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Pulmonary Jeopardy Wav

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Pulmonary Jeopardy Wav

1. 1. Pulmonary Jeopardy 100 200 300 5000 4000 3000 2000 1000 500 400 100 200 300 5000 4000 3000 2000 1000 500 400 100 200 300 5000 4000 3000 2000 1000 500 400 100 200 300 5000 4000 3000 2000 1000 500 400 100 200 300 5000 4000 3000 2000 1000 500 400 100 200 300 5000 4000 3000 2000 1000 500 400 100 200 300 5000 4000 3000 2000 1000 500 400 Mech Vent Flow Blood Lab Exch Basics 100 200 300 5000 4000 3000 2000 1000 500 400 Misc.
2. 6. <ul><li>IRV </li></ul><ul><li>TV </li></ul><ul><li>FRC </li></ul><ul><li>RV </li></ul>The lung volumes and capacities are measured using spirometry. Which of the following measured values is the sum of two volumes?
3. 22. <ul><ul><li>In a constant temperature system, the pressure of a gas is inversely proportional to the volume </li></ul></ul><ul><ul><li>A. Charles' Law </li></ul></ul><ul><ul><ul><li>B. Boyle's Law </li></ul></ul></ul><ul><ul><ul><li>C. Dalton's Law </li></ul></ul></ul><ul><ul><ul><li>D. Henry's Law </li></ul></ul></ul><ul><ul><ul><li>E. O'Leary's Law </li></ul></ul></ul>
4. 23. <ul><ul><li>What is the partial pressure of oxygen in the atmosphere at sea level (barometric pressure = 760 mm Hg) </li></ul></ul><ul><ul><li>A. 600 mm Hg </li></ul></ul><ul><ul><li>B. 160 mm Hg </li></ul></ul><ul><ul><li>C. 0.3 mm Hg </li></ul></ul><ul><ul><li>D. 47 mm Hg </li></ul></ul><ul><ul><li>E. 0.0 mm Hg </li></ul></ul>
5. 24. <ul><ul><li>The volume of air that can be forcible exhaled after a normal expiration is the </li></ul></ul><ul><ul><li>A. extra volume </li></ul></ul><ul><ul><li>B. expiratory reserve volume </li></ul></ul><ul><ul><li>C. expiratory capacity </li></ul></ul><ul><ul><li>D. expiratory super volume </li></ul></ul><ul><ul><li>E. inspiratory-expiratory volume </li></ul></ul>
6. 25. <ul><ul><li>During expiration, as the diaphragm relaxes the pressure in the alveolus becomes? </li></ul></ul><ul><ul><li>A. more positive </li></ul></ul><ul><ul><li>B. less positive </li></ul></ul><ul><ul><li>C. more negative </li></ul></ul><ul><ul><li>D. equal to intrapleural pressure </li></ul></ul><ul><ul><li>E. subatmospheric </li></ul></ul>
7. 26. <ul><ul><li>In an individual suffering from pulmonary fibrosis, the work of breathing is increased due to: </li></ul></ul><ul><ul><li>A. an increase in surface tension. </li></ul></ul><ul><ul><li>B. a decrease in lung compliance. </li></ul></ul><ul><ul><li>C. an increase in airway resistance. </li></ul></ul><ul><ul><li>D. an increase in chest wall compliance. </li></ul></ul><ul><ul><li>E. an increase in diaphragm stiffness. </li></ul></ul>
8. 27. <ul><ul><li>Which of the following results in a shift of the O 2 dissociation curve to the left? </li></ul></ul><ul><ul><ul><li>A. a decrease in pH. </li></ul></ul></ul><ul><ul><ul><li>B. an increase in arterial PCO 2 . </li></ul></ul></ul><ul><ul><ul><li>C. a rise in temperature. </li></ul></ul></ul><ul><ul><ul><li>D. exercise. </li></ul></ul></ul><ul><ul><ul><li>E. an increased pH. </li></ul></ul></ul>
9. 28. <ul><ul><li>In a lung unit with an abnormally low ventilation/perfusion ratio, it can be said that the: </li></ul></ul><ul><ul><li>A. amount of perfusion exceeds the amount of ventilation. </li></ul></ul><ul><ul><li>B. amount of ventilation exceeds the amount of perfusion. </li></ul></ul><ul><ul><li>C. blood emerging from the unit has a reduced PCO 2 . </li></ul></ul><ul><ul><li>D. anatomic dead space has decreased. </li></ul></ul><ul><ul><li>E. physiological dead space has decreased. </li></ul></ul>
10. 29. <ul><ul><li>A patient is having difficulty breathing. A spirometric evaluation reveals a FVC that is 50% of predicted, a FEV 1.0 that is 55% of predicted, and a normal FEV 1.0 /FVC ratio. These observations suggest that the patient has: </li></ul></ul><ul><ul><li>A. an obstructive impairment. </li></ul></ul><ul><ul><li>B. a restrictive impairment. </li></ul></ul><ul><ul><li>C. both an obstructive and a restrictive impairment. </li></ul></ul><ul><ul><li>D. a diffusive impairment. </li></ul></ul><ul><ul><li>E. both an obstructive and a diffusive impairment. </li></ul></ul>
