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Topic 20. Pathophysiology of respiratory system



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Topic 20. Pathophysiology of respiratory system.
1. A young man with suspicion on narcotic poisoning was admitted into neurological department. Which of the disorders of external respiration can be expected?

  1. Asphyxia

  2. Alveolar hyperventilation

  3. Kussmaul respiration

  4. Biot's respiration

  5. Alveolar hypoventilation*

2. In pathogenesis of which types of respiration the main link is the fall of excitability of respiratory centre to carbon dioxide due to oxygen starvation of this centre?



  1. Accelerated and deep breathing*

  2. Expiratory dyspnea

  3. Periodic respiration

  4. Inspiratory dyspnea

  5. Combined dyspnea

3. As a result of casualty the obturation of the lung trachea occurred. Which stage of respiration will be impaired first?



  1. Tissue respiration

  2. Lung ventilation *

  3. Exchange of gases in the lungs

  4. Exchange of gases in tissues

  5. Transport of oxygen and carbon dioxide

4. The functional state of respiratory system was examined in a patient with emphysema. What is more characteristic for this state?



  1. Increase of tidal volume*

  2. Increase of vital volume of the lungs

  3. Increase of inspiratory reserve volume

  4. Decrease of total volume of the lungs

  5. Decrease of inspiratory reserve volume

5. The syndrome of respiratory insufficiency is often observed in premature born children. What is the main cause of this?



  1. Swallowing of amniotic water

  2. Immaturity of lung alveoli due to deficiency of surfactant*

  3. Intrauterine hypercapnia

  4. Imperfection of the nervous regulation of the respiratory act E. Intrauterine asphyxia

6. Paleness of the skin, accelerated superficial respiration is observed in a newborn. Numerous diffused atelectasis are revealed at X-ray examination. What is the most possible cause of this condition?



  1. Pneumothorax

  2. Hydrothorax

  3. Tuberculosis

  4. Bronchial asthma

  5. Surfactant deficiency*

7. A patient who was at a resuscitation department with skull injury suddenly developed convulsions on the background of regaining consciousness, and short arrest of breathing was changed by solitary sighs with calming down character. What types of respiration appeared in the patient?



  1. Gasping respiration*

  2. Cheyne-Stokes respiration

  3. Biot’s respiration

  4. Kussmaul respiration

  5. Apneustic respiration

8. During meal a child breathe in a seed. What respiratory changes will develop in the child?

  1. First expiratory dyspnea, then inspiratory one

  2. At first inspiratory dyspnea, then expiratory one*

  3. At first arrest of breathing, then expiratory dyspnea

  4. Expiratory dyspnea, then Cheyne-Stokes respiration

  5. Inspiratory dyspnea, then Biot’s respiration

9. A partial respiratory insufficiency developed in a patient due to a chronic impairment of the organs of respiratory system. What is a characteristic sign of partial respiratory insufficiency?




  1. Hypoxemia and hypercapnia

  2. Hypoxemia and decrease of alveolar ventilation

  3. Decrease of alveolar ventilation and hypercapnia

  4. Hypoxemia and gaseous acidosis

  5. Hypoxemia without hypercapnia*

10. When developing of pulmonary emphysema in a patient the following is notified:



  1. Increase of functional “dead space”.*

  2. Inspiratory dyspnea

  3. Cardiac insufficiency (left ventricular type)

  4. Decrease of resistance to the airflow in the respiratory tract

  5. Decrease of functional “dead space”

11. Decrease of the passage at the level of middle and small bronchi is observed in a patient. What process will be the leading in the development of respiratory insufficiency?



