A patient has pleural effusion with empyema. The following are clinical manifestations except:
Bradycardia
Pleural pain
Cough
Fever
The Correct Answer is A
A. Bradycardia: Bradycardia, which is a slower than normal heart rate, is not a typical clinical manifestation of pleural effusion with empyema. In fact, fever and infection usually lead to tachycardia (an increased heart rate) as the body attempts to respond to infection.
B. Pleural pain: Pleural pain is a common symptom associated with pleural effusion and empyema, resulting from irritation of the pleura due to inflammation or infection.
C. Cough: A cough can occur with pleural effusion and empyema, often as a response to irritation or pressure in the thoracic cavity. It may also be associated with underlying lung conditions contributing to the effusion.
D. Fever: Fever is a typical clinical manifestation of empyema, indicating an infectious process. The presence of infection in the pleural space often results in systemic signs of infection, such as fever.
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Related Questions
Correct Answer is B
Explanation
A. Aortic stenosis: Aortic stenosis can lead to heart failure due to left ventricular outflow obstruction, but it is not the most direct cause of pulmonary edema. This condition may present with other symptoms, such as chest pain or syncope, rather than fluid accumulation in the lungs.
B. Left-sided heart failure: Left-sided heart failure is a primary cause of pulmonary edema, as it leads to increased pressure in the pulmonary circulation and fluid leakage into the alveoli. Assessing for this condition is crucial, as it directly contributes to the patient's pulmonary edema and requires immediate management.
C. Mitral valve prolapse: Mitral valve prolapse can cause mitral regurgitation and lead to heart failure, but it is less commonly associated with acute pulmonary edema compared to left-sided heart failure. While assessment is important, it is not the priority in this scenario.
D. Right-sided heart failure: Right-sided heart failure typically leads to systemic congestion and peripheral edema rather than pulmonary edema. While it can coexist with left-sided heart failure, it is not the primary concern when assessing a patient specifically for pulmonary edema.
Correct Answer is B
Explanation
A. Norepinephrine causes bronchial smooth muscle contraction and mucus secretion but it also causes high blood pressure: This statement is misleading in the context of asthma. Norepinephrine primarily acts on alpha and beta receptors, influencing blood pressure and bronchodilation but is not the main mediator in asthma pathophysiology. The focus should be on inflammation and airway responsiveness.
B. Uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring: This statement accurately describes the pathophysiologic process in asthma. Persistent inflammation in asthma can cause increased bronchial hyperresponsiveness, leading to airway narrowing and potential long-term remodeling and scarring of the airways if not controlled. Effective management is essential to prevent these adverse outcomes.
C. Immunoglobulin G causes smooth muscle contraction which will eventually weaken the respiratory muscles: Immunoglobulin E (IgE) is primarily involved in allergic reactions and asthma, and it does not directly cause smooth muscle contraction that weakens respiratory muscles.
D. The release of epinephrine leads to development of cardiac dysrhythmias: While epinephrine can have cardiovascular effects, including increased heart rate and potential for dysrhythmias, this is not directly relevant to the pathophysiology of asthma. The focus in asthma management is on controlling airway inflammation and bronchoconstriction rather than on cardiac issues.
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