pulmonary pathophysiology questions

C. Permanent enlargement of acini

1. What is the hallmark structural change seen in emphysema?

A. Bronchial wall thickening
B. Fibrotic pleura
C. Permanent enlargement of acini
D. Consolidation of alveoli

B. Asthma

2. Which condition is characterized by reversible airway obstruction?

A. Emphysema
B. Asthma
C. Chronic bronchitis
D. Bronchiectasis

C. Chronic bronchitis

3. Which pulmonary condition is associated with productive cough lasting at least 3 months for 2 consecutive years?

A. Asthma
B. Emphysema
C. Chronic bronchitis
D. ARDS

C. Emphysema

4. Which obstructive disease is linked to α1-antitrypsin deficiency?

A. Asthma
B. Chronic bronchitis
C. Emphysema
D. Pneumonia

C. High-pitched wheezing

5. What is a common auscultation finding in patients with emphysema?

A. Coarse crackles
B. Pleural rubs
C. High-pitched wheezing
D. Rhonchi

C. FEV1/FVC ratio

6. What PFT finding is typically decreased in obstructive lung diseases like COPD?

A. Total lung capacity
B. Residual volume
C. FEV1/FVC ratio
D. Inspiratory reserve volume

C. Pneumoconiosis

7. Which condition results from inhalation of inorganic dusts and causes pulmonary fibrosis?

A. Bronchiectasis
B. ARDS
C. Pneumoconiosis
D. Asthma

C. Pleural plaques

8. What is a common radiographic finding in asbestosis?

A. Bullae
B. Upper lobe nodules
C. Pleural plaques
D. Hilar lymphadenopathy

C. High-resolution CT scan

9. What is the gold standard imaging technique for diagnosing bronchiectasis?

A. Chest X-ray
B. MRI
C. High-resolution CT scan
D. Pulmonary angiography

B. Bronchiectasis

10. Which of the following conditions is most associated with thick, purulent sputum and chronic infection?

A. Asthma
B. Bronchiectasis
C. ARDS
D. Silicosis

B. Emphysema

11. Which condition is associated with increased lung compliance?

A. Asthma
B. Emphysema
C. ARDS
D. Pneumoconiosis

B. Alveolar fluid accumulation from increased permeability

12. What is the primary cause of acute respiratory distress syndrome (ARDS)?

A. Autoimmune reaction
B. Alveolar fluid accumulation from increased permeability
C. Bronchial hyperresponsiveness
D. Pleural effusion

C. Eosinophils

13. What is the primary cell involved in the inflammatory response of asthma?

A. Neutrophils
B. Lymphocytes
C. Eosinophils
D. Macrophages

C. Mucus gland hypertrophy and hypersecretion

14. What pathophysiologic change occurs in chronic bronchitis?

A. Loss of alveolar walls
B. Airway hyperresponsiveness
C. Mucus gland hypertrophy and hypersecretion
D. Bronchial smooth muscle atrophy

C. V/Q mismatch with shunt

15. What is the major mechanism of hypoxemia in ARDS?

A. Low inspired oxygen
B. Diffusion impairment
C. V/Q mismatch with shunt
D. Decreased hemoglobin

C. Idiopathic pulmonary fibrosis

16. Which of the following is a restrictive lung disease?

A. Emphysema
B. Chronic bronchitis
C. Idiopathic pulmonary fibrosis
D. Asthma

C. Total lung capacity

17. What lung volume is typically reduced in restrictive lung diseases?

A. Residual volume
B. Tidal volume
C. Total lung capacity
D. Minute ventilation

D. Chronic sputum production

18. What symptom is least likely in emphysema?

A. Barrel chest
B. Clubbing
C. Dyspnea
D. Chronic sputum production

B. Vascular remodeling

19. What is the effect of chronic hypoxia on pulmonary vasculature?

A. Vasodilation
B. Vascular remodeling
C. Decreased vascular resistance
D. Capillary rupture

A. Right ventricular failure due to pulmonary disease

20. What is cor pulmonale?

A. Right ventricular failure due to pulmonary disease
B. Left heart failure with pulmonary edema
C. Coronary artery disease
D. Asthma with cardiac arrhythmia

A. Normal FEV1/FVC ratio with reduced volumes

21. What spirometry pattern is typical in restrictive lung disease?

A. Normal FEV1/FVC ratio with reduced volumes
B. Low FEV1 with high FVC
C. Decreased FEV1/FVC ratio
D. Elevated TLC

B. Clubbing

22. What is a classic physical exam finding in bronchiectasis?

A. Wheezing
B. Clubbing
C. Dullness to percussion
D. Whispered pectoriloquy

A. Type I

23. What type of hypersensitivity reaction is asthma?

A. Type I
B. Type II
C. Type III
D. Type IV

D. Pseudomonas

24. What common organism causes infection in cystic fibrosis-related bronchiectasis?

A. E. coli
B. Staphylococcus aureus
C. Streptococcus pneumoniae
D. Pseudomonas aeruginosa

B. Cachectic, pursed-lip breathing

25. What characterizes pink puffers (emphysema dominant COPD)?

A. Obese, cyanotic with edema
B. Cachectic, pursed-lip breathing
C. Frequent infections and mucus production
D. Right heart failure

