Self-Study Questions for the Respiratory Pathophysiology Unit

1. What determines FRC (functional residual capacity)?

2. Name at least three factors that can reduce airway resistance.

3. List at least two factors that can shift the oxygen hemoglobin desaturation curve to the
LEFT.

4. Calculate the alveolar-arterial oxygen gradient for a patient with the following set of arterial
blood gases: pH 7.08; PaCO2 80; PaO2 40; HCO3- 24.

5. What is your interpretation of the following arterial blood gas: pH 7.08; PaCO2 80; PaO2 40;
HCO3- 24?

6. Which of the following types of pulmonary vessels (arterial, venous &/or lymphatic) is/are
found in the connective tissue adjacent to airways?

7. Name at least two major differences between the histology of bronchi and bronchioles.

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8. List at least three differences between the pathology of centrilobular and panlobular
emphysema.

9. Name at least two similarities and two differences between the microscopic pathology of
chronic bronchitis and asthma.

10. What features would make you consider a diagnosis of cystic fibrosis rather than immotile
cilia syndrome in a 9 year-old child?

11. Why does infant respiratory distress syndrome potentially lead to pulmonary hypertension?

12. List one diagnosis associated with each of the five classes of pulmonary hypertension.

13. Name at least two risk factors for pulmonary thromboembolism.

14. Define paradoxical thromboembolism.

15. Name an anticoagulant drug which does NOT depend on renal function for elimination.

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16. How do you monitor warfarin (Coumadin) for effectiveness?

17. What laboratory tests on pleural fluid would indicate the fluid is a transudate? Why is it
important to distinguish a transudate from an exudate?

18. If the majority of cells found in pleural fluid are lymphocytes, what disease(s) would you be
considering?

19. Describe the main differences between simple and complicated coal workers'
pneumoconiosis.

20. The function of which pulmonary cell type is severely impaired in individuals with silicosis?

21. List two important functions of

the cell type indicated by the arrows
in this photomicrograph of injured
lung.

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22. What are some clinical clues that a patient is likely to have bacterial pneumonia rather than
just a bad cold?

23. Why does the absence of a spleen increase the risk for the development of Streptococcus
pneumoniae pneumonia?

24. For the three major fungal pulmonary infectious diseases that can affect immunocompetent
individuals (blastomycosis, coccidioidomycosis and histoplasmosis), describe the areas in
the U.S. where these diseases are endemic, as well as the characteristic microscopic
morphology of the pathogenic organisms.

25. Name at least three conditions which increase the risk for progression from latent
tuberculosis infection (LTBI) to active tuberculosis (TB disease).

26. If a patient is not doing well on a 4-drug treatment regimen for tuberculosis, what would be
the problem in adding a 5th drug to help?

27. Why do we start therapy for tuberculosis with 3-4 drugs?

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28. What pathology MOST supports a diagnosis of idiopathic pulmonary fibrosis?

29. Which of the idiopathic interstitial lung diseases have a strong association with smoking?

30. If a 30 year-old African American woman presents to your office with exertional dyspnea and
a dry cough, has a moderate restrictive defect on pulmonary function testing and has a
chest X-ray showing bilateral hilar lymphadenopathy, you would be able to guess the
diagnosis. So why would you need a biopsy?

31. List at least three non-infectious causes of granulomatous inflammation in the lung.

32. What factors would lead you to believe that a patient with suspected idiopathic pulmonary
fibrosis would NOT need an open lung biopsy?

33. What is the most common mechanism causing hypoxemia?

34. When evaluating a patient, what factors might lead you to start mechanical (or assisted)
ventilation?

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35. For which cell type of lung cancer would you most likely expect hemoptysis (coughing up
blood)?

36. Compare and contrast the development of squamous cell carcinoma and adenocarcinoma
of the lung from normal epithelium to premalignant lesions to an invasive malignancy.

37. How does a pathologist distinguish between a typical carcinoid tumor and small cell lung
carcinoma?

38. Who should be screened for lung cancer based on the National Lung Screening Trial?

39. What is the clinical relevance of the long latency period for lung cancer (from the first
malignant cell to clinical manifestations)?

40. Define what is meant by a paraneoplastic syndrome and provide at least three examples.

41. How can you differentiate non-REM from REM sleep?

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42. Name at least one Dont of good sleep hygiene which you yourself are guilty of.

43. List at least three of the parameters monitored during a polysomnogram (sleep study).

44. List at least three causes of excessive daytime sleepiness.

45. What are the three changes in pulmonary mechanics that occur as people age?