Question 1

Which of the following is considered the best corrective treatment for intrapulmonary shunting?

Accepted Answer

A)  Increase the FIO2. 
B)  Eliminate CO2. 
C)  Restore ventilation to the airless alveoli. 
D)  Increase the respiratory rate. 
A)  Increase the FIO2. 
B)  Eliminate CO2. 
C)  Restore ventilation to the airless alveoli. 
D)  Increase the respiratory rate. C

Question 2

Which of the following changes is consistent with hypoxemia due to hypoventilation?

Accepted Answer

A)  Increased P(A-a)O2 
B)  Reciprocal changes between PaCO2 and PaO2 
C)  Shunt 
D)  Dead space 
A)  Increased P(A-a)O2 
B)  Reciprocal changes between PaCO2 and PaO2 
C)  Shunt 
D)  Dead space B

Question 3

Which of the following is the definition of absolute shunt?

Accepted Answer

A)  When ventilation gradually decreases to zero with no change in blood flow 
B)  When ventilation gradually increases with no change in blood flow 
C)  When ventilation gradually increases with a corresponding change in blood flow 
D)  When ventilation gradually decreases to zero with an associated decrease in blood flow 
A)  When ventilation gradually decreases to zero with no change in blood flow 
B)  When ventilation gradually increases with no change in blood flow 
C)  When ventilation gradually increases with a corresponding change in blood flow 
D)  When ventilation gradually decreases to zero with an associated decrease in blood flow A

Question 4

Which of the following statements are true of PaO2/PAO2?
I.PaO2/PAO2 is more stable than P(A-a)O2 when FIO? changes.
II.The lower normal limit for PaO2/PAO2 is approximately 0.75.
III.The higher normal limit for PaO2/PAO2 is 1.0.
IV.PaO2/PAO2 is less stable than P(A-a)O2 when FIO2 changes.

Accepted Answer

A)  I, II 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III 
A)  I, II 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III

Question 5

Assuming that cardiovascular function is constant, which of the following is the most reliable indicator of shunt?

Accepted Answer

A)  PaO2 
B)  P(A-a)O2 
C)  PaO2/FIO2 
D)  PaO2/PAO2 
A)  PaO2 
B)  P(A-a)O2 
C)  PaO2/FIO2 
D)  PaO2/PAO2

Question 6

Which of the following is an indicator of the severity of shunt?

Accepted Answer

A)  PaO2 
B)  P(A-a)O2 
C)  PaO2/FIO2 
D) P $ \overline{\mathrm{E}} $CO2 
A)  PaO2 
B)  P(A-a)O2 
C)  PaO2/FIO2 
D) P $ \overline{\mathrm{E}} $CO2

Question 7

The record of a patient on mechanical ventilation reveals the following information: VE = 10 L/min, PaCO2 = 43 mm Hg $ \mathrm{P}_{\overline{\mathrm{E}}} \mathrm{CO}_{2} $ , = 17 mm Hg, PaO2 = 70 mm Hg.Can ventilation be considered efficient for this patient?

Accepted Answer

A)  Yes, because the minute ventilation is within normal limits. 
B)  Yes, because the PaCO2 is within normal limits. 
C)  No, because the $ \mathrm{P}_{\overline{\mathrm{E}}} \mathrm{CO}_{2} $ does not match the PaCO2. 
D)  No, because dead space ventilation is greater than 40%. 
A)  Yes, because the minute ventilation is within normal limits. 
B)  Yes, because the PaCO2 is within normal limits. 
C)  No, because the $ \mathrm{P}_{\overline{\mathrm{E}}} \mathrm{CO}_{2} $ does not match the PaCO2. 
D)  No, because dead space ventilation is greater than 40%.

Question 8

Which of the following are conditions associated with intrapulmonary shunting?
I.Pneumonia
II.Pulmonary edema
III.Pneumothorax
IV.Bronchial occlusion

Accepted Answer

A)  I, II, III 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III 
A)  I, II, III 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III

Question 9

Increasing the FIO2 in patients with $ \dot{V}_{A} /\dot {Q} c $ mismatch will have which of the following effects?

Accepted Answer

A)  It will not improve PaO2. 
B)  It will cause little improvement in PaO2. 
C)  It will improve PaO2. 
D)  It will decrease PaO2. 
A)  It will not improve PaO2. 
B)  It will cause little improvement in PaO2. 
C)  It will improve PaO2. 
D)  It will decrease PaO2.

Question 10

What type of patients with severe flow limitation an $ \dot{V}_{A} /\dot {Q} c $ mismatch may be unable to increase their overall alveolar ventilation enough to sustain a normal PaCO2?

