A nurse is caring for a client with manifestations of status asthmaticus. Which of the following factors play a role in creating circulatory surge of inflammatory cells and cytokines in this condition? (Select all that apply.)
(Select All that Apply.)

Epithelial cells

OT lymphocytes

Hyperreactivity

Mast cells

Inflammation

Answer and Explanation

Correct Answer : A,D,E

Choice A Reason:

Epithelial cells is correct. Epithelial cells lining the airways play a role in initiating the inflammatory response in asthma by releasing cytokines and other inflammatory mediators. These cells can contribute to the circulatory surge of inflammatory cells and cytokines seen in status asthmaticus.

Choice B Reason:

OT lymphocytes is incorrect. There is no specific cell type known as "OT lymphocytes." It's possible this may refer to T lymphocytes (T cells), which are involved in the immune response in asthma but are not typically associated with a circulatory surge in status asthmaticus.

Choice C Reason:

Hyperreactivity is incorrect. Hyperreactivity refers to the exaggerated response of the airways to various stimuli, leading to bronchoconstriction and inflammation. While hyperreactivity is a characteristic feature of asthma, it does not directly contribute to a circulatory surge of inflammatory cells and cytokines.

Choice D Reason:

Mast cells is correct. Mast cells are key players in the pathophysiology of asthma. They release various inflammatory mediators, including histamine and leukotrienes, which contribute to airway inflammation, bronchoconstriction, and mucus production. Mast cells can participate in the circulatory surge of inflammatory cells and cytokines in status asthmaticus.

Choice E Reason:

Inflammation is correct. Inflammation is a hallmark feature of asthma and plays a central role in the pathogenesis of status asthmaticus. The inflammatory response involves the recruitment and activation of various inflammatory cells, release of cytokines, and other mediators that contribute to airway obstruction and systemic effects.

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Correct Answer is D

Explanation

Choice A Reason:

Hypoxemia due to dead space is not appropriate. Dead space refers to areas of the lung where ventilation occurs but no perfusion takes place. In ARDS, hypoxemia typically occurs due to ventilation-perfusion (V/Q) mismatch and shunting rather than dead space.

Choice B Reason:

Impaired carbon dioxide elimination due to shunting is not appropriate. Shunting occurs when blood bypasses ventilated alveoli, leading to inadequate gas exchange. In ARDS, shunting contributes to hypoxemia, but it doesn't directly impair carbon dioxide elimination.

Choice C Reason:

Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch is incorrect. V/Q mismatch occurs when ventilation and perfusion are mismatched in different areas of the lung. This leads to areas of low ventilation (dead space) and areas of low perfusion (shunting). V/Q mismatch contributes to hypoxemia in ARDS but does not typically lead to decreased pulmonary arterial pressure.

Choice D Reason:

Decreased pulmonary compliance due to stiffness is correct. This is a characteristic feature of ARDS. The inflammation and damage to the alveoli cause them to become stiff, reducing pulmonary compliance and impairing lung expansion during ventilation.

A. Pregabalin B. Natalizumab C. Furosemide D. Metoprolol

Correct Answer is B

Explanation

Choice A Reason:

Pregabalin is incorrect. Pregabalin is a medication used to treat neuropathic pain, seizures, and generalized anxiety disorder. It is not associated with an increased risk of PML.

Choice B Reason:

Natalizumab is correct.: Natalizumab is a monoclonal antibody used to treat relapsing forms of MS. It is associated with an increased risk of developing PML, particularly in individuals who are JC virus antibody positive. Regular monitoring of JC virus antibody status and clinical vigilance is required when using natalizumab to reduce the risk of PML.

Choice C Reason:

Furosemide: Furosemide is a loop diuretic used to treat edema and hypertension. It is not associated with an increased risk of PML.

Choice D Reason:

Metoprolol is incorrect .Metoprolol is a beta-blocker used to treat hypertension, angina, and heart failure. It is not associated with an increased risk of PML.

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A nurse is caring for a client with manifestations of status asthmaticus. Which of the following factors play a role in creating circulatory surge of inflammatory cells and cytokines in this condition? (Select all that apply.) (Select All that Apply.)

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A nurse is caring for a client with manifestations of status asthmaticus. Which of the following factors play a role in creating circulatory surge of inflammatory cells and cytokines in this condition? (Select all that apply.)
(Select All that Apply.)