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RESP 1330: O2 and CO2 Transport

Total questions: 50

Worksheet time: 50mins

Name
Class
Date
1.

If a patient is hypervolemic, which hemodynamic parameter would be most affected?

a)

CVP

b)

PCWP

c)

RAP

d)

PAP

2.

What volume or capacity describes the amount of air left in the lungs after a normal tidal volume exhalation?

a)

Vital Capacity (VC)

b)

Functional Residual Capacity (FRC)

c)

Residual Volume (RV)

d)

Expiratory Reserve Volume (ERV)

3.

What volume or capacity describes how much air can breathed in after a tidal volume inhalation?

a)

IRV

b)

IC

c)

TLC

d)

VC

4.

Which capacity includes all of the following:

IRV

Vt

ERV

a)

TLC

b)

VC

c)

IC

d)

FRC

5.

Which of the following are terms for HbO2?

I. Oxygenated Hb

  1. 2. Combined Hb

  2. 3. Carboxyhemoglobin

  3. 4. Oxyhemoglobin

  4. 5. Oxyclean

a)

1 and 2

b)

1, 2, 3, and 4

c)

3 and 5

d)

I, 2, and 4

6.

Which of the following are terms for deoxygenated Hb

I. Reduced

  1. 2. Conjoined Hb

  2. 3. Uncombined Hb

  3. 4. Heme Alone

  4. 5. Deescalated Hb

a)

1 and 3

b)

1, 2, 3, and 5

c)

3 and 5

d)

I, 2, and 4

7.

What is the formula for CaO2

a)

(Hb × 1.34 × SaO2) + (PaO2 × 0.003)

b)

(Hb × 1.34) + (PcO2 x 0.003)

c)

(Hb x 1.34 x ScO2) + (PAO2 x 0.003)

d)

(PB - PH2O)FiO2 - (PaCO2/0.8)

8.

What is the formula for CcO2

a)

(Hb × 1.34 × SaO2) + (PaO2 × 0.003)

b)

(Hb × 1.34) + (PcO2 x 0.003)

c)

(Hb x 1.34 x ScO2) + (PAO2 x 0.003)

d)

(PB - PH2O)FiO2 - (PaCO2/0.8)

9.

Which axis of the oxyhemoglobin dissociation curve shows the percentage of Hb that's bound to O2?

a)

left, or y-axis

b)

bottom, or x-axis

c)

the "sometimes" option on the right side

10.

Which axis of the oxyhemoglobin dissociation curve shows the oxygen pressure, or PO2?

a)

left, or y-axis

b)

bottom, or x-axis

c)

the "sometimes" option on the right side

11.

Which axis of the oxyhemoglobin dissociation curve shows the oxygen content?

a)

left, or y-axis

b)

bottom, or x-axis

c)

the "sometimes" option on the right side

12.

How many O2 molecules can Hb hold?

a)

5 g%

b)

4

c)

15

d)

35-45

13.

How many g% does Hb have to be reduced for a patient to appear cyanotic?

a)

5

b)

4

c)

15

d)

33

14.

If I were to administer supplemental oxygen to a patient and moved their PaO2 from 85 to 100, what kind of change would I expect to see in their Hb/oxygen saturation?

a)

almost none

b)

significant change

c)

moderate change

d)

a change of around 30

15.

Which part of the oxyhemoglobin dissociation curve represents a "safety zone" for loading and unloading oxygen?

a)

steep portion

b)

flat portion

c)

the s-shaped portion

16.

PO2 below 60 will cause a rapid decrease in the amount of oxygen bound to hemoglobin. This means that Oxygen delivery to tissues will

a)

be enhanced

b)

be decreased

c)

stop until the PO2 increased to at least 60 again

d)

be fine - this occurs in the safety zone

17.

Assuming that your patient has a normal Hb and a normal breathing pattern, estimate the patient's saturation if PaO2 is 55

a)

65

b)

75

c)

85

d)

95

18.

When the oxyhemoglobin dissociation curve shifts to the left, how does Hb behave?

  1. 1. Readily picks up O2

  2. 2. Resists picking up O2

  3. 3. Is quick to release O2 to tissues

  4. 4. resists releasing O2 to tissues

a)

1 and 4

b)

2 and 3

c)

2 and 4

d)

1 and 3

19.