11. 30. <ul><ul><li>FRC is increased in individuals with emphysema, because: </li></ul></ul><ul><ul><ul><li>A. the decreased compliance of the chest wall keeps the lungs at a higher volume. </li></ul></ul></ul><ul><ul><ul><li>B. the increased compliance of the lungs allows the chest wall to move closer to its resting position. </li></ul></ul></ul><ul><ul><ul><li>C. the decrease in airway resistance limits the volume of air that can be exhaled during quiet breathing. </li></ul></ul></ul><ul><ul><ul><li>D. the patient breathes at a higher lung volume to overcome the diffusion limitation produced by the disease. </li></ul></ul></ul><ul><ul><ul><li>E. hypoxic stimulation of the peripheral chemoreceptors results in a reflex-mediated increase in FRC. </li></ul></ul></ul>
12. 31. <ul><ul><li>At end-inspiration, with an open glottis, the alveolar pressure is: </li></ul></ul><ul><ul><li>A. less than atmospheric pressure. </li></ul></ul><ul><ul><li>B. less than pleural pressure. </li></ul></ul><ul><ul><li>C. equal to pleural pressure. </li></ul></ul><ul><ul><li>D. equal to atmospheric pressure. </li></ul></ul><ul><ul><li>E. greater than atmospheric pressure . </li></ul></ul>
13. 32. <ul><ul><li>Residual volume is the lung volume at which the: </li></ul></ul><ul><ul><ul><li>A. tendency for the lung to recoil inward is exactly balanced by the tendency for the chest wall to recoil outward. </li></ul></ul></ul><ul><ul><ul><li>B. respiratory musculature can cause no further movement of the chest wall inward. </li></ul></ul></ul><ul><ul><ul><li>C. lungs contain their &quot;absolute&quot; volume. </li></ul></ul></ul><ul><ul><ul><li>D. only remaining air in the lung is that contained in the anatomic dead space. </li></ul></ul></ul><ul><ul><ul><li>E. chest wall is at its &quot;resting position&quot;. </li></ul></ul></ul>
14. 33. <ul><ul><li>The expiratory reserve volume (ERV) is defined as the: </li></ul></ul><ul><ul><ul><li>A. volume of gas that can be exhaled after a maximal inspiration. </li></ul></ul></ul><ul><ul><ul><li>B. volume of gas that can be maximally exhaled from functional residual capacity. </li></ul></ul></ul><ul><ul><ul><li>C. volume of gas in the lungs after a maximal inspiration. </li></ul></ul></ul><ul><ul><ul><li>D. volume of gas in a single inspiration or expiration. </li></ul></ul></ul><ul><ul><ul><li>E. volume of hot air released during a single lecture. </li></ul></ul></ul>
15. 34. <ul><ul><li>The blood emerging from a lung unit with an abnormally low ventilation/perfusion ratio would have a: </li></ul></ul><ul><ul><ul><li>A. PO 2 greater than 100 mmHg and a PCO 2 lower than 40 mmHg. </li></ul></ul></ul><ul><ul><ul><li>B. PO 2 equaling 100 mmHg and a PCO 2 equaling 40 mmHg. </li></ul></ul></ul><ul><ul><ul><li>C. PO 2 less than 100 mmHg and a PCO 2 greater than 40 mmHg. </li></ul></ul></ul><ul><ul><ul><li>D PO 2 less than 100 mmHg and a PCO 2 less than 40 mmHg. </li></ul></ul></ul><ul><ul><ul><li>E. PO 2 greater than 100 mmHg and a PCO 2 greater than 40 mmHg. </li></ul></ul></ul>
16. 35. <ul><ul><li>In an upright individual, blood flow to the base of the lungs exceeds that to the apex because: </li></ul></ul><ul><ul><ul><li>A. basal blood vessels are intrinsically larger than apical vessels and thus have a reduced resistance to flow. </li></ul></ul></ul><ul><ul><ul><li>B. enhanced sympathetic nerve activity to the basal vessels causes them to preferentially vasodilate. </li></ul></ul></ul><ul><ul><ul><li>C. valves in the pulmonary artery preferentially direct blood to the basal portions of the lungs. </li></ul></ul></ul><ul><ul><ul><li>D. basal blood vessels are intrinsically more compliant than apical vessels. </li></ul></ul></ul><ul><ul><ul><li>E. the hydrostatic pressure gradient distends basal vessels more and thus lowers their resistance to flow. </li></ul></ul></ul>