B. Obese, cyanotic, productive cough

26. What characterizes blue bloaters (chronic bronchitis dominant COPD)?

A. Thin with quiet breath sounds
B. Obese, cyanotic, productive cough
C. Pursed-lip breathing
D. High lung compliance

C. Paralyzes cilia

27. What is the effect of smoking on mucociliary clearance?

A. Enhances ciliary function
B. Decreases mucus production
C. Paralyzes cilia
D. Stimulates surfactant

B. Silicosis

28. Which of the following conditions is most associated with upper lobe fibrosis?

A. Asbestosis
B. Silicosis
C. Sarcoidosis
D. Interstitial pneumonitis

B. Goblet cell hyperplasia and basement membrane thickening

29. What histological finding is seen in asthma?

A. Fibrotic scarring
B. Goblet cell hyperplasia and basement membrane thickening
C. Alveolar wall destruction
D. Pleural effusion

C. Emphysema

30. Which condition is least likely to cause a restrictive pattern on PFT?

A. ARDS
B. Interstitial lung disease
C. Emphysema
D. Pleural effusion

B. Infection/sepsis

31. What is the most common cause of death in ARDS?

A. Hypoxemia
B. Infection/sepsis
C. Pulmonary embolism
D. Bronchospasm

C. Proliferative

32. Which phase of ARDS involves proliferation of type II pneumocytes?

A. Exudative
B. Fibrotic
C. Proliferative
D. Necrotic

C. Bilateral diffuse infiltrates

33. What is the classic CXR finding in ARDS?

A. Unilateral infiltrates
B. Pleural effusion
C. Bilateral diffuse infiltrates
D. Hyperinflated lungs

C. Cystic fibrosis

34. What condition is characterized by impaired chloride transport and thick mucus?

A. Asthma
B. COPD
C. Cystic fibrosis
D. Sarcoidosis

C. Sarcoidosis

35. Which restrictive lung disease presents with non-caseating granulomas?

A. Silicosis
B. Asbestosis
C. Sarcoidosis
D. ARDS

D. Alpha-1 antitrypsin level

36. Which test confirms α1-antitrypsin deficiency?

A. Arterial blood gas
B. Serum protein electrophoresis
C. Chest X-ray
D. Alpha-1 antitrypsin level

B. Loss of alveolar surface area

37. What causes decreased DLCO in emphysema?

A. Increased perfusion
B. Loss of alveolar surface area
C. Increased cardiac output
D. Airway remodeling

C. Smoking

38. What is the major environmental risk factor for COPD?

A. Genetic mutation
B. Air pollution
C. Smoking
D. Sedentary lifestyle

B. Tuberculosis

39. What is the most common cause of bronchiectasis worldwide?

A. Pneumonia
B. Tuberculosis
C. Asthma
D. Pulmonary embolism

C. Mixed

40. What type of respiratory failure occurs in severe COPD exacerbation?

A. Hypoxemic
B. Hypercapnic
C. Mixed
D. Obstructive

C. Prolongs expiration and reduces air trapping

41. What effect does pursed-lip breathing have in emphysema?

A. Worsens oxygenation
B. Triggers bronchospasm
C. Prolongs expiration and reduces air trapping
D. Decreases respiratory rate

C. Alveolar-capillary membrane damage

42. What is the hallmark feature of ARDS pathophysiology?

A. Elevated CO₂
B. Surfactant overproduction
C. Alveolar-capillary membrane damage
D. Chronic inflammatio

B. COPD

43. Which obstructive disease is typically non-reversible?

A. Asthma
B. COPD
C. Cystic fibrosis
D. Bronchiectasis

A. Respiratory alkalosis

44. What is the common ABG finding in early-stage asthma attack?

A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Normal ABG

A. Hypoxemia

45. What causes digital clubbing in bronchiectasis?

A. Hypoxemia
B. Hypercapnia
C. Hyperventilation
D. Pulmonary hypertension

C. Idiopathic pulmonary fibrosis

46. What condition is associated with “honeycomb lung” on imaging?

A. COPD
B. ARDS
C. Idiopathic pulmonary fibrosis
D. Asthma

B. Asthma

47. Which pulmonary disease is associated with nasal polyps and aspirin sensitivity?

A. COPD
B. Asthma
C. Sarcoidosis
D. Cystic fibrosis

C. IL-5

48. Which cytokine is most involved in eosinophilic inflammation in asthma?

A. IL-1
B. IL-4
C. IL-5
D. IL-10

C. Workplace allergens/chemicals

49. What is the common trigger for occupational asthma?

A. Viral infection
B. Cold air
C. Workplace allergens/chemicals
D. Autoimmune response

C. Mechanical ventilation with low tidal volume

50. What is the most effective treatment for ARDS in ICU?

A. Antibiotics
B. Inhaled steroids
C. Mechanical ventilation with low tidal volume
D. Diuretics