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Respiratory Physiology Worksheet Extraction

Total questions: 80

Worksheet time: 40mins

Name
Class
Date
1.

A 25-year-old medical student participates in a charity run. During heavy exercise, which muscles are used for active expiration?

a)

Diaphragm and external intercostals

b)

Diaphragm and internal intercostals

c)

Internal intercostals and abdominal recti

d)

Scaleni and sternocleidomastoid

2.

A premature infant (28 weeks) develops cyanosis and labored breathing. A deficiency in which substance increases surface tension and causes alveolar collapse?

a)

Albumin

b)

Dipalmitoylphosphatidylcholine

c)

Mucus

d)

Carbonic anhydrase

3.

If the transpulmonary pressure is 5 cm H2O and the lung volume increases by 1.0 liter, what is the lung compliance?

a)

0.1 L/cm H2O

b)

0.2 L/cm H2O

c)

0.5 L/cm H2O

d)

1.0 L/cm H2O

4.

Which pressure is defined as the pressure in the thin space between the lung visceral pleura and the chest wall parietal pleura?

a)

Alveolar pressure

b)

Pleural pressure

c)

Transpulmonary pressure

d)

Transthoracic pressure

5.

In a saline‑filled lung, the compliance is much greater than in an air‑filled lung because:

a)

Saline reduces tissue elasticity

b)

Saline removes the air‑fluid interface/surface tension

c)

Saline increases the secretion of surfactant

d)

Saline decreases the recoil of elastic fibers

6.

A patient with emphysema has high lung compliance. This is primarily due to:

a)

Increased surfactant production

b)

Destruction of alveolar septa and elastic fibers

c)

Increased thickness of the respiratory membrane

d)

Reduced airway resistance

7.

Which muscle is considered the primary muscle of inspiration in a healthy adult at rest?

a)

Internal intercostals

b)

Abdominal recti

c)

Diaphragm

d)

Serratus anterior

8.

During inspiration, the pleural pressure becomes:

a)

More positive

b)

More negative

c)

Equal to atmospheric pressure

d)

Zero

9.

The work of breathing is increased in "Restrictive" lung diseases primarily because of an increase in:

a)

Airway resistance work

b)

Compliance work

c)

Tissue resistance work

d)

Surface tension work

10.

What is the normal value of alveolar pressure during the middle of a quiet expiration?

a)

−1 cm H2O

b)

+1 cm H2O

c)

0 cm H2O

d)

+5 cm H2O

11.

A 22‑year‑old woman has a tidal volume (VT) of 500 mL, a residual volume (RV) of 1200 mL, and an expiratory reserve volume (ERV) of 1100 mL. What is her functional residual capacity (FRC)?

a)

1600 mL

b)

2300 mL

c)

2800 mL

d)

3300 mL

12.

Which of the following lung volumes cannot be measured by a simple spirometer?

a)

Tidal volume

b)

Vital capacity

c)

Functional residual capacity

d)

Inspiratory reserve volume

13.

A patient has a vital capacity of 4.5 L and a total lung capacity of 6.0 L. What is their residual volume?

a)

1.0 L

b)

1.5 L

c)

2.0 L

d)

2.5 L

14.

In an obstructive lung disease like chronic bronchitis, the FEV1/FVC ratio is typically:

a)

>0.85

b)

0.80

c)

<0.70

d)

Normal

15.

A 70‑year‑old man with pulmonary fibrosis has a low FVC but a normal or high FEV1/FVC ratio. This is characteristic of:

a)

Obstructive lung disease

b)

Restrictive lung disease

c)

Normal aging

d)

Asthma

16.

The volume of air that remains in the lungs after a maximal forceful expiration is the:

a)

Functional residual capacity

b)

Residual volume

c)

Expiratory reserve volume

d)

Dead space

17.

If a person has a respiratory rate of 15 breaths/min and a tidal volume of 500 mL, what is their minute respiratory volume?

a)

6.0 L/min

b)

7.5 L/min

c)

5.0 L/min

d)

10.0 L/min

18.

Physiological dead space is equal to anatomical dead space in:

a)

Healthy individuals

b)

Patients with emphysema

c)

Patients with pneumonia

d)

Patients with pulmonary edema

19.

A patient with a tidal volume of 600 mL and a dead space of 150 mL has a breathing frequency of 10/min. The alveolar ventilation rate is:

a)

6000 mL/min

b)

4500 mL/min

c)

7500 mL/min

d)

1500 mL/min

20.

