Basic and Clinical Sciences (BCSE) Practice Exam

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What pathology is known to increase blood flow through the pulmonary circulation?

  1. Left to right shunts

  2. Pulmonary arterial hypertension

  3. Right heart failure

  4. Chronic obstructive pulmonary disease

The correct answer is: Left to right shunts

Left to right shunts are pathologies that result in increased blood flow through the pulmonary circulation. In these cases, there is an abnormal connection between the left side of the heart and the right side, typically due to congenital heart defects such as an atrial septal defect or ventricular septal defect. As a result, oxygenated blood from the left heart flows back into the right heart, which then enters the pulmonary circulation. This leads to an overall increase in blood volume and pressure within the pulmonary arteries, causing heightened blood flow through the lungs. The other options refer to conditions that do not typically increase pulmonary blood flow in the same manner. Pulmonary arterial hypertension involves increased pressure in the pulmonary vessels often due to narrowed or obstructed arteries, leading to resistance rather than increased flow. Right heart failure occurs when the right side of the heart cannot effectively pump blood, which may eventually result in congestion rather than increased flow. Chronic obstructive pulmonary disease primarily affects airflow and gas exchange, with changes in pulmonary circulation that stem from hypoxia and vascular remodeling rather than an increase in blood flow.