Accepted Answer

A)  Asthmatics 
B)  Patients with advanced COPD 
C)  Patients with severe pneumonia 
D)  Patients with bronchiectasis 
A)  Asthmatics 
B)  Patients with advanced COPD 
C)  Patients with severe pneumonia 
D)  Patients with bronchiectasis

Question 11

Which of the following are causes of general hypoventilation?
I.Muscle paralysis
II.Muscle weakness
III.Drug-induced respiratory center depression
IV.Muscle spasm

Accepted Answer

A)  I, II 
B)  I, II, III 
C)  II, IV 
D)  I, III 
A)  I, II 
B)  I, II, III 
C)  II, IV 
D)  I, III

Question 12

Assuming that cardiovascular function is unstable, which of the following is the most reliable indicator of shunt?

Accepted Answer

A)  $\dot{Q}$S 
B)  P(A-a)O2 
C)  PaO2/FIO2 
D)  PaO2/PAO2 
A)  $\dot{Q}$S 
B)  P(A-a)O2 
C)  PaO2/FIO2 
D)  PaO2/PAO2

Question 13

Which of the following is the most common cause of chronic hypercapnia?

Accepted Answer

A)  $ \dot{V}_{A} /\dot {Q} c $ mismatch 
B)  Hypoventilation 
C)  Relative shunt 
D) Dead space 
A)  $ \dot{V}_{A} /\dot {Q} c $ mismatch 
B)  Hypoventilation 
C)  Relative shunt 
D) Dead space

Question 14

What is the hallmark of intrapulmonary shunting?

Accepted Answer

A)  Refractory hypoxemia 
B)  Refractory hypercapnia 
C)  Hypoxemia not refractory to oxygen therapy 
D)  Hypercapnia not refractory to oxygen therapy 
A)  Refractory hypoxemia 
B)  Refractory hypercapnia 
C)  Hypoxemia not refractory to oxygen therapy 
D)  Hypercapnia not refractory to oxygen therapy

Question 15

What is the anticipated P(A-a)O2 when 100% oxygen is breathed?

Accepted Answer

A)  10-20 mm Hg 
B)  20-30 mm Hg 
C)  40-50 mm Hg 
D)  >50 mm Hg 
A)  10-20 mm Hg 
B)  20-30 mm Hg 
C)  40-50 mm Hg 
D)  >50 mm Hg

Question 16

Which level of calculated shunt fraction is associated with the least significant clinical effect?

Accepted Answer

A)  10% or less 
B)  20% or less 
C)  30% or less 
D)  Less than 50% 
A)  10% or less 
B)  20% or less 
C)  30% or less 
D)  Less than 50%

Question 17

What are the major characteristics of increased alveolar dead space?
I.Pulmonary embolism
II.Increased work of breathing
III.Retractions
IV. $ \dot{v} $E out of proportion with the PaCO2

Accepted Answer

A)  I, II 
B)  II, IV 
C)  I, II, III, IV 
D)  II, III 
A)  I, II 
B)  II, IV 
C)  I, II, III, IV 
D)  II, III

Question 18

Which of the following conditions are associated with dead space?
I.Pulmonary embolism
II.Severe hypotension
III.Alveolar overdistension
IV.Auto-PEEP

Accepted Answer

A)  I, II 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III 
A)  I, II 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III

Question 19

A physician is trying to determine the best index of oxygenation for a patient undergoing mechanical ventilation who has required frequent changes in FIO2.Which of the following available indices of oxygenation should be recommended for this patient?

Accepted Answer

A)  PaO2/PAO2 
B)  PaO2/FIO2 
C)  P(A-a)O2 
D)  PAO2/PaO2 
A)  PaO2/PAO2 
B)  PaO2/FIO2 
C)  P(A-a)O2 
D)  PAO2/PaO2

Question 20

Which of the following techniques prevent alveolar collapse even during expiration?
I.PEEP
II.CPAP
III.IPAP
IV.IPPB

Accepted Answer

A)  I, II 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III 
A)  I, II 
B)  III, IV 
C)  I, II, III, IV 
D)  II, III

Exam 12: Ventilation-Perfusion Relationships

Which of the following is considered the best corrective treatment for intrapulmonary shunting?

Which of the following changes is consistent with hypoxemia due to hypoventilation?

Which of the following is the definition of absolute shunt?

