2025 APRIL SUMMATIVE EXAMS edited

Zone 1 of the lung states that

• occurs in the most gravity dependent part of the lung

• pulmonary artery pressure exceed pulmonary venous pressure

• there is perfusion in the absence of ventilation

• pulmonary capillaries are distended

Which statement describes ventilation-perfusion relationship

• blood flow is independent of gravity

• ideal V/Q ratio is 1 and occurs at the level of the 3rd rib

• Dead Space has low ventilation relative to blood flow

• Absolute shunt has low blood flow relative to ventilation

During induction of a Pediatric patient under general anesthesia, the consultant in charge cuts and shortens the length of the endotracheal tube. Which of the following statement could be the consultant's basis.

• affects CO2 elimination

• increase oxygenation

• hastens speed of induction

• facilitates emergence

The following patient condition/s will markedly decrease pulmonary function and would likewise result in post operative pulmonary complications.

• any chronic disease

• 5 pack years smoking hx

• Chest wall and spinal deformity

• Patients living in high altitude

The following will depress ventilation

• cold local anesthetic applied at medullary surface

• Inhaled anesthetics

• opioid

• all of the above

Physiologic dead space arises from ventilation of structure with inadequate or no exchange of respiratory gases. This statement is true regarding physiologic dead space

• ratio of alveolar to dead space ventilation is 1:2

• 3ml/kg anatomic dead space

• rapid changes in physiologic dead space occurs from changes in minute ventilation

• An abrupt decrease in Cardiac output will increase physiologic dead space

The following statement/s is/are true of lung volume and capacities

• Tidal Volume - gas that moves in and out of lungs during quiet breathing (6-8ml/kg)

• Vital Capacity - correlates well with capability of deep breathing and effective coughing. (100ml/Kg)

• Inspiratory Capacity - largest volume of gas that can be inspired from resting expiratory level and is frequently increased in significant extrathoracic obstruction

• ERV - provides significant diagnostic value

The following are lung changes associated with aging.

• A. constriction of alveoli

• B. Enlargement of air spaces

• C. Increase in exchange surface area

• D. Increase  lung recoil

The lung segment/lobe that has the highest probability of aspiration

• Right upper lobe

• Right middle lobe

• Right lower lobe

• Left upper lobe

Which of the Lung changes associated with Aging will result in blunted ventilatory response?

• Decrease respiratory muscle strength

• Decrease sensitivity to hypoxemia and hypercapnia

• Decrease compliance of chest wall, thereby increasing work of breathing

• Decrease lung recoil