What is the direct effect of mediators released during the inflammatory response in SIRS?
Decreased endothelial damage
Decreased inflammation
Decreased vascular permeability
Increased vascular permeability
The Correct Answer is D
A. Decreased endothelial damage:
Inflammatory mediators increase endothelial injury, not decrease it.
B. Decreased inflammation:
The mediators trigger and sustain inflammation, not reduce it.
C. Decreased vascular permeability:
This is the opposite of what occurs. Mediators cause capillary leak and edema.
D. Increased vascular permeability:
Inflammatory cytokines and mediators in SIRS lead to capillary leakage, allowing fluid and proteins to enter the interstitial space, contributing to tissue edema and organ dysfunction.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Refractory hypoxemia:
This is the hallmark of ARDS. It means hypoxemia (low oxygen levels in the blood) that does not improve despite increasing oxygen therapy. It results from severe ventilation-perfusion mismatch and alveolar damage.
B. Pink frothy sputum:
This is more characteristic of pulmonary edema due to left-sided heart failure, not specifically ARDS.
C. Hypoglycemia:
Hypoglycemia is not a typical symptom of ARDS. It might occur due to other metabolic issues or sepsis, but it is not diagnostic.
D. Hypercapnia:
While CO₂ retention can occur in late stages, ARDS is primarily marked by oxygenation failure, not ventilatory failure initially.
Correct Answer is C
Explanation
A. Increased blood pressure:
Hypotension, not hypertension, is more typical as perfusion worsens in SIRS/MODS.
B. Decreased respiratory rate as the patient becomes somnolent:
Early on, tachypnea is more common as the body attempts to compensate for metabolic acidosis. Decreased RR is a late sign.
C. Mental status changes due to hypoxemia:
This is an early and sensitive indicator of worsening oxygen delivery to the brain and other organs in SIRS/MODS.
D. Normal assessment findings. Early signs of MODS are often not noticed:
Early signs can be detected, especially changes in mental status, urine output, or respiratory rate. Saying they are “not noticed” may result in missed intervention opportunities.
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