Pulmonary System Disorders Flashcards
7 cards from real Physician Assistant 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 Disorders flashcards as text
A 52-year-old with obstructive sleep apnea refuses CPAP. Which consequence of untreated OSA poses the greatest cardiovascular risk?
Answer: Repetitive hypoxemia and sympathetic surges causing systemic hypertension
Repetitive hypoxic episodes and arousal-associated sympathetic activation cause sustained systemic hypertension, which is the primary cardiovascular complication of OSA.
A 40-year-old woman presents with exertional dyspnea and a mean pulmonary artery pressure of 30 mmHg on right heart catheterization. She has no left heart disease or lung disease. Which treatment is first-line for Group 1 pulmonary arterial hypertension?
Answer: Phosphodiesterase-5 inhibitors or endothelin receptor antagonists
PDE-5 inhibitors (sildenafil) or endothelin receptor antagonists (bosentan, ambrisentan) are first-line for Group 1 PAH in patients without vasoreactivity on testing.
A 35-year-old non-smoker presents with lower lobe-predominant emphysema and recurrent liver disease. Which deficiency should be suspected?
Answer: Alpha-1 antitrypsin deficiency
Alpha-1 antitrypsin deficiency causes panacinar emphysema predominantly in the lower lobes and can cause liver disease from misfolded protein accumulation in hepatocytes.
A mechanically ventilated ARDS patient has plateau pressure of 32 cmH2O and PEEP of 10 cmH2O. Driving pressure is 22 cmH2O. Which ventilator adjustment best reduces ventilator-induced lung injury?
Answer: Reduce tidal volume to achieve driving pressure ≤15 cmH2O
Driving pressure (plateau - PEEP) >15 cmH2O is associated with increased ARDS mortality; reducing tidal volume to lower driving pressure reduces stress on remaining functional lung units.
A 60-year-old with COPD and FEV1 of 35% predicted has multiple hospitalizations yearly. Which long-acting bronchodilator combination has the strongest evidence for reducing exacerbations?
Answer: Long-acting beta-agonist plus inhaled corticosteroid plus long-acting muscarinic antagonist (triple therapy)
Triple therapy (LABA + LAMA + ICS) reduces exacerbation rates more than dual therapy in severe COPD patients with frequent exacerbations, per the IMPACT trial.
A 25-year-old with asthma is awakened 4 nights per week by wheezing and uses rescue albuterol daily. Spirometry shows FEV1 of 75% predicted with 15% bronchodilator response. How is this asthma classified?
Answer: Moderate persistent asthma
Daily symptoms, nighttime awakenings more than once per week, and FEV1 60-80% predicted classify asthma as moderate persistent, requiring step 3-4 therapy.
A 70-year-old post-lobectomy patient develops fever, purulent sputum, and a new air-fluid level on CXR 10 days postoperatively. What is the most likely diagnosis?
Answer: Lung abscess
An air-fluid level within a cavitary lesion with fever and purulent sputum after thoracic surgery indicates a lung abscess, often from anaerobic or gram-negative organisms.