Author Question: A patient has undergone a bronchoscopy and physical examination of the pulmonary system. The ... (Read 51 times)

saliriagwu · **on:** Jul 16, 2018

A patient has undergone a bronchoscopy and physical examination of the pulmonary system. The following clinical data were obtained: carbonaceous sputum airway edema erythema/ulceration What type of lung condition does this patient likely exhibit?

A. postlung transplantation
B. ischemia-reperfusion induced lung injury
C. smoke inhalation/pulmonary burn
D. idiopathic pulmonary fibrosis

Question 2

Which of the following pathophysiologic changes may occur in association with brain death and be harmful to the lungs from an organ donor? I. deactivation of pulmonary surfactant II. increased capillary permeability III. cytokine pulmonary-mediated pro-inflammatory response IV. activation of pulmonary fibroblasts

A. I, IV only
B. II, III only
C. I, II, III only
D. II, III, IV only

kjohnson · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Signs of inhalational injury may be absent until several days after the injury. The presence of carbonaceous sputum strongly suggests inhalational injury. Fiberoptic bronchoscopy to look for airway edema, erythema, or ulceration is indicated. Proximal airways may be normal in the case of inhalation of small particles that deposit in the distal airways and alveoli. Xenon 133 ventilationperfusio n scanning should be performed to confirm inhalational injury when clinically suspected.
D. Incorrect response: See explanation C

Answer to Question 2

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: The process of brain death can lead to a cascade of physiologic events that may be harmful to potential donor lungs. Initially, brain death causes excessive sympathetic stimulation that may lead to increased pulmonary capillary permeability. Combined with aggressive volume resuscitation, this predisposes the donor's lungs to pulmonary edema. Brain death is also accompanied by a cytokinemediated pro-inflammatory response, which further contributes to pulmonary edema and acute lung injury. Potential donors frequently have associated pulmonary complications, including aspiration, neurogenic pulmonary edema, pneumonia, or pulmonary trauma.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.