  1. Disturbance of diffusion

  2. Hyperperfusion

  3. Hypoventilation*

  4. Hypoperfusion

  5. Hyperventilation

12. In the decrease of the middle and small bronchial passages in a patient the following is observed:



  1. Development of gaseous alkalosis

  2. Decrease of pressure in pulmonary circulation

  3. Development of inspiratory dyspnea

  4. Hypocapnia

  5. Decrease of pO2 and increase of pCO2 in the alveolar air*

13. In obstructive type of respiratory disturbances in a patient it will be determined



  1. Increase in forced vital volume of the lungs

  2. Expiratory dyspnea*

  3. Increase in vital volume of the lungs

  4. Decrease of the tidal volume

  5. Decrease of the total volume of the lungs

14. In restrictive type of respiratory disturbances in a patient the following is revealed A. Decrease of rate and increase of depth of respiration

  1. Expiratory dyspnea

  2. Increase of vital capacity of the lungs

  3. Increase of tidal volume of the lungs

  4. Decrease of tidal volume of the lungs*

15. Gaseous alkalosis is revealed in the patient is blood. What process impairment is connected with this development?




  1. Impairment of diffusion

  2. Hyperventilation*

  3. Hyperperfusion

  4. Hypoventilation

  5. Hypoperfusion

16. The application of oxygen did not eliminate hypoxemia in a patient with partial respiratory insufficiency. What is the mechanism of respiratory insufficiency?



  1. Disturbance of diffusion

  2. Hyperperfusion (functional shunt)

  3. Hypoventilation

  4. Hyperperfusion (anatomical shunt)*

  5. Hyperventilation

17. Patient aged 62 was admitted into neurological department due to cerebral hemorrhage. Grave condition. Increase of depth and rate of respiration and then its decrease and apnea is observed. After that the cycle of respiratory movements start again. What type of respiration appeared in the patient?



  1. Apneustic respiration

  2. Kussmaul respiration

  3. Gasping respiration

  4. Cheyne-Stokes respiration*

  5. Biot’s respiration

18. After Tiffeneau's test index decreased to 30% in the patient. The development of what pathological process in the organs of respiratory systems does it indicate?



  1. Lobular pneumonia

  2. Pneumothorax

  3. Obstructive bronchitis*

  4. Tuberculous pleurisy

  5. Pneumosclerosis

19. A patient has developed atelectasis, which was accompanied by alveolar collapse. What contributes to this?



  1. Hyperventilation

  2. Spasm of lung vessels

  3. Arterial hypertension

  4. Surfactant deficiency*

  5. Respiratory acidosis

20. A patient has the pathology of the lung with the disturbance of external respiration and development of hypercapnia and hypoxia. How many times is the ability of CO2 to diffusion through alveolar-capillary membrane higher than the same one of oxygen? A. 5



  1. 10

  2. 15

  3. 20

  4. 25*

21. Patient’s respiratory rate is 10 per min, respiratory volume - 1.1 l whistling rales are heard over the lungs on auscultation. Which of pathogenetic forms of external respiratory disturbance has this patient:



  1. Diffuse-pneumonia

  2. Diffuse-restrictive

  3. Ventilation -restrictive

  4. Primary-dyskinetic

  5. Obstructive*

22. Which of the pathogenetic forms of external respiratory disturbance may develop in traumatic costal fracture? A. Primary-dyskinetic



  1. Ventilation-restrictive.*

  2. Obstructive

  3. Diffuse-restrictive

  4. Diffuse pneumonia

23. Which of pathogenetic forms of external respiratory disturbance may appear in cerebrospinal trauma of the level of cervico-thoracic part of the spine?



  1. Obstructive

  2. Primary-dyskinetic*

  3. Ventilation -restrictive

  4. Diffuse-restrictive

  5. Diffuse pneumonic

24. In which of pathologic processes does obstructive form of disturbance of external respiration appear?



  1. Pulmonary edema

  2. Pneumonia

  3. Pleurisy

  4. Bronchial asthma*

  5. Open pneumothorax

25. In which of pathologic processes does ventilation -restrictive form of external respiratory disturbance develop?

  1. Pulmonary edema*

  2. Bronchial asthma

  3. Poliomyelitis

  4. Syringomyelitis

  5. Bronchitis

26. In what form of dyspnea develops in insufficiency of surfactant system of the lungs?




  1. Rare shallow respiration

  2. Fast deep respiration

  3. Fast shallow respiration*

  4. Expiratory dyspnea

  5. Rare deep respiration

27. Which of pathogenetic forms of external respiratory disturbance may develop in craniocerebral trauma? A. Diffuse-pneumonic



  1. Diffuse-restrictive

  2. Ventilation -restrictive

  3. Primary dyskinetic*

  4. Obstructive

28. A patient aged 23 was admitted to the hospital with a craniocerebral injury in a poor condition. Respiration is characterized by spasmatic effort of inspiration which does not stop and sometimes is broken by expiration. What type of respiration is this typical for?



