airway obstruction
D. Bronchoconstriction
Answer: B
Explanation: Pulmonary fluid accumulation leads to V/Q mismatch, reducing oxygenation.
23. Which of the following symptoms is a hallmark of respiratory failure in myasthenia gravis?
A. Sudden onset of fever and chills
B. Progressive dyspnea and reduced tidal volume
C. Wheezing and stridor
D. Chronic cough and sputum production
Answer: B
Explanation: Myasthenia gravis can cause progressive weakness in respiratory muscles, leading to hypoventilation.
24. Which pulmonary function test (PFT) finding is expected in a patient with ALS?
A. Increased FEV1/FVC ratio
B. Decreased total lung capacity (TLC)
C. Increased residual volume (RV)
D. Decreased FEV1/FVC ratio
Answer: B
Explanation: ALS is a restrictive disease, leading to decreased TLC due to weakened respiratory muscles.
25. Which sleep-related breathing disorder is most common in patients with neuromuscular disease?
A. Central sleep apnea
B. Obstructive sleep apnea
C. Cheyne-Stokes respiration
D. Nocturnal hypoventilation
Answer: D
Explanation: Neuromuscular diseases often lead to nocturnal hypoventilation due to weak inspiratory muscles.
26. Which diagnostic test is most useful for evaluating chronic respiratory failure in neuromuscular disorders?
A. Chest X-ray
B. Pulmonary function tests (PFTs)
C. Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP)
D. D-dimer
Answer: C
Explanation: MIP and MEP measure respiratory muscle strength, which is critical in diagnosing respiratory failure in neuromuscular diseases.
27. Which oxygen therapy strategy should be avoided in chronic CO₂ retainers, such as neuromuscular patients?
A. Low-flow oxygen therapy
B. High-flow nasal cannula (HFNC)
C. Non-invasive ventilation (NIV)
D. 100% oxygen via non-rebreather mask
Answer: D
Explanation: High levels of oxygen can suppress the hypoxic drive in CO₂ retainers, worsening hypercapnia.
28. What is the most common cause of pulmonary hypertension in patients with chronic renal failure?
A. Left ventricular dysfunction
B. Pulmonary embolism
C. Hypoxemia-induced vasoconstriction
D. Increased alveolar compliance
Answer: A
Explanation: Pulmonary hypertension in renal failure is commonly due to left ventricular dysfunction and volume overload.
29. Which condition is associated with diaphragmatic fatigue and paradoxical breathing?
A. Chronic bronchitis
B. Spinal cord injury
C. Pulmonary fibrosis
D. Bronchiectasis
Answer: B
Explanation: Spinal cord injuries affecting the phrenic nerve can cause diaphragmatic paralysis, leading to paradoxical breathing.
30. Which of the following is the most serious complication of respiratory muscle weakness in neuromuscular disorders?
A. Aspiration pneumonia
B. Atelectasis
C. Respiratory failure
D. Pulmonary hypertension
Answer: C
Explanation: Respiratory failure is the leading cause of death in neuromuscular disorders due to progressive respiratory muscle weakness.