- 1.
If a patient’s total lung capacity is 5.0 L with a tidal volume of 0.5 L, an inspiratory reserve volume of 3.0 L, and an expiratory reserve volume of 1.0 L, then the residual volume is:
- a.
0.5 L
- b.
1.0 L
- c.
1.5 L
- d.
2.0 L
- e.
2.5 L
- a.
- 2.
The minute ventilation of an individual with a tidal volume of 500 mL and a respiratory rate of 12 breaths per minute is:
- a.
42 mL
- b.
500 mL
- c.
42 L/min
- d.
5 L/min
- e.
6 L/min
- a.
3–9. Match the arterial blood gas values (a to g) with the most likely condition (3 to 9). A condition can be used more than once.
| Pa o 2 mm Hg | Pa co 2 mm Hg | Ca o 2 Vol % | Sa o 2 % | |
|---|---|---|---|---|
| a. | 100 | 40 | 20 | 97 |
| b. | 100 | 40 | 10 | 98 |
| c. | 100 | 40 | 10 | 50 |
| d. | 120 | 20 | 20 | 99 |
| e. | 650 | 40 | 22 | 100 |
| f. | 60 | 60 | 17 | 85 |
| g. | 45 | 48 | 20 | 80 |
- 3.
A person with normal lungs breathing 100% oxygen
- 4.
Anemia
- 5.
Hypoventilation
- 6.
Carbon monoxide poisoning
- 7.
Severe chronic bronchitis
- 8.
Normal
- 9.
Hyperventilation
- 10.
Flow resistance across a set of airways is lowest under the following conditions:
- a.
Airway radius is large, airways are in series, gas is of low viscosity
- b.
Airway radius is large, airways are in parallel, gas is of high viscosity
- c.
Airway radius is small, airways are in series, gas is of low viscosity
- d.
Airway radius is small, airways are in parallel, gas is of high viscosity
- e.
Airway radius is large, airways are in parallel, gas is of low viscosity
- a.
- 11.
The airways most responsible for the resistance of the respiratory system during nasal breathing are:
- a.
The nose to the larynx
- b.
The trachea to segmental bronchi
- c.
The subsegmental airways
- d.
The terminal bronchioles
- e.
The alveoli and alveolar ducts
- a.
- 12.
Which of the following factors does not contribute to lung resistance?
- a.
Lung volume
- b.
Number and length of conducting airways
- c.
Airway smooth muscle tone
- d.
Elastic recoil
- e.
Static lung compliance
- a.
- 13.
Expiratory flow limitation occurs when:
- a.
Pleural (intrathoracic) pressure exceeds elastic recoil pressure
- b.
The pressure outside an airway is greater than the pressure inside the airway
- c.
Dynamic lung compliance is greater than static lung compliance
- d.
Lung volume is increased
- e.
Expiratory flow rates are high
- a.
- 14.
A person’s respiratory rate at rest is determined by:
- a.
The compliance and resistance of their respiratory system
- b.
The minimal oxygen cost of breathing
- c.
The metabolic demands of the body
- d.
The work of breathing
- e.
All of the above
- a.
- 15.
Which of the following statements about the measurement of lung volumes is correct?
- a.
FRC by helium dilution technique is the same as FRC measured by body plethysmography in individuals with obstructive and restrictive pulmonary disease.
- b.
TLC is determined by inspiratory muscle strength and lung elastic recoil.
- c.
The FVC is greater than the SVC in individuals with obstructive pulmonary disease.
- d.
The functional residual capacity is increased in individuals with muscle weakness.
- e.
One of the hallmarks of obstructive lung disease is an RV/TLC ratio less than 25%.
- a.
- 16.
Which of the following pulmonary function test results best describes an individual with moderate chronic bronchitis?
- a.
Normal vital capacity, normal FEV 1 , normal FEV 1 /FVC, reduced expiratory flow rates, decreased D lco
- b.
Normal vital capacity, reduced FEV 1 , decreased FEV 1 /FVC, reduced expiratory flow rates, decreased D lco
- c.
Normal vital capacity, normal FEV 1 , normal FEV 1 /FVC, reduced expiratory flow rates, normal D lco
- d.
Normal vital capacity, reduced FEV 1 , decreased FEV 1 /FVC, reduced expiratory flow rates, normal D lco
- e.
Reduced vital capacity, reduced FEV 1 , normal FEV 1 /FVC, reduced expiratory flow rates, normal D lco
- a.
- 17.
A 55-year-old woman, a former smoker, complains of shortness of breath. She has an FVC of 2.4 L and an SVC of 2.9 L. These findings suggest:
- a.
Restrictive lung disease
- b.
Obstructive lung disease
- c.
Muscle weakness
- d.
Anemia
- e.
Upper airway obstruction
- a.
- 18.
Pulmonary function tests (spirometry and lung volumes) might be indicated in all of the following except:
- a.
Smokers older than 20 years of age
- b.
Evaluation of the severity of pulmonary hypertension
- c.
Assessment of the risk of lung resection
- d.
Congestive heart failure
- e.
Children with asthma
- a.
- 19.
Factors affecting normal values for pulmonary function tests include all except:
- a.
Age
- b.
Sex
- c.
Ethnicity
- d.
Barometric pressure
- e.
Height
- a.
- 20.
Which of the following statements about the effort-independent part of the expiratory flow volume curve is correct?
- a.
It occurs in the first 20% of the expiratory maneuver.
- b.
It depends on expiratory muscle force.
- c.
It is a measure of small airway function.