  1. Apneustic respiration*

  2. Gasping respiration

  3. Kussmaul's respiration

  4. Cheyne-Stokes’ respiration

  5. Biot’s respiration

29. A patient aged 64 was admitted to the hospital with complaints of cough with sputum, marred dyspnea. Objectively forced position, respiratory rate - 32 per min:

additional muscles take part in the act of respiration. X-ray examination: the lungs have increased transparency. What is the main link in the pathogenesis of respiratory insufficiency of this patient?


  1. Decrease of elastic abilities of the lungs*

  2. Accumulation of sputum in the lungs

  3. Thin mucus membranes of bronchi

  4. Impairment of surfactant system of the lung

  5. Pneumosclerosis

30. Both vagus nerves were cut during experiment on animal. How may vagus respiration be characterized?



  1. Frequent and deep

  2. Very rare and deep*

  3. Rare and shallow

  4. Frequent and shallow

  5. Periodic

31. A child with diphtheria developed larynx edema. What type of respiration is observed?



  1. Gasping respiration

  2. Apneustic respiration

  3. Kussmaul’s respiration

  4. Dyspnea*

  5. Biot’s respiration

32. A female patient was admitted to the hospital with exertion of chronic bronchitis. Antibiotic treatment was administered. On the fourth day general condition became worse: the temperature persisted, dyspnea and cough increased, itching eruptions appeared on the skin, diffused dry whistles were heard on auscultation. There is eosinophilia (10%) in the blood. Aggregation of symptoms of the patient is caused by the development of: A. Asthmatic bronchitis

  1. Bronchial asthma

  2. Bronchopneumonia

  3. Allergic reaction

  4. Drug allergic reaction*

33. The deficiency of alpha-1-antitrypsine was determined in a patient with pulmonary emphysema. What is the leading mechanism of the development of emphysema in this patient?



  1. Excessive discharge of elastase by lymphocytes

  2. Increase of histamine discharge

  3. Dilation of bronchioles

  4. Activation of elastolysis*

  5. Decrease of elastase discharge by neutrophilic granulocytes

34. A patient with bronchial asthma has developed acute respiratory insufficiency.

What type of respiratory insufficiency appears in this case?



  1. Dysregulatory disorder of alveolar ventilation

  2. Diffuse

  3. Perfuse

  4. Restrictive disturbance of alveolar ventilation

  5. Obstructive disturbance of alveolar ventilation*

35. 0.5 ml of air was introduced into a rat’s pleural cavity. What type of respiratory insufficiency appears in this case?

  1. Restrictive disturbance of alveolar respiration*

  2. Obstructive disturbance of alveolar ventilation

  3. Perfuse

  4. Diffuse

  5. Dysregulatory disturbance of alveolar ventilation

36. Acute respiratory insufficiency appeared in a patient with tetanus. What type of respiratory insufficiency develops in this case? A. Restrictive disturbance of alveolar respiration

  1. Dysregulatory disturbance of alveolar ventilation*

  2. Obstructive disturbance of alveolar ventilation

  3. Perfuse

  4. Diffuse

37. Increased content of carbon dioxide is in a room. How does respiration change (its depth and rate) in a man entered this room?



  1. Depth of respiration increases

  2. Rate of respiration increases

  3. Depth and rate of respiration increase*

  4. Depth of respiration decreases

  5. Rate of respiration decreases

38. When eating a child aspired some food. Strong cough, cyanosis of skin and mucous membranes, increase in pulse rate, rare respiration, and lengthening of inspiration developed in him. What kind of disorder of external respiration developed in this child?



  1. Stenotic respiration

  2. Expiratory dyspnea stage in asphyxia*

  3. Inspiratory dyspnea stage in asphyxia

  4. Biot’s respiration

  5. Alternative respiration

39. A 56-year-old patient, who is fitter by occupation, has been suffering form fibrouscavernous tuberculosis of lungs for 10 years. During later 3 weeks cough and weakness intensify, amount of purulent-mucous phlegm with blood increases in him. What is the reason for developed ventilation insufficiency in this case?



