In which of the following clinical conditions is pulsus paradoxus likely to develop? I. bronchiectasis II. asthma III. cardiac tamponade IV. COPD

A. II only
B. I, IV only
C. II, III only
D. I, II, IV only


?ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Pulsus paradoxus is an exaggeration of the normal variation in the pulse and blood pressure during a spontaneous inspiration. Normally, the pulse and the blood pressure become weaker during inspiration, and strengthen during exhalation. With pulsus paradoxus, the variation that occurs during the ventilatory cycle heightens. Pulsus paradoxus has been associated with the following clinical conditions: (1) severe asthma, (2) upper airway obstruction, (3) hypovolemia, and (4) cardiac tamponade.
D. Incorrect response: See explanation C.

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