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Egan Ch. 12

Total questions: 35

Worksheet time: 1hrs 10mins

Name
Class
Date
1.

What is the most important component in the O2 transport system?

a)

Dissolved O2 in ml/dl

b)

HCO3–

c)

Hb

d)

PaO2

2.

During normal inspiration, which of the following occurs?

a)

Alveoli at the apexes expand less than those at the bases.

b)

Alveoli at the apexes expand more than those at the bases.

c)

Alveoli at the bases and apexes expand almost equally.

d)

Alveoli at the bases expand less than those at the apexes.

3.

Which condition causes an increase in alveolar dead space?

a)

Absorption atelectasis

b)

Blockage of pulmonary circulation

c)

Increase in anatomic dead space

d)

Pulmonary vasodilation

4.

Calculate the approximate PAO2 given the following conditions (assume R = 0.8): FiO2 = .40, PB = 770 mm Hg, PACO2 = 31 mm Hg

a)

100 mm Hg

b)

135 mm Hg

c)

250 mm Hg

d)

723 mm Hg

5.

What is the approximate normal level of carbon dioxide production (CO2) for an adult?

a)

200 ml/min

b)

250 ml/min

c)

4200 ml/min

d)

2000 ml/min

6.

Which of the following “layers” must be traversed by gases moving across the alveolar-capillary membrane?

1. Alveolar epithelial membrane

2. Capillary endothelial membrane

3. Interstitial space

4. Transbronchial radial tethering mechanisms

a)

1, 2, 3

b)

1, 2, 4

c)

2, 3

d)

All the above

7.

What is the normal range of PAO2 – PaO2 for healthy young adults breathing room air?

a)

5 to 10 mm Hg

b)

10 to 20 mm Hg

c)

20 to 30 mm Hg

d)

50 to 60 mm Hg

8.

The PAO2 depends on which of the following factors?

1. Ambient (atmospheric) pressure

2. Fractional concentration of inspired O2

3. Level of VA

4. Types of fuels burned (fat, protein, and carbohydrate)

a)

1, 2, 3

b)

2, 3, 4

c)

3, 4

d)

all the above

9.

The expected PaO2 for an 80-year-old man who is otherwise in good health and breathing room air is approximately what level?

a)

50 mm Hg

b)

75 mm Hg

c)

80 mm Hg

d)

90 mm Hg

10.

When a Hb molecule accumulates excessive amounts of HCO3–, it is expelled from the cell in exchange for Cl–. What is this called?

a)

Bohr effect

b)

Haldane effect

c)

Hamburger phenomenon

d)

Hydrolysis phenomenon

11.

Which of the following would you expect to find with “O2 debt”?

1. Accentuated in diseases such as sepsis.

2. O2 demand exceeds O2 delivery.

3. O2 excess usage results in debt.

a)

1, 2

b)

2, 3

c)

1, 3

d)

all the above

12.

At body temperature, how much O2 will physically dissolve in plasma at a PO2 of 40 mm Hg?

a)

0.12 ml/dl

b)

0.20 ml/dl

c)

0.30 ml/dl

d)

1.34 g/dl

13.

A patient with a normal PaO2 and cardiac output is exhibiting signs and symptoms of tissue hypoxia. What is the most likely cause?

a)

Hemoglobin deficiency

b)

Low ambient PO2

c)

Right-to-left shunt

d)

Hypoventilation

14.

If the total hemoglobin content (Hb + HbO2) of a sample of blood is 20 g/dl and the oxyhemoglobin (HbO2) content is 15 g/dl, what is the HbO2 saturation?

a)

17%

b)

50%

c)

75%

d)

83%

15.

On what does the movement of gases between the lungs and the body tissues mainly depend?

a)

Active transport

b)

Gaseous diffusion

c)

Membrane dialysis

d)

Membrane transport

16.

A patient has a whole-body O2 consumption of 320 ml/min and a measured CaO2 – CO2 of 8 ml/dl. What is the cardiac output?

a)

3.2 L/min

b)

4.0 L/min

c)

5.0 L/min

d)

7.0 L/min

17.

What is the primary factor that maintains the pressure gradient that drives O2 from the capillaries into the interstitial spaces and into the cells?

a)

Bohr effect on the RBC

b)

Cellular consumption of O2

c)

Haldane effect on the RBC

d)

Increased carbon dioxide in blood decreasing Hb affinity for O2

18.

In a person breathing room air (and with all else being normal), if the alveolar PCO2 rises from 40 to 70 mm Hg, what would you expect?

a)

PAO2 to fall by approximately 30 mm Hg

b)

PAO2 to fall by approximately 40 mm Hg

c)

PAO2 to rise by approximately 30 mm Hg

d)

PAO2 to rise by approximately 40 mm Hg

19.

