Multiple-Choice Examination







  • 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



  • 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




  • 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



  • 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



  • 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



  • 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



  • 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



  • 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%.



  • 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



  • 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



  • 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



  • 19.

    Factors affecting normal values for pulmonary function tests include all except:



    • a.

      Age


    • b.

      Sex


    • c.

      Ethnicity


    • d.

      Barometric pressure


    • e.

      Height



  • 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.



  • 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



  • 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



  • 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



  • 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



  • 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



  • 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



  • 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



  • 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



  • 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



  • 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



  • 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.



  • 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



  • 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.




  • 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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Oct 11, 2019 | Posted by in RESPIRATORY | Comments Off on Multiple-Choice Examination
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