When the oxyhemoglobin dissociation curve shifts to the right, how does Hb behave?

  1. 1. Readily picks up O2

  2. 2. Resists picking up O2

  3. 3. Is quick to release O2 to tissues

  4. 4. resists releasing O2 to tissues

a)

1 and 4

b)

2 and 3

c)

2 and 4

d)

1 and 3

20.

Which of the following would shift the oxyhemoglobin dissociation curve to the right?

  1. 1. decreased PCO2

  2. 2. decreased 2-3 BPG

  3. 3. decreased pH

  4. 4. increased temp

a)

3 and 4

b)

2 and 3

c)

1 and 4

d)

1 and 2

21.

Which of the following would shift the oxyhemoglobin dissociation curve to the left?

  1. 1. decreased PCO2

  2. 2. decreased 2-3 BPG

  3. 3. decreased pH

  4. 4. increased temp

a)

3 and 4

b)

2 and 3

c)

1 and 4

d)

1 and 2

22.

Which of the following would shift the oxyhemoglobin dissociation curve to the right?

  1. 1. increased PCO2

  2. 2. decreased 2-3 BPG

  3. 3. decreased pH

  4. 4. increased temp

a)

2, 3, and 4

b)

2 and 3

c)

1 and 4

d)

1, 3, and 4

23.

Which of the following would shift the oxyhemoglobin dissociation curve to the left?

  1. 1. increased PCO2

  2. 2. decreased 2-3 BPG

  3. 3. increased pH

  4. 4. increased temp

a)

2, 3, and 4

b)

2 and 3

c)

1 and 4

d)

1, 3, and 4

24.

The presence of fetal hemoglobin (HbF) and carboxyhemoglobin (COHb) shift the oxyhemoglobin dissociation curve to the

a)

right

b)

left

25.

You are caring for a patient who is hyperventilating. Your preceptor informs you that their ABG shows a pH of 7.48 and a PaCO2 of 29.

What direction would you expect the O2Hb dissociation curve to shift?

a)

left

b)

right

c)

up

d)

down

26.

Which of the following does NOT impact Total Oxygen Delivery

a)

cardiac size

b)

cardiac output

c)

ability to oxygenate blood

d)

Hb concentration

27.

What is another way of expressing Oxygen consumption?

a)

oxygen uptake

b)

total oxygen delivery

c)

oxygen extraction ratio

d)

shunt percentage

28.

The Oxygen coefficient ratio or the Oxygen utilization ratio is also known as

a)

oxygen uptake

b)

total oxygen delivery

c)

oxygen extraction ratio

d)

shunt percentage

29.

Which of the following increase the VO2 (oxygen consumption)?

a)

exercise, peripheral shunting, hypothermia, shivering

b)

hyperthermia, seizures, exercise, certain poisons

c)

skeletal muscle relaxation, seizures, hypothermia, peripheral shunting

d)

shivering, hyperthermia, seizures, exercise

30.

Which of the following decrease the VO2 (oxygen consumption)?

a)

peripheral shunting, hypothermia, muscle relaxation

b)

hyperthermia, seizures, exercise, certain poisons

c)

skeletal muscle relaxation, seizures, hypothermia, peripheral shunting

d)

shivering, hyperthermia, seizures, exercise

31.

Factors that increase the O2ER (oxygen extraction ratio) are anything that:

a)

increases oxygen consumption and/or decreases delivery

b)

decreases consumption and/or increases delivery

c)

increases oxygen consumption and/or increases delivery

d)

decreases oxygen consumption and/or decreases delivery

32.

Factors that decrease the O2ER (oxygen extraction ratio) are anything that:

a)

increases oxygen consumption and/or decreases delivery

b)

decreases consumption and/or increases delivery

c)

increases oxygen consumption and/or increases delivery

d)

decreases oxygen consumption and/or decreases delivery

33.

What would a low cardiac output and seizures do to the O2ER (oxygen extraction ratio)?

a)

increase

b)

decrease

34.

What would peripheral shunting and hypothermia do to the O2ER (oxygen extraction ratio)

a)

increase

b)

decrease

35.

What would increased hemoglobin and arterial oxygenation combined with skeletal muscle relaxation due to the O2ER (oxygen extraction ratio)?

a)

increase

b)

decrease

36.

