Pulmonary Jeopardy

1. Pulmonary Jeopardy Mech Vent Flow Blood Lab Misc. Exch Basics 100 100 100 100 100 100 100 100 200 200 200 200 200 200 200 200 300 300 300 300 300 300 300 300 400 400 400 400 400 400 400 400 500 500 500 500 500 500 500 500 1000 1000 1000 1000 1000 1000 1000 1000 2000 2000 2000 2000 2000 2000 2000 2000 3000 3000 3000 3000 3000 3000 3000 3000 4000 4000 4000 4000 4000 4000 4000 4000 5000 5000 5000 5000 5000 5000 5000 5000

6. The lung volumes and capacities are measured using spirometry. Which of the following measured values is the sum of two volumes? • IRV • TV • FRC • RV

21. In a constant temperature system, the pressure of a gas is inversely proportional to the volume • A. Charles' Law • B. Boyle's Law • C. Dalton's Law • D. Henry's Law • E. O'Leary's Law

22. What is the partial pressure of oxygen in the atmosphere at sea level (barometric pressure = 760 mm Hg) • A. 600 mm Hg • B. 160 mm Hg • C. 0.3 mm Hg • D. 47 mm Hg • E. 0.0 mm Hg

23. The volume of air that can be forcible exhaled after a normal expiration is the • A. extra volume • B. expiratory reserve volume • C. expiratory capacity • D. expiratory super volume • E. inspiratory-expiratory volume

24. During expiration, as the diaphragm relaxes the pressure in the alveolus becomes? • A. more positive • B. less positive • C. more negative • D. equal to intrapleural pressure • E. subatmospheric

25. In an individual suffering from pulmonary fibrosis, the work of breathing is increased due to: • A. an increase in surface tension. • B. a decrease in lung compliance. • C. an increase in airway resistance. • D. an increase in chest wall compliance. • E. an increase in diaphragm stiffness.

26. Which of the following results in a shift of the O2 dissociation curve to the left? • A. a decrease in pH. • B. an increase in arterial PCO2. • C. a rise in temperature. • D. exercise. • E. an increased pH.

27. In a lung unit with an abnormally low ventilation/perfusion ratio, it can be said that the: • A. amount of perfusion exceeds the amount of ventilation. • B. amount of ventilation exceeds the amount of perfusion. • C. blood emerging from the unit has a reduced PCO2. • D. anatomic dead space has decreased. • E. physiological dead space has decreased.

28. A patient is having difficulty breathing. A spirometric evaluation reveals a FVC that is 50% of predicted, a FEV1.0 that is 55% of predicted, and a normal FEV1.0/FVC ratio. These observations suggest that the patient has: • A. an obstructive impairment. • B. a restrictive impairment. • C. both an obstructive and a restrictive impairment. • D. a diffusive impairment. • E. both an obstructive and a diffusive impairment.

29. FRC is increased in individuals with emphysema, because: • A. the decreased compliance of the chest wall keeps the lungs at a higher volume. • B. the increased compliance of the lungs allows the chest wall to move closer to its resting position. • C. the decrease in airway resistance limits the volume of air that can be exhaled during quiet breathing. • D. the patient breathes at a higher lung volume to overcome the diffusion limitation produced by the disease. • E. hypoxic stimulation of the peripheral chemoreceptors results in a reflex-mediated increase in FRC.

30. At end-inspiration, with an open glottis, the alveolar pressure is: • A. less than atmospheric pressure. • B. less than pleural pressure. • C. equal to pleural pressure. • D. equal to atmospheric pressure. • E. greater than atmospheric pressure.

31. Residual volume is the lung volume at which the: • A. tendency for the lung to recoil inward is exactly balanced by the tendency for the chest wall to recoil outward. • B. respiratory musculature can cause no further movement of the chest wall inward. • C. lungs contain their "absolute" volume. • D. only remaining air in the lung is that contained in the anatomic dead space. • E. chest wall is at its "resting position".

32. The expiratory reserve volume (ERV) is defined as the: • A. volume of gas that can be exhaled after a maximal inspiration. • B. volume of gas that can be maximally exhaled from functional residual capacity. • C. volume of gas in the lungs after a maximal inspiration. • D. volume of gas in a single inspiration or expiration. • E. volume of hot air released during a single lecture.

33. The blood emerging from a lung unit with an abnormally low ventilation/perfusion ratio would have a: • A. PO2 greater than 100 mmHg and a PCO2 lower than 40 mmHg. • B. PO2 equaling 100 mmHg and a PCO2 equaling 40 mmHg. • C. PO2 less than 100 mmHg and a PCO2 greater than 40 mmHg. • D PO2 less than 100 mmHg and a PCO2 less than 40 mmHg. • E. PO2 greater than 100 mmHg and a PCO2 greater than 40 mmHg.