Which capacity is defined as the maximum amount of air a person can expel from the lungs after first filling the lungs to their maximum extent?

a)

Inspiratory capacity

b)

Functional residual capacity

c)

Vital capacity

d)

Total lung capacity

21.

In "Zone 3" of the lung (lower parts), blood flow is continuous because:

a)

Alveolar pressure is always higher than arterial pressure

b)

Arterial and venous pressures remain higher than alveolar pressure

c)

Alveolar pressure is zero

d)

Gravity decreases capillary pressure

22.

Which factor causes the most significant increase in pulmonary arterial pressure during heavy exercise?

a)

Massive increase in left atrial pressure

b)

Large increase in cardiac output

c)

Sympathetic vasoconstriction

d)

Decreased lung compliance

23.

What is the normal mean pulmonary arterial pressure?

a)

10 mmHg

b)

15 mmHg

c)

25 mmHg

d)

5 mmHg

24.

Pulmonary edema is most likely to occur when the pulmonary capillary hydrostatic pressure exceeds:

a)

7 mmHg

b)

15 mmHg

c)

28 mmHg

d)

40 mmHg

25.

A patient with mitral stenosis develops left‑sided heart failure. Which pressure rise is the immediate precursor to pulmonary edema?

a)

Right atrial pressure

b)

Left atrial pressure

c)

Pulmonary vein pressure

d)

Both B and C

26.

The shift of blood from the lungs to the systemic circulation occurs during:

a)

Exercise

b)

Blowing a trumpet (high intrathoracic pressure)

c)

Deep inspiration

d)

Lying down

27.

What is the physiological purpose of "hypoxic pulmonary vasoconstriction"?

a)

To increase overall lung blood flow

b)

To shunt blood away from poorly ventilated alveoli

c)

To increase systemic oxygenation

d)

To prevent pulmonary edema

28.

Pleural effusion (excess fluid in the pleural space) can be caused by:

a)

Blockage of lymphatic drainage

b)

Heart failure

c)

Reduced plasma colloid osmotic pressure

d)

All of the above

29.

The "safety factor" against pulmonary edema is approximately:

a)

5 mmHg

b)

14 mmHg

c)

21 mmHg

d)

30 mmHg

30.

Pulmonary capillaries are unique because they:

a)

Are surrounded by air on all sides

b)

Are very thick to prevent rupture

c)

Only carry deoxygenated blood

d)

Do not allow any filtration

31.

The rate of diffusion of a gas across the respiratory membrane is inversely proportional to:

a)

Surface area of the membrane

b)

Partial pressure gradient

c)

Thickness of the membrane

d)

Solubility of the gas

32.

Why is the diffusion capacity of CO2 much higher than that of O2?

a)

CO2 has a lower molecular weight

b)

CO2 has a much higher solubility coefficient

c)

CO2 has a higher pressure gradient

d)

CO2 binds more strongly to hemoglobin

33.

The partial pressure of oxygen (PO2) in humidified tracheal air (at 37°C) is approximately:

a)

159 mmHg

b)

149 mmHg

c)

104 mmHg

d)

40 mmHg

34.

The average PO2 of blood entering the pulmonary capillaries (venous blood) is:

a)

100 mmHg

b)

40 mmHg

c)

46 mmHg

d)

95 mmHg

35.

Which of the following makes up the "respiratory membrane"?

a)

Alveolar epithelium and capillary endothelium

b)

Surfactant layer

c)

Interstitial space

d)

All of the above

36.

During exercise, the diffusion capacity for O2 increases because:

a)

Capillaries dilate and previously dormant capillaries open

b)

The respiratory membrane becomes thinner

c)

Hemoglobin concentration increases

d)

The heart rate decreases

37.

The partial pressure of CO2 in the alveoli is primarily determined by:

a)

Rate of CO2 excretion and rate of alveolar ventilation

b)

Atmospheric PCO2

c)

Thickness of the membrane

d)

Solubility of CO2

38.

Alveolar PO2 is usually 104 mmHg. Why is systemic arterial PO2 only about 95 mmHg?

a)

Diffusion is incomplete

b)

Shunt blood (bronchial circulation) mixes with oxygenated blood

c)

O2 is consumed by the capillary endothelium

d)

Errors in measurement

39.

In a person standing upright, the ventilation‑perfusion (V/Q) ratio is highest at the:

a)

Base of the lung

b)

Apex of the lung

c)

Middle of the lung

d)

Hilum

40.