17. 36. <ul><ul><li>Type II epithelial cells of the lungs produce a chemical called surfactant. The presence of surfactant: </li></ul></ul><ul><ul><ul><li>A. prevents airway resistance from increasing to exceedingly high values. </li></ul></ul></ul><ul><ul><ul><li>B. decreases the muscular effort required to ventilate the lungs. </li></ul></ul></ul><ul><ul><ul><li>C. is responsible for the infant respiratory distress syndrome. </li></ul></ul></ul><ul><ul><ul><li>D. is responsible for the fluid in prenatal lungs. </li></ul></ul></ul><ul><ul><ul><li>E. causes small alveoli to empty into large alveoli. </li></ul></ul></ul>
18. 38. <ul><ul><li>The stimulus for hypoxic pulmonary vasoconstriction is: </li></ul></ul><ul><ul><li>A. venous hypoxemia. </li></ul></ul><ul><ul><li>B. arterial hypoxemia. </li></ul></ul><ul><ul><li>C. cerebral hypoxia. </li></ul></ul><ul><ul><li>D. alveolar hypoxia. </li></ul></ul><ul><ul><li>E. tissue hypoxia. </li></ul></ul>
19. 39. <ul><ul><li>Airway resistance may be decreased by: </li></ul></ul><ul><ul><li>A. deflating the lung. </li></ul></ul><ul><ul><li>B. parasympathetic stimulation. </li></ul></ul><ul><ul><li>C. sympathetic stimulation. </li></ul></ul><ul><ul><li>D. being in a room full of smokers. </li></ul></ul><ul><ul><li>E. Inhaling a marble </li></ul></ul>
20. 40. <ul><ul><li>At zero gravity, blood flow: </li></ul></ul><ul><ul><ul><li>A. to the base of the lung should exceed that to the apex. </li></ul></ul></ul><ul><ul><ul><li>B. throughout the lung should be homogeneously distributed. </li></ul></ul></ul><ul><ul><ul><li>C. in the lung will not differ from that which occurs at normal gravity. </li></ul></ul></ul><ul><ul><ul><li>D to the ventral surface of the lung will exceed that to the dorsal surface. </li></ul></ul></ul><ul><ul><ul><li>E. to the lung would completely stop </li></ul></ul></ul>
21. 41. <ul><ul><li>An individual whose lungs have a large number of lung units with abnormally high ventilation/perfusion ratios would exhibit a/an: </li></ul></ul><ul><ul><ul><li>A. normal arterial PO 2 of 100 mmHg but an abnormally high arterial PCO 2 . </li></ul></ul></ul><ul><ul><ul><li>B. reduced arterial PO 2 . </li></ul></ul></ul><ul><ul><ul><li>C. alveolar PO 2 and PCO 2 approximating those of mixed venous blood. </li></ul></ul></ul><ul><ul><ul><li>D. increase in physiological dead space. </li></ul></ul></ul><ul><ul><ul><li>E. Increase in heavy breathing </li></ul></ul></ul>
22. 42. <ul><ul><li>During inspiration from functional residual capacity, alveoli at the base of the lung expand to a greater degree than alveoli at the apex, because: </li></ul></ul><ul><ul><ul><li>A. alveoli at the base are located on a steeper portion of the compliance curve than those at the apex. </li></ul></ul></ul><ul><ul><ul><li>B. the forces of surface tension prevent adequate expansion of alveoli in the apex. </li></ul></ul></ul><ul><ul><ul><li>C. dynamic compression of the airways prevents alveoli in the apex from adequately expanding. </li></ul></ul></ul><ul><ul><ul><li>D. the accessory muscles of inspiration do not become activated until very high ventilatory volumes are reached. </li></ul></ul></ul>
23. 43. <ul><ul><li>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: </li></ul></ul><ul><ul><li>A. alveolar pressure of the right lung has become negative. </li></ul></ul><ul><ul><li>B. transmural pressure of the right lung was positive. </li></ul></ul><ul><ul><li>C. pleural pressure between the right lung and chest wall was atmospheric. </li></ul></ul><ul><ul><li>D. that the patient stabbed himself. </li></ul></ul>
