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Pulmonary System Flashcards

7 cards from real PANCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Pulmonary System flashcards as text

  1. A 55-year-old smoker presents with progressive dyspnea and a barrel chest. Spirometry shows FEV1/FVC ratio of 0.60. Which pathophysiologic mechanism best explains his air trapping?

    Answer: Loss of elastic recoil causing dynamic airway collapse

    In emphysema, destruction of alveolar walls reduces elastic recoil, causing dynamic small airway collapse during expiration and air trapping.

  2. A 30-year-old woman with known asthma presents to the ED with severe bronchospasm unresponsive to two doses of albuterol. Which medication is most appropriate next?

    Answer: IV magnesium sulfate

    IV magnesium sulfate relaxes bronchial smooth muscle and is indicated for severe acute asthma refractory to initial bronchodilator therapy.

  3. A patient with community-acquired pneumonia has a parapneumonic effusion. Thoracentesis reveals pH 7.15, glucose 45 mg/dL, and LDH 1,200 U/L. What is the next best step?

    Answer: Chest tube drainage

    A pH <7.20, glucose <60 mg/dL, and elevated LDH indicate a complicated parapneumonic effusion requiring chest tube drainage.

  4. Which finding on chest X-ray is most characteristic of a tension pneumothorax?

    Answer: Contralateral tracheal deviation with ipsilateral lung collapse

    Tension pneumothorax causes mediastinal shift away from the affected side due to positive pressure buildup, displacing the trachea contralaterally.

  5. A 45-year-old with silicosis develops a new cavitary upper lobe lesion. Which organism is most likely responsible?

    Answer: Mycobacterium tuberculosis

    Silicosis dramatically increases susceptibility to tuberculosis, which preferentially causes upper lobe cavitary lesions.

  6. A patient with COPD has a resting PaO2 of 54 mmHg and cor pulmonale. What is the minimum daily duration of supplemental oxygen required to improve mortality?

    Answer: 15 hours

    The NOTT trial established that at least 15 hours per day of supplemental oxygen reduces mortality in hypoxemic COPD patients.

  7. A 60-year-old presents with recurrent hemoptysis, and CT shows a central endobronchial lesion. Biopsy reveals squamous cell carcinoma. Which paraneoplastic syndrome is most associated with this tumor type?

    Answer: Hypercalcemia due to PTHrP secretion

    Squamous cell carcinoma of the lung is the most common cause of hypercalcemia of malignancy via PTHrP secretion.