Which of the following statements is true regarding the Haldane effect?

a)

At high SaO2 levels, carbon dioxide more readily forms carbamino compounds.

b)

At high SaO2 levels, the capacity of blood to hold carbon dioxide decreases.

c)

At high SaO2 levels, the capacity of blood to hold carbon dioxide increases.

d)

At low SaO2 levels, the capacity of blood to hold carbon dioxide decreases.

20.

The oxidation of the Hb molecule’s iron ions to the ferric state (Fe3+) results in which of the following?

1. Form of anemia called sickle cell anemia

2. Formation of methemoglobin (metHb)

3. Inability of metHb to bind with O2

a)

1, 2

b)

1, 3

c)

2, 3

d)

all the above

21.

Which of the following increases the affinity of Hb for O2?

1. Decreased 2,3-DPG

2. Decreased PCO2

3. Increased pH

4. Increased temperature

a)

1, 2, 4

b)

1, 2, 3

c)

2, 4

d)

all the above

22.

Which of the following conditions must exist for gas to move between the alveolus and pulmonary capillary?

a)

Adequate alveolar ventilation (VA)

b)

Normal central nervous system (CNS) control mechanism

c)

Sufficient amount of blood hemoglobin (Hb)

d)

Difference in partial pressures (pressure gradient)

23.

Which of the following equations best describes O2 delivery to the tissues?

a)

Arterial O2 content ÷ cardiac output

b)

Arterial O2 content X cardiac output

c)

Cardiac output + arterial O2 content

d)

Cardiac output X vascular resistance

24.

The lowest PO2 would normally be found in what location?

a)

Arterial blood

b)

Atmospheric air

c)

Cells

d)

Venous blood

25.

An abnormal metabolic state in which the tissues are unable to utilize the O2 made available to them best describes which of the following?

a)

Diffusion hypoxia

b)

Dysoxia

c)

Hemic hypoxia

d)

Physiologic shunt

26.

What is the highest PAO2 one could expect to observe in an individual breathing room air at sea level?

a)

90 to 100 mm Hg

b)

110 to 120 mm Hg

c)

640 to 670 mm Hg

d)

710 to 760 mm Hg

27.

In which of the following conditions will erythrocyte concentration of 2,3-DPG be decreased?

a)

Anemia

b)

Banked blood

c)

High pH

d)

Hypoxemia

28.

Which of the following would you expect to occur if ventilation to an area of the lung remained constant but perfusion to this same area decreased?

1. The PACO2 should fall.

2. The PAO2 should fall.

3. The ratio should rise.

a)

3

b)

1, 2

c)

1, 3

d)

all the above

29.

Which of the following values corresponds most closely to the normal PO2 and PCO2 in the mixed venous blood returning to the lungs from the right side of the heart?

a)

PO2 = 40 mm Hg; PCO2 = 46 mm Hg

b)

PO2 = 40 mm Hg; PCO2 = 100 mm Hg

c)

PO2 = 100 mm Hg; PCO2 = 40 mm Hg

d)

PO2 = 100 mm Hg; PCO2 = 46 mm Hg

30.

When using therapeutic agents that can cause methemoglobinemia (methHb), which of the following is important to prevent adverse effects?

a)

Checking the frequency of ventilation

b)

Frequent monitoring for methHb to weigh the risk against the benefit

c)

Occasional monitoring for sickle cell anemia

d)

Frequent monitoring for abnormal body temperature (high or low)

31.

According to the Fick principle, if O2 consumption remains constant, an increase in cardiac output will manifest itself as which of the following?

a)

Decrease in the CaO2 – CO2.

b)

Increase in the CaO2.

c)

Increase in the CaO2 – CO2.

d)

Decrease in the CO2.

32.

What is the effect of an elevated intracellular 2,3-DPG concentration?

a)

Decreases the availability of O2 to the tissues.

b)

Increases the affinity of Hb for O2.

c)

Increases the availability of O2 to the tissues.

d)

Shifts the HbO2 dissociation curve to the left.

33.

What role does the Bohr effect play in O2 transport?

a)

Describes the effect of varying enzyme levels on Hb and O2 affinity.

b)

Diminishes tissue oxygenation due to electrolyte imbalances.

c)

Enhances O2 delivery to tissues and O2 pickup at lungs.

d)

Explains the effect that O2 levels have on carbon dioxide transport.

34.

A patient has a P50 value of 29 mm Hg. What does this indicate?

a)

Decreased affinity of Hb for O2

b)

Higher than normal Hb saturation for a given PO2

c)

Increased affinity of Hb for O2

d)

Normal position in the HbO2

35.

Regarding pulmonary blood flow in the upright lung, which of the following statements is true?

a)

The apexes receive approximately 20 times more blood flow than the bases.

b)

The bases receive approximately 20 times more blood flow than the apexes.

c)

The greatest blood flow is found at the apexes of the lungs.

d)

The pulmonary circulation is a high-pressure system.