- d.
Abnormalities are indicative of severe airway obstruction.
- e.
Abnormalities occur early in restrictive lung disease.
- a.
- 21.
The D lco is frequently abnormal in all except which of the following conditions?
- a.
Lung resection
- b.
Chemotherapy-induced pulmonary toxicity
- c.
Pulmonary hypertension
- d.
Multiple pulmonary emboli
- e.
Idiopathic pulmonary fibrosis
- a.
- 22.
A 40-year-old mountain climber has the following blood gas values at sea level (760 mm Hg): Pa o 2 = 96 torr, Pa co 2 = 40 torr, pH = 7.40, and F io 2 = 0.21. He climbs to the top of Pike’s Peak (barometric pressure, 445 mm Hg). What is his P ao 2 at the top of Pike’s Peak (assume that his Pa co 2 and R are unchanged)?
- a.
25 mm Hg
- b.
34 mm Hg
- c.
44 mm Hg
- d.
55 mm Hg
- e.
60 mm Hg
- a.
- 23.
An increase in dead space ventilation without a change in tidal volume will result in:
- a.
An increase in alveolar P co 2 without significant change in alveolar P o 2
- b.
An increase in alveolar P co 2 with a decrease in alveolar P o 2
- c.
A decrease in alveolar P co 2 without significant change in alveolar P o 2
- d.
A decrease in alveolar P co 2 without significant change in alveolar P o 2
- e.
No change in alveolar P co 2 or alveolar P o 2
- a.
- 24.
The inspired oxygen tension at the level of the trachea when an individual is at the summit of Mt. Everest (barometric pressure, 250 torr) is:
- a.
25 mm Hg
- b.
43 mm Hg
- c.
62 mm Hg
- d.
75 mm Hg
- e.
100 mm Hg
- a.
- 25.
Anatomic dead space is determined by:
- a.
The size and number of the airways
- b.
The number of alveoli that are ventilated but not perfused
- c.
The mechanical properties of the chest and chest muscles
- d.
The characteristics of inspired gas
- e.
Physiologic dead space
- a.
- 26.
If the alveolar ventilation is 4 L/min and the CO 2 production is 200 mL/min, what is the P aco 2 (assume barometric pressure is 760 torr)?
- a.
31 torr
- b.
36 torr
- c.
38 torr
- d.
50 torr
- e.
55 torr
- a.
- 27.
How many milliliters of O 2 does 100 mL of blood contain at a Pa o 2 of 40 mm Hg?
- a.
4 mL
- b.
6 mL
- c.
8 mL
- d.
10 mL
- e.
12 mL
- a.
- 28.
A patient has a hemoglobin level of 10 g/100 mL of blood. What is his O 2 -carrying capacity?
- a.
10 mL O 2 /100 mL blood
- b.
13 mL O 2 /100 mL blood
- c.
15 mL O 2 /100 mL blood
- d.
20 mL O 2 /100 mL blood
- e.
25 mL O 2 /100 mL blood
- a.
- 29.
If the arterial–venous difference is 5 mL O 2 /100 mL blood in the preceding question, what is the O 2 content of the venous blood?
- a.
5 mL O 2 /100 mL blood
- b.
8 mL O 2 /100 mL blood
- c.
10 mL O 2 /100 mL blood
- d.
15 mL O 2 /100 mL blood
- e.
18 mL O 2 /100 mL blood
- a.
- 30.
A sample of blood has a Po 2 of 100 mm Hg and is 98% saturated. The hemoglobin is 15 g/100 mL. The O 2 content of this blood is:
- a.
10 mL/100 mL blood
- b.
15 mL/100 mL blood
- c.
20 mL/100 mL blood
- d.
23 mL/100 mL blood
- e.
25 mL/100 mL blood
- a.
- 31.
Investigators are studying a recently discovered gas. This gas has a high solubility in the alveolar–capillary membrane and a low solubility in the plasma. It does not appear to bind chemically to blood. Which of the following statements is true about this gas?
- a.
The amount of gas absorbed into the blood is inversely proportional to the partial pressure gradient across the alveolar–capillary membrane.
- b.
Diffusion across the capillary–tissue interface will be greater than diffusion across the alveolar–capillary interface.
- c.
Diffusion will be directly related to the thickness of the membrane.
- d.
The higher the molecular weight, the greater the diffusion.
- e.
Diffusion will be perfusion-limited.
- a.
- 32.
Which of the following factors is associated with enhanced O 2 release to the tissues?
- a.
Decreased temperature
- b.
Increased P co 2
- c.
Decreased 2,3-DPG
- d.
Increased pH
- e.
Tissue bicarbonate levels
- a.
- 33.
What of the following statements about the Bohr effect is correct?
- a.
It is primarily due to the effect of CO 2 on pH and on hemoglobin.
- b.
It shifts the oxyhemoglobin dissociation curve to the left in the tissues.
- c.
It enhances CO 2 uptake from the tissues and CO 2 unloading in the lung.
- d.
It increases the levels of 2,3-DPG in red blood cells.
- e.
It is related to chloride exchange processes in the red blood cell.
- a.
34–37. Match the blood gas values in a to e with the acid–base disorders shown in 34 to 37.
| pH | HCO 3 − | Pa co 2 | |
|---|---|---|---|
| a. | 7.23 | 10 | 25 |
| b. | 7.34 | 26 | 50 |
| c. | 7.37 | 28 | 50 |
| d. | 7.46 | 30 | 44 |
| e. | 7.66 | 22 | 20 |
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