Answer to Question 1
ANS: A
A. Correct response: One of the well-recognized clinical manifestations of extra-alveolar air is pneumothorax, but extra-alveolar air can manifest itself also as pneumomediastinum, pulmonary interstitial emphysema, subcutaneous emphysema, pneumoperitoneum, and systemic gas embolization. Although any patient receiving mechanical ventilation is susceptible to these complications, the highest risk groups appear to patients with severe airflow obstruction. These patients include asthmatics, patients with COPD, and patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.
Answer to Question 2
ANS: B
A. Incorrect response: Pneumothorax is the presence of extra-alveolar air in the pleural space.
B. Correct response: Pneumoperitoneum is the presence of air or gas in the peritoneum. Pneumoperitoneum generally follows pneumomediastinum and results from air dissecting initially into the retroperitoneal space.
C. Incorrect response: Pulmonary interstitial pneumonia (PIE) refers to the dissection of air along vascular sheaths following alveolar rupture.
D. Incorrect response: A tension pneumothorax is a pneumothorax characterized by the continuous collection of air in the pleural space until the pressure reaches supra-atmospheric levels.
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Illustration of the anatomy of a normal subject (A) and a patient with sleep apnea (B)