24. 44. <ul><ul><li>On a normal O 2 dissociation curve and a curve that has been shifted to the right . The rightward shifted curve: </li></ul></ul><ul><ul><ul><li>A. allows more O 2 to be unloaded from the blood for a given fall in PO 2 . </li></ul></ul></ul><ul><ul><ul><li>B. allows less O 2 to be unloaded from the blood for a given fall in PO 2 . </li></ul></ul></ul><ul><ul><ul><li>C. allows a greater degree of oxygen loading of the blood within the lungs. </li></ul></ul></ul><ul><ul><ul><li>D. reduces the amount of oxygen that can be maximally carried by the blood. </li></ul></ul></ul><ul><ul><ul><li>E. may have resulted from a boring lecture. </li></ul></ul></ul>
25. 45. <ul><ul><li>An individual with anemia (blood hemoglobin concentration of 6 g/dl) would have all of the following, EXCEPT : </li></ul></ul><ul><ul><li>A. reduced total arterial oxygen content. </li></ul></ul><ul><ul><li>B. normal arterial dissolved oxygen content. </li></ul></ul><ul><ul><li>C. normal arterial PO 2 . </li></ul></ul><ul><ul><li>D. decreased oxyhemoglobin saturation. </li></ul></ul><ul><ul><li>E. normal oxyhemoglobin saturation . </li></ul></ul>
26. 46. <ul><ul><li>At a given PCO 2 , CO 2 content is greater when there is less O 2 in the blood (Haldane effect), because: </li></ul></ul><ul><ul><ul><li>A. less HCO 3 - is produced, which allows more CO 2 to be carried in solution. </li></ul></ul></ul><ul><ul><ul><li>B. the CO 2 solubility coefficient is increased. </li></ul></ul></ul><ul><ul><ul><li>C. plasma proteins can form more carbamino compounds when PO 2 is reduced. </li></ul></ul></ul><ul><ul><ul><li>D. deoxygenated Hb is a better buffer of H + ions. </li></ul></ul></ul>
27. 47. 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
28. 48. Alveolar pressure of oxygen at sea level is approximately A. 21 mmHg B. 45 mmHg C. 40 mmHg D. 100 mmHg
29. 49. <ul><li>Pulmonary vascular resistance </li></ul><ul><li>A. Falls when left atrial pressure increases </li></ul><ul><li>Is maximum near the functional residual </li></ul><ul><li>capacity </li></ul><ul><li>C. Is very low during the fetal life </li></ul><ul><li>D. Is decreased on sympathetic stimulation </li></ul>
30. 50. 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. PO 2 Lower Higher E. PCO 2 Higher Lower
31. 51. 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
32. 52. Transfer of CO into the blood is “diffusion limited” because A. Partial pressure of CO rises very high in the blood as it flows along the pulmonary capillary B. CO chemically combines with Hb at a very high rate, keeping the pressure gradient at a high level C. CO transports is not dependent on thickness of alveolar-capillary membrane D. CO transport is limited by the amount of blood flowing through pulmonary capillaries
33. 53. Which of the following has the greatest effect on the ability of blood to transport oxygen A. Capacity of the blood to dissolve oxygen B. pH of plasma C. CO 2 content of red blood cells D. Amount of hemoglobin in the blood E. Temperature of the blood
34. 54. What is the difference in the arterial oxygen content of an individual who is breathing room air versus breathing 100%oxygen A. Zero B. About 1.8ml C. About 5.4ml D. 10.2ml
35. 55. The affinity of hemoglobin for oxygen is decreased by all of the following EXCEPT A. Increased hydrogen ion concentration B. Increased temperature C. Exercise D. Increased 2,3 DPG E. Decreased temperature
36. 56. How is CO2 transported ? A A small portion of CO 2 (5%) is transported in the dissolved state to the lungs. B The dissolved CO 2 reacts with water to form carbonic acid. C Formation of carbamino compounds with plasma proteins and hemoglobin. D All of the above E None of the above
37. 57. BOYLES law states A. In a constant temperature system, pressure is inversely proportional to volume. B. In a constant volume system, pressure is directly proportional to the temperature. C. In a constant temperature system, pressure is directly proportional to volume. D. In a constant volume system, pressure is inversely proportional to the temperature.