You are caring for a short of breath 65 year old patient in the emergency room. The physician wants to determine whether the patient is experiencing absolute or relative shunting. What would you recommend?

a)

Apply Oxygen therapy and evaluate the patient's response

b)

Obtain an arterial blood gas and calculate the PAO2

c)

Obtain a Hb level and calculate shunt percentage

d)

methylene blue and ascorbic acid

37.

You are caring for a patient with an increase COHb. The physician asks for your treatment recommendations. What would you recommend?

a)

a blood transfusion

b)

Obtain an arterial blood gas and calculate the PAO2

c)

100% Oxygen therapy

d)

methylene blue and ascorbic acid

38.

You are caring for a patient with MetHb. The physician asks for your treatment recommendations. What would you recommend?

a)

a blood transfusion

b)

Obtain an arterial blood gas and calculate the PAO2

c)

100% Oxygen therapy

d)

methylene blue and ascorbic acid

39.

Which of the following most closely matches the definition of hypoxemia?

a)

low oxygen tension in arterial blood

b)

insufficient amount of oxygen at the tissue level for normal aerobic metabolism to occur

c)

Total amount of oxygen delivered or transported to peripheral tissues

d)

a comparison of oxygen extracted to oxygen delivered

40.

Which of the following most closely matches the definition of hypoxia?

a)

low oxygen tension in arterial blood

b)

insufficient amount of oxygen at the tissue level for normal aerobic metabolism to occur

c)

Total amount of oxygen delivered or transported to peripheral tissues

d)

a comparison of oxygen extracted to oxygen delivered

41.

Which of the following can be causes of hypoxic hypoxia?

  1. 1. high altitude

  2. 2. fibrosis

  3. 3. anemia

  4. 4. shunting

a)

1 and 2

b)

2 and 3

c)

1 and 4

d)

3 and 4

42.

Which of the following can be causes of hypoxic hypoxia?

  1. 1. cyanide poisoning

  2. 2. pulmonary edema

  3. 3. hypoventilation

  4. 4. slow/stagnant blood flow

a)

1 and 2

b)

2 and 3

c)

1 and 4

d)

3 and 4

43.

Which of the following can be causes of histotoxic hypoxia?

  1. 1. cyanide poisoning

  2. 2. pulmonary edema

  3. 3. hypoventilation

  4. 4. slow/stagnant blood flow

a)

1 only

b)

2 and 3

c)

1 and 4

d)

3 and 4

44.

Which of the following can be causes of circulatory hypoxia?

  1. 1. arterial-venous shunts

  2. 2. pulmonary edema

  3. 3. hypoventilation

  4. 4. slow/stagnant blood flow

a)

1 only

b)

2 and 3

c)

1 and 4

d)

3 and 4

45.

Which of the following can be causes of anemic hypoxia?

  1. 1. COHb

  2. 2. MetHb

  3. 3. hypoventilation

  4. 4. hemorrhage

a)

1 and 2

b)

1, 2 , and 3

c)

1, 2, and 4

d)

3 and 4

46.

Which mechanisms are used to transport CO2 in RBCs?

  1. 1. carbamino compound

  2. 2. bicarbonate

  3. 3. carbamino-Hb

  4. 4. dissolved CO2

a)

all of the above

b)

1, 2, and 3

c)

2, 3, and 4

d)

1 and 3 only

e)

2 and 4 only

47.

What is called when CO2 combines with H2O to form carbonic acid (H2CO3)

a)

hydrolyzing CO2

b)

carbonated water

c)

carboxyhydrogen

d)

carbamino

48.

A cool thing about the hydrolysis reaction is that it can go both directions. When bicarbonate combines with hydrogen, what is formed?

a)

carbonic acid

b)

carbamino compound

c)

hydrolyzed HCO3

49.

What does carbonic acid dissociate into in the lungs?

a)

CO2 and H2O

b)

HCO3 and H

c)

carbon and Hb

50.

Comparing the CO2 dissociation curve and the O2Hb dissociation curve..... which of the following is true

a)

PCO2 changes have a greater effect on CO2 content than PO2 changes have on O2 content

b)

PO2 changes have a greater effect on O2 content than PCO2 changes have on CO2 content

c)

both follow the 40-50-60-/70-80-90 rule

d)

Small changes in caffeine content have a large and positive impact on Adrienne's attitude, unless the safety zone is exceeded