A 41-year-old woman is diagnosed with asthma. Which of the following most closely explains the pathophysiology of airway constriction associated with asthma?
Inflammation of the bronchial wall leads to mucosal thickening, epithelial cell desquamation, and denudation of the basement membrane.
An irritant causes an inflammatory response, which leads to destruction of the alveolar air sacs. This causes irreversible obstructive airway physiology.
Airway obstruction occurs due to the combination of inflammatory cell infiltration, mucus hypersecretion with mucus plug formation, and smooth muscle contraction.
The inflammatory response initiated by a viral or bacterial infection causes leakage of the alveolar-capillary membrane at the site of inflammation, causing a decrease in lung compliance and shortness of breath.
The Correct Answer is C
Choice A reason: While mucosal thickening and epithelial damage are part of asthma’s pathology, this description is incomplete and does not fully explain the mechanism of airway constriction. It omits the critical roles of smooth muscle contraction and mucus plugging, which are central to airflow limitation.
Choice B reason: This describes the pathophysiology of emphysema, a form of chronic obstructive pulmonary disease (COPD), not asthma. Emphysema involves destruction of alveolar walls and irreversible airflow obstruction, which is not characteristic of asthma.
Choice C reason: Asthma is a chronic inflammatory disorder of the airways characterized by variable and reversible airflow obstruction. The key mechanisms include infiltration of inflammatory cells (e.g., eosinophils, mast cells), mucus hypersecretion with plug formation, and bronchial smooth muscle contraction. These processes lead to narrowing of the airways and symptoms such as wheezing, dyspnea, and coughing.
Choice D reason: This describes the pathophysiology of acute respiratory distress syndrome (ARDS), not asthma. ARDS involves alveolar-capillary membrane damage and decreased lung compliance due to fluid leakage, which is unrelated to the bronchial hyperresponsiveness seen in asthma.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: These factors are associated with irritable bowel syndrome and other colonic disorders, not peptic ulcer disease. PUD affects the stomach and duodenum, not the colon.
Choice B reason: This describes the pathophysiology of inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. It does not apply to PUD, which is primarily driven by gastric acid and mucosal injury.
Choice C reason: PUD results from an imbalance between aggressive factors (e.g., gastric acid, pepsin, H. pylori, NSAIDs) and protective mechanisms (e.g., mucus, bicarbonate, mucosal blood flow). H. pylori disrupts mucosal defenses, and NSAIDs inhibit prostaglandin synthesis, both contributing to ulcer formation.
Choice D reason: LES dysfunction and TLESRs are associated with gastroesophageal reflux disease (GERD), not PUD. GERD involves reflux of gastric contents into the esophagus, whereas PUD involves mucosal erosion in the stomach or duodenum.
Correct Answer is B
Explanation
Choice A reason: REM sleep behavior disorder involves acting out dreams due to loss of normal muscle atonia during REM sleep. It typically presents with violent movements or vocalizations during sleep, not with uncomfortable leg sensations or the urge to move the legs.
Choice B reason: Restless legs syndrome is characterized by an urge to move the legs, often accompanied by uncomfortable sensations such as burning or tingling, especially in the evening or at rest. Symptoms are relieved by movement and can interfere with sleep and social functioning, matching the patient’s description.
Choice C reason: Circadian rhythm sleep-wake disorders involve misalignment between the internal circadian clock and the external environment, leading to sleep disturbances. These disorders do not typically present with sensory symptoms in the legs.
Choice D reason: Hypersomnolence disorder is marked by excessive daytime sleepiness despite adequate sleep duration. It does not involve sensory discomfort or the urge to move the legs, making it an unlikely diagnosis in this case.
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