34. In an upright individual, blood flow to the base of the lungs exceeds that to the apex because: • A. basal blood vessels are intrinsically larger than apical vessels and thus have a reduced resistance to flow. • B. enhanced sympathetic nerve activity to the basal vessels causes them to preferentially vasodilate. • C. valves in the pulmonary artery preferentially direct blood to the basal portions of the lungs. • D. basal blood vessels are intrinsically more compliant than apical vessels. • E. the hydrostatic pressure gradient distends basal vessels more and thus lowers their resistance to flow.

35. Type II epithelial cells of the lungs produce a chemical called surfactant. The presence of surfactant: • A. prevents airway resistance from increasing to exceedingly high values. • B. decreases the muscular effort required to ventilate the lungs. • C. is responsible for the infant respiratory distress syndrome. • D. is responsible for the fluid in prenatal lungs. • E. causes small alveoli to empty into large alveoli.

37. The stimulus for hypoxic pulmonary vasoconstriction is: • A. venous hypoxemia. • B. arterial hypoxemia. • C. cerebral hypoxia. • D. alveolar hypoxia. • E. tissue hypoxia.

38. Airway resistance may be decreased by: • A. deflating the lung. • B. parasympathetic stimulation. • C. sympathetic stimulation. • D. being in a room full of smokers. • E. Inhaling a marble

39. At zero gravity, blood flow: • A. to the base of the lung should exceed that to the apex. • B. throughout the lung should be homogeneously distributed. • C. in the lung will not differ from that which occurs at normal gravity. • D to the ventral surface of the lung will exceed that to the dorsal surface. • E. to the lung would completely stop

40. An individual whose lungs have a large number of lung units with abnormally high ventilation/perfusion ratios would exhibit a/an: • A. normal arterial PO2 of 100 mmHg but an abnormally high arterial PCO2. • B. reduced arterial PO2. • C. alveolar PO2 and PCO2 approximating those of mixed venous blood. • D. increase in physiological dead space. • E. Increase in heavy breathing

41. During inspiration from functional residual capacity, alveoli at the base of the lung expand to a greater degree than alveoli at the apex, because: • A. alveoli at the base are located on a steeper portion of the compliance curve than those at the apex. • B. the forces of surface tension prevent adequate expansion of alveoli in the apex. • C. dynamic compression of the airways prevents alveoli in the apex from adequately expanding. • D. the accessory muscles of inspiration do not become activated until very high ventilatory volumes are reached.

42. A patient arrives in the emergency room with a right-sided pneumothorax caused by a knife wound to the chest. You suture the wound, but a close observation of the patient suggests that the right lung is still collapsed. These observations indicate that: • A. alveolar pressure of the right lung has become negative. • B. transmural pressure of the right lung was positive. • C. pleural pressure between the right lung and chest wall was atmospheric. • D. that the patient stabbed himself.

43. On a normal O2 dissociation curve and a curve that has been shifted to the right . The rightward shifted curve: • A. allows more O2 to be unloaded from the blood for a given fall in PO2. • B. allows less O2 to be unloaded from the blood for a given fall in PO2. • C. allows a greater degree of oxygen loading of the blood within the lungs. • D. reduces the amount of oxygen that can be maximally carried by the blood. • E. may have resulted from a boring lecture.

44. An individual with anemia (blood hemoglobin concentration of 6 g/dl) would have all of the following, EXCEPT: • A. reduced total arterial oxygen content. • B. normal arterial dissolved oxygen content. • C. normal arterial PO2. • D. decreased oxyhemoglobin saturation. • E. normal oxyhemoglobin saturation.

45. At a given PCO2, CO2 content is greater when there is less O2 in the blood (Haldane effect), because: • A. less HCO3- is produced, which allows more CO2 to be carried in solution. • B. the CO2 solubility coefficient is increased. • C. plasma proteins can form more carbamino compounds when PO2 is reduced. • D. deoxygenated Hb is a better buffer of H+ ions.

46. Alveolar pressure may exceed arterial pressure in all of the following conditions EXCEPT A. Hemorrhage B. Patients on positive pressure ventilation C. Normal individual playing a wind instrument D. Healthy woman during normal inspiration

47. Alveolar pressure of oxygen at sea level is approximately A. 21 mmHg B. 45 mmHg C. 40 mmHg D. 100 mmHg

48. Pulmonary vascular resistance • A. Falls when left atrial pressure increases • Is maximum near the functional residual • capacity • C. Is very low during the fetal life • D. Is decreased on sympathetic stimulation

49. Please select the correct relationship Top of the lung Bottom of the lung A. Ventilation Higher Lower B. Blood Flow Higher Lower C. V/Q Higher Lower D. PO2 Lower Higher E. PCO2 Higher Lower

50. Select the FALSE statement regarding the diffusion capacity for oxygen A. It is directly proportional to the number of pulmonary capillaries opened at a given time B. It is inversely proportional to the thickness of the alveolar-capillary membrane C. It is increased during the exercise D. It is unaffected by removal of part of the lung