A V/Q ratio of zero indicates:

a)

Physiological dead space

b)

Physiological shunt (no ventilation)

c)

Normal gas exchange

d)

Perfect ventilation

41.

Most oxygen is transported in the blood:

a)

Dissolved in plasma

b)

As bicarbonate

c)

Bound to hemoglobin

d)

Bound to albumin

42.

The Bohr Effect refers to the shift of the O2–Hb dissociation curve to the right in response to:

a)

Increased pH

b)

Increased CO2 and H+ ions

c)

Decreased temperature

d)

Decreased 2,3-DPG

43.

What is the PO2 at which hemoglobin is 50% saturated (P50)?

a)

40 mmHg

b)

27 mmHg

c)

100 mmHg

d)

60 mmHg

44.

Most CO2 (about 70%) is transported in the blood as:

a)

Dissolved CO2

b)

Carbaminohemoglobin

c)

Bicarbonate ions

d)

Carbonic acid

45.

The Chloride Shift (Hamburger phenomenon) involves the movement of chloride ions into the RBC in exchange for:

a)

Oxygen

b)

Bicarbonate ions

c)

Sodium ions

d)

Potassium ions

46.

The Haldane Effect describes how:

a)

CO2 shifts the O2 curve

b)

Binding of O2 with Hb tends to displace CO2 from the blood

c)

CO binds more strongly to Hb than O2

d)

Temperature affects O2 binding

47.

Carbon monoxide (CO) is dangerous because:

a)

It shifts the O2–Hb curve to the right

b)

It binds to Hb with 250 times the affinity of O2

c)

It dissolves easily in plasma

d)

It stimulates the chemoreceptors directly

48.

What happens to the O2–Hb curve at high altitudes?

a)

Shifts to the left

b)

Shifts to the right (due to increased 2,3-DPG)

c)

Becomes flat

d)

No change

49.

Utilization Coefficient is defined as the:

a)

Percentage of blood that gives up its oxygen as it passes through tissues

b)

Total volume of O2 in blood

c)

Rate of O2 consumption by cells

d)

Solubility of O2

50.

During resting conditions, how many milliliters of O2 are delivered to the tissues per 100 mL of blood?

a)

20 mL

b)

5 mL

c)

15 mL

d)

1.34 mL

51.

The primary chemosensitive area in the medulla is most directly stimulated by:

a)

O2

b)

CO2

c)

Hydrogen ions (H+)

d)

Nitrogen

52.

Peripheral chemoreceptors (carotid and aortic bodies) are most sensitive to changes in:

a)

Arterial PCO2

b)

Arterial PO2 (below 60 mmHg)

c)

Blood pH

d)

CO concentration

53.

The Hering-Breuer Inflation Reflex helps prevent:

a)

Hypoxia

b)

Over-inflation of the lungs

c)

Alveolar collapse

d)

Hypercapnia

54.

Cheyne-Stokes breathing is a type of periodic breathing characterized by:

a)

Rapid breathing due to metabolic acidosis

b)

Waxing and waning of respiration with periods of apnea

c)

Deep gasps followed by expiration

d)

Totally irregular breathing

55.

Obstructive sleep apnea is most commonly associated with:

a)

Damage to the respiratory center

b)

Obesity and airway obstruction by the tongue/soft palate

c)

High altitude

d)

Lack of surfactant

56.

The Pneumotaxic Center in the upper pons primarily functions to:

a)

Stimulate inspiration

b)

Switch off inspiration (limit inspiration duration)

c)

Monitor CO2 levels

d)

Control the diaphragm

57.

What is the most potent stimulus for the central chemoreceptors?

a)

A drop in arterial PO2

b)

A rise in arterial PCO2

c)

A rise in arterial pH

d)

Exercise

58.

In a patient with chronic COPD, the respiratory drive may become dependent on:

a)

CO2 levels

b)

Low O2 levels (hypoxic drive)

c)

High pH

d)

Lung stretch receptors

59.

Acclimatization to low PO2 at high altitude involves:

a)

Increased RBC count (polycythemia)

b)

Increased vascularity of tissues

c)

Increased ventilation

d)

All of the above

60.

The Dorsal Respiratory Group (DRG) is primarily responsible for:

a)

Basic rhythm of inspiration

b)

Forced expiration

c)

Pneumotaxic control

d)

Swallowing

61.

A 45-year-old male with a history of deep vein thrombosis suddenly develops chest pain and shortness of breath. Diagnosis: pulmonary embolism. What happens to the V/Q ratio in the affected area?

a)

It becomes zero

b)

It becomes infinite (dead space)

c)

It remains 0.8

d)

It decreases

62.