  1. Decrease in number of functioning alveoli*

  2. Disturbances of functions of respiratory center

  3. Disturbances of functions of neuro-muscular apparatus

  4. Disturbances of agility of the thorax

  5. Disturbances of airways passage

40. A 50-year-old unconscious patient was admitted to the endocrinology department. It is known that patient has been suffering from diabetes mellitus for many years. What kind of disorders of external respiration will be present in this patient?



  1. Kussmaul’s respiration*

  2. Asphyxia

  3. Biot’s respiration

  4. Stenotic respiration

  5. Chain-Stocks respiration

41. Attack of suffocation developed in a 45-year-old woman suffered from bronchial asthma for a long time. What pathogenetic mechanism does this phenomenon have?



  1. Expiratory narrowing of small bronchi*

  2. Loose of elasticity of lung tissue

  3. Decrease in sensitivity of respiratory center

  4. Disorders of agility of the thorax

  5. Impairment of perfusion of lung tissue

42. Edema of larynx developed in a child on the background of allergic reaction. What kind of respiratory failure has developed in this case?
A. Obstructive*

B Restrictive



  1. Dysregulatory

  2. Parenchymatous

  3. -

43. A patient with both-sided lung edema was in the emergency department. What kind of dyspnea is observed in this case?

A Shallow frequent respiration*


  1. Deep frequent respiration

  2. Shallow rare respiration

  3. Shallow respiration

  4. Asphyxia

44. Lung fibrosis with disorders of alveolar ventilation developed in a miner. What is the leading mechanism in this disorder development?



  1. Restriction of respiratory surface of lungs*

  2. Narrowing of upper airways

  3. Disorders of neural regulation of respiration

  4. Restriction of agility of the thorax

  5. Spasm of bronchi

45. A 60-year-old male patient in severe condition was admitted to the hospital. The patient has been suffering from diabetes mellitus for 10 years. At second day of his stay at the in-patient department his condition sharply worsened: coma developed, noisy respiration appeared, which was accompanied by deep inspirations with forced expirations and participation of expiratory muscles. What kind of disorders of respiration is observed in the patient?



  1. Kussmaul’s respiration*

  2. Stenotic respiration

  3. Tachypnea

  4. Chain-Stocks’ respiration

  5. Biot’s respiration

46. A patient with craniocerebral trauma has respiration, which is characterized by respiratory movements becoming deeper and then becoming shallower and after that short pause in respiration occurs. What periodical respiration is this type characteristic for?



  1. Chain-Stocks’ respiration*

  2. Biot’s respiration

  3. Kussmaul’s respiration

  4. Gasping respiration

  5. Apneustic respiration

47. A female patient N., aged 16, with asphyxia was admitted to the emergency department. She has expiratory dyspnea with respiration rate of 8 per minute, BP of 80/50 mmHg, heartbeat rate of 40 bpm, and narrowed pupils. What phase of asphyxia does this patient have?

  1. II phase*

  2. I phase

  3. II phase

  4. IV phase

  5. -

48. A boy was admitted to resuscitation department. He has inspiratory dyspnea, general excitation, widened pupils, tachycardia, and BP of 160/100 mmHg. What phase of asphyxia does this patient have?



  1. I phase*

  2. II phase

  3. III phase

  4. IV phase

  5. -

49. A 15-year-old girl has been suffering from bronchial asthma for 5 years. What kind of hypoxia does this patient have?



  1. Respiratory*

  2. Circulatory

  3. Hemic D. Tissue

E. Mixed
ANSWERS. 1.-E.2.-A.3.-B.4.-A.5.-B.6.-E.7.-A.8.-B.9.-E.10.-A.11.-C.12.-E.13.-B.14.-

E. 15.-B.16.-D.17.-D.18.-C.19.-D.20.-E.21.-E.22.-B.23.-B.24.-D.25.-A.26.-C. 27.D.28.-A.29.-A.30.-B.31.-D.32.-E.33.-D.34.-E.35.-A.36.-B.37.-C.38.-B.39.-A. 40.-A.

41.-A. 42.-A. 43.-A. 44.-A. 45.-A. 46.-A. 47.-A. 48.-A. 49.-A.



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