38. 58. On the the summit of Mt. Everest, where the barometric pressure is about 247mmHg, the partial pressure of inspired oxygen is about? A. 1 mm Hg B. 8 mm Hg C. 42 mm Hg D. 100 mm Hg
39. 59. The volume of air that could enter the lung after a normal inspiration is the A. Tidal volume B. Expiratory reserve volume C. Residual volume D. Inspiratory reserve volume E. Dead space volume
40. 60. During inspiration, as the diaphragm contracts, the pressure in the pleural space becomes? A. Equal to zero B. More positive C. More negative D. Equal to the pressure in the alveoli E. Equal to the pressure in the atmosphere
41. 61. When a pneumothorax is induced, the chest wall__________ and the lungs____ A. Collapses in, Expands out B. Expands out, Collapses in C. Both Remain where they were D. Both collapse in
42. 62. <ul><li>A lack of normal surfactant results in? </li></ul><ul><li>A. An increased lung compliance </li></ul><ul><li>B. Stabilization of alveolar volume </li></ul><ul><li>C. An increased retractive force of the lungs </li></ul><ul><li>A reduced alveolar-arterial oxygen tension </li></ul><ul><li>difference </li></ul><ul><li>E. A decrease in the filtration forces in the pulmonary capillary </li></ul>
43. 63. During the effort independent region of a forced expiration, flow is limited by? A. Contraction of expiratory muscles B. Inertia of chest wall C. Transmural pressure becomes zero D. Increased airway compliance E. Transmural pressure becomes positive
44. 64. A patient is being artificially ventilated during surgery at a rate of 20 breaths/min and a tidal volume of 250ml/breath. Assuming a normal anatomical dead space of 150ml, the alveolar ventilation in this patient is A. 1000ml/min B. 2000ml/min C. 3000ml/min D. 4000ml/min E. 5000ml/min
45. 65. In which of the following conditions is alveolar PO 2 increased and alveolar PCO 2 decreased A.Breathing air with low PO 2 B.Increased alveolar ventilation and unchanged metabolism C.Decreased alveolar ventilation and unchanged metabolism D.Increased metabolism and unchanged alveolar ventilation E.Proportional increase in metabolism and alveolar ventilation
46. 66. In the upright position, ventilation per unit lung volume is greater at the base of the lung than at the apex because the base of the lung A. Has more negative intrapleural pressure than the apex at the start of inspiration B. Is less expanded than the the apex C. Has lower compliance than the apex D. Has more intrapulmonary-intrapleural pressure difference than the apex at the start of inspiration
47. 67. BOYLES law states A. In a constant temperature system, pressure is inversely proportional to volume. B. In a constant volume system, pressure is directly proportional to the temperature. C. In a constant temperature system, pressure is directly proportional to volume. D. In a constant volume system, pressure is inversely proportional to the temperature.
48. 109. Daily Double
49. 110. Daily Double
50. 111. Daily Double
51. 112. Final Jeopardy
52. 113. With a typical resting oxygen consumption of 250ml/min, what must Cardiac output be for survival, if the blood had no hemoglobin??
53. 114. V02 = CO X a-v02 250ml/min = CO X 0.3 ml02/dl blood 250ml/min 3ml/L = 83L/min
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