Which of the following statements are true of PaO2/PAO2? I.PaO2/PAO2 is more stable than P(A-a)O2 when FIO? changes. II.The lower normal limit for PaO2/PAO2 is approximately 0.75. III.The higher normal limit for PaO2/PAO2 is 1.0. IV.PaO2/PAO2 is less stable than P(A-a)O2 when FIO2 changes.

Assuming that cardiovascular function is constant, which of the following is the most reliable indicator of shunt?

Which of the following is an indicator of the severity of shunt?

The record of a patient on mechanical ventilation reveals the following information: VE = 10 L/min, PaCO2 = 43 mm Hg PE‾CO2 \mathrm{P}_{\overline{\mathrm{E}}} \mathrm{CO}_{2} PE​CO2​ , = 17 mm Hg, PaO2 = 70 mm Hg.Can ventilation be considered efficient for this patient?

Which of the following are conditions associated with intrapulmonary shunting? I.Pneumonia II.Pulmonary edema III.Pneumothorax IV.Bronchial occlusion

Increasing the FIO2 in patients with V˙A/Q˙c \dot{V}_{A} /\dot {Q} c V˙A​/Q˙​c mismatch will have which of the following effects?

What type of patients with severe flow limitation an V˙A/Q˙c \dot{V}_{A} /\dot {Q} c V˙A​/Q˙​c mismatch may be unable to increase their overall alveolar ventilation enough to sustain a normal PaCO2?

Which of the following are causes of general hypoventilation? I.Muscle paralysis II.Muscle weakness III.Drug-induced respiratory center depression IV.Muscle spasm

Assuming that cardiovascular function is unstable, which of the following is the most reliable indicator of shunt?

Which of the following is the most common cause of chronic hypercapnia?

What is the hallmark of intrapulmonary shunting?

What is the anticipated P(A-a)O2 when 100% oxygen is breathed?

Which level of calculated shunt fraction is associated with the least significant clinical effect?

What are the major characteristics of increased alveolar dead space? I.Pulmonary embolism II.Increased work of breathing III.Retractions IV. v˙ \dot{v} v˙ E out of proportion with the PaCO2

Which of the following conditions are associated with dead space? I.Pulmonary embolism II.Severe hypotension III.Alveolar overdistension IV.Auto-PEEP

A physician is trying to determine the best index of oxygenation for a patient undergoing mechanical ventilation who has required frequent changes in FIO2.Which of the following available indices of oxygenation should be recommended for this patient?

Which of the following techniques prevent alveolar collapse even during expiration? I.PEEP II.CPAP III.IPAP IV.IPPB

The Airways and Alveoli

The Lungs and Chest Wall

Mechanics of Ventilation

Ventilation

Pulmonary Function Measurements

Pulmonary Blood Flow

Gas Diffusion

Oxygen Equilibrium and Transport

Carbon Dioxide Equilibrium and Transport

Acid-Base Regulation

Control of Ventilation

Clinical Assessment of Acid-Base and Oxygenation Status

Physiological Basis for Oxygenation and Lung Protection Strategies

Physiology of Sleep Disordered Breathing

Fetal and Newborn Cardiopulmonary Physiology

Functional Anatomy of the Cardiovascular System

Cardiac Electrophysiology

The Electrocardiogram and Cardiac Arrhythmias In Adults

Control of Cardiac Output and Hemodynamic

Filtration, Urine Formation, and Fluid Regulation

Electrolyte and Acid-Base Regulation

Cardiopulmonary Response to Exercise in Health and Disease

Aging and the Cardiopulmonary System

Filters

The record of a patient on mechanical ventilation reveals the following information: VE = 10 L/min, PaCO₂= 43 mm Hg $\mathrm{P}_{\overline{\mathrm{E}}} \mathrm{CO}_{2}$ , = 17 mm Hg, PaO₂ = 70 mm Hg.Can ventilation be considered efficient for this patient?

Increasing the FIO₂ in patients with $\dot{V}_{A} /\dot {Q} c$ mismatch will have which of the following effects?

What type of patients with severe flow limitation an $\dot{V}_{A} /\dot {Q} c$ mismatch may be unable to increase their overall alveolar ventilation enough to sustain a normal PaCO₂?

What is the anticipated P(A-a)O₂ when 100% oxygen is breathed?

What are the major characteristics of increased alveolar dead space? I.Pulmonary embolism II.Increased work of breathing III.Retractions IV. $\dot{v}$ _E out of proportion with the PaCO₂

A physician is trying to determine the best index of oxygenation for a patient undergoing mechanical ventilation who has required frequent changes in FIO₂.Which of the following available indices of oxygenation should be recommended for this patient?