A victim of a fire is brought to the ER. Despite a normal arterial PO2, the patient is cyanotic and has cherry-red skin. This is classic for:

a)

Carbon dioxide poisoning

b)

Carbon monoxide poisoning

c)

Cyanide poisoning

d)

Oxygen toxicity

63.

A patient with severe kyphoscoliosis (deformed chest wall) will show which pattern on spirometry?

a)

Decreased FEV1/FVC ratio

b)

Decreased vital capacity and total lung capacity

c)

Increased residual volume

d)

Normal compliance

64.

A 6-year-old child with an acute asthma attack is wheezing. The physiological cause of the wheeze is:

a)

Increased lung compliance

b)

Decreased airway radius (increased resistance)

c)

Pulmonary edema

d)

Decreased surfactant

65.

Mountain sickness (headache, nausea) at high altitudes is primarily due to:

a)

Low PCO2

b)

Hypoxia and cerebral vasodilation

c)

Nitrogen narcosis

d)

High O2 levels

66.

Nitrogen Narcosis occurs in deep-sea divers because:

a)

Nitrogen becomes more soluble at high pressure

b)

Nitrogen is toxic to the lungs

c)

Oxygen levels are too low

d)

Carbon dioxide builds up

67.

A person hyperventilates for 1 minute. Why do they often experience a period of apnea immediately afterward?

a)

O2 levels are too high

b)

CO2 levels have dropped below the threshold to stimulate breathing

c)

The diaphragm is tired

d)

pH has become acidic

68.

A patient has a PaO2 of 50 mmHg and a PaCO2 of 60 mmHg. This condition is:

a)

Respiratory alkalosis

b)

Respiratory acidosis with hypoxia

c)

Metabolic acidosis

d)

Normal

69.

Which factor would cause the O2–Hb dissociation curve to shift to the left?

a)

High altitude

b)

Fetal hemoglobin (HbF)

c)

High temperature

d)

High 2,3-DPG

70.

A patient in a coma has a breathing pattern of deep, rapid breaths (Kussmaul breathing). This is usually due to:

a)

Sleep apnea

b)

Metabolic acidosis (e.g., diabetic ketoacidosis)

c)

Brainstem stroke

d)

Pulmonary embolism

71.

The A–a gradient (alveolar–arterial O2 difference) increases in:

a)

Hypoventilation

b)

High altitude

c)

Diffusion defects (e.g., fibrosis)

d)

Normal breathing

72.

The term Hypercapnia refers to:

a)

Low O2 in blood

b)

High CO2 in blood

c)

High pH

d)

Rapid breathing

73.

In the fetus, the lungs are filled with fluid. The first breath requires very high negative pressure to overcome:

a)

Surface tension in the collapsed alveoli

b)

Thick mucus

c)

Low chest wall compliance

d)

High venous pressure

74.

The solubility of oxygen in plasma is:

a)

0.003 mL/100mL/mmHg

b)

0.03 mL/100mL/mmHg

c)

0.3 mL/100mL/mmHg

d)

3.0 mL/100mL/mmHg

75.

Decompression Sickness (the bends) is caused by the formation of bubbles of:

a)

Oxygen

b)

Carbon dioxide

c)

Nitrogen

d)

Helium

76.

The pressure required to keep an alveolus open is inversely proportional to its radius (Law of Laplace). This explains why:

a)

Large alveoli collapse more easily

b)

Small alveoli would collapse into large ones without surfactant

c)

Surfactant is unnecessary for small alveoli

d)

Compliance is constant

77.

Which of the following is a component of the Work of Breathing?

a)

Compliance work

b)

Tissue resistance work

c)

Airway resistance work

d)

All of the above

78.

During quiet breathing, expiration is a passive process because of:

a)

Diaphragm contraction

b)

Elastic recoil of the lungs

c)

Surfactant activation

d)

Gravity

79.

Chronic high-altitude exposure leads to an increase in 2,3-DPG. This results in:

a)

Easier loading of O2 in lungs

b)

Easier unloading of O2 to the tissues

c)

Decreased RBC production

d)

Left shift of the curve

80.

Alveolar ventilation is more effective at increasing oxygenation than increasing respiratory rate because:

a)

It reduces anatomical dead space

b)

It overcomes the wasted air in the dead space

c)

It prevents surfactant depletion

d)

It decreases CO2 solubility