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281 Cards in this Set
- Front
- Back
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1. Which of the following is the function of the turbinates?
a. Divide the two nasal fossae b. Increase the surface area of the nasal cavity c. Prevent aspiration of fluids into the airway d. Coordinate swallowing and coughing |
increase the surface area of the nasal cavity
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2. Which of the following are the main functions of the nose?
I. Humidification II. Heating III. Filtering IV. Immune |
humidificaiton
heating filtering |
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3. What size particles do not gain entry to the lower airways?
a. >2 µm b. >3 µm c. > 4 µm d. > 5 µm |
> 5 µm
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4. In a deeply unconscious patient, which of the following is the most common threat to upper airway patency?
a. Cervical spine movement b. Bulbar paralysis c. Neural compromise d. Soft tissue obstruction |
soft tissue obstruction
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5. Which of the following signs is not consistent with complete airway obstruction?
a. Low-pitched snoring sound b. Intercostals retractions c. Increased work of breathing d. Suprasternal retractions |
low pitched snoring sound
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6. Which of the following structures is an important landmark during the insertion of a tube into the trachea?
a. Thyroid cartilage b. Cricoids membrane c. Vallecula d. Oropharynx |
vallecula
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7. What is the narrowest portion of the airway in the infant?
a. Vocal cords b. Cricoids ring c. Vallecula d. Epiglottis |
cricoid ring
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8. What is the narrowest portion of the airway in the adult larynx?
a. Vocal cords b. Cricoids ring c. Vallecula d. Glottis |
glottis
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9. Which of the following is the term associated with a sound created by high velocity air flowing through a narrowed glottis?
a. Crackle b. Stridor c. Grunting d. Wheezing |
stidor
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10. If an endotracheal tube is inserted too far in the process of intubation, its tip is more likely to enter the left bronchus.
a. True b. False |
false (Right lung)
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11. Which of the following is the term that describes a volume of gas that is approximately 150mL in the average adult and does not participate in gas exchange?
a. Tidal volume b. Residual volume c. Anatomical dead space d. Shunt |
anatomical dead space
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12. Which of the following are collateral air passages that make it possible for the acinus and alveoli to receive ventilation from neighboring airways and alveoli?
I. Pores of Kohn II. Canals of Lambert III. Intraalveolar digitations IV. Brewer connections |
Pores of Kohn and Canals of Lambert
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13. Which group of cells comprises most of the alveolar surface?
a. Type I b. Type II c. Type III d. Macrophages |
Type I
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14. Which group of cells engulfs microorganisms and foreign material in the alveolus?
a. Type I b. Type II c. Type III d. Macrophages |
macrophages
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15. Which of the following are explanations for the left hemidiaphragmatic surface to be slightly lower than the right?
I. The heart rests on the left half of the diaphragm, pushing it downward II. The presence of air in the stomach acts as a vacuum pulling it downward III. The liver, directly below the right half of the diaphragm, props up this area |
the heart rests onthe left half of the diaphragm, pushing it downward, the liver, directly below the right half of the diaphragm, props up this area
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16. What is the term that describes the presence of fluid in the pleural space caused by inflammation?
a. Pleural effusion b. Thoracentesis c. Pleural rub d. Pneumothorax |
pleural effusion
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17. What is the meaning of the anatomical shunting?
a. The systemic arterial blood can never have the same partial pressure of oxygen as the alveolar gas b. The systemic venous blood will have the same partial pressure of oxygen as the alveolar gas c. The systemic arterial blood will have the same partial pressure of oxygen as the alveolar gas d. That systemic arterial blood will be higher than the partial pressure of oxygen of the alveolar gas |
the systemic arterial blood can never have the same partial pressure of oxygen as the alveolar gas
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18. Which of the following is the source of innervations for the lung?
a. Somatic nervous system b. Cranial nerves c. Autonomic nervous system d. Visceral nerves |
automonic nervous system
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19. Which of the following are the main neurotransmitters of the autonomic system?
I. Norepinephrine II. Acetylcholine III. Dopamine IV. Adrenaline |
norepinephrine and acetylcholine
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20. Which of the following statements is not true of the effect of parasympathetic stimulation?
a. It increases mucous production b. It increases mucous glycoproteins c. It increases viscosity of airway secretions d. It produces watery secretions |
it increases viscosity of airway secretions
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21. Which of the following is a good example of slowly adapting stretch receptors?
a. Herring Breuer reflex b. Gag reflex c. Corneal reflex d. Brudzinski reflex |
Herring Breuer reflex
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22. You are assisting a PGY-1 surgery resident with the insertion of a chest tube. The resident turns to you asking which border of the rib he should avoid when placing the tube. Your answer should be:
a. The upper border b. The lower border c. It does not matter d. Between the upper and lower border |
the lower border
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23. Which of the following parts of the sternum marks the level of the carina?
a. Manubrium b. Xiphoid process c. Angle of Louis d. Body |
Angle of Louis
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24. Which of the following is the primary muscle active in quiet breathing?
a. Diaphragm b. Intercostals muscles c. Pectoralis major d. Abdominal muscles |
Diaphragm
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25. Which of the following are considered accessory muscles of respiration?
I. Sternomastoids II. Pectoralis major III. Trapezius IV. Abdominals |
Sternomastoids, pectoralis major, abdominals
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26. If the lungs fail to empty normally during exhalation, because of either weakened elastic recoil forces or high resistance to airflow, the retained volume causes which change in the chest radiograph?
a. Flattening of the diaphragm b. Bullae formation c. Pneumothorax d. Pleural effusion |
flattening of the diaphragm
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27. Which of the following mechanisms is responsible for the creation of the subatmospheric pressure between the lung and chest wall?
I. Both lungs and chest wall pull outward II. The lung has a tendency to recoil inward and pull away from the chest wall III. The thorax has a tendency to recoil outward, away from the lung |
the lung has a tendency to recoil inward and pull away fro the chest wall; the thorax has a tendency to recoil outward, away from the lung
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28. What causes air to move in or out of the lungs while keeping the lungs in an inflated state?
a. Volume gradients b. Pressure gradients c. Temperature gradients d. Flow gradients |
pressure gradients
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29. Change in lung volume resulting from a unit of pressure change is known as which of the follwoign?
a. Elastance b. Lung compliance c. Airway resistance d. Lung recoil |
lung compliance
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30. Which of the following statements is true of stiff lungs of patients with restrictive disorders?
a. The more elastic the lung, the more its compliance b. The less elastic the lung, the less its compliance c. The more elastic the lung, the less its compliance |
the more elastic the lung, the less its compliance
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31. Which of the following conditions is characterized by a loss of elastic lung tissue?
a. Chronic bronchitis b. Acute respiratory distress syndrome c. Emphysema d. Pneumonia |
emphysema
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32. Which of the following conditions is characterized by high lung recoil forces?
a. Pulmonary fibrosis b. Pleural effusion c. Emphysema d. Pneumonia |
pulmonary fibrosis
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33. Which of the following is the function of the surfactant?
a. Feed alveolar cell type I b. Lower surface tension c. Increase surface tension d. Lubricate alveoli |
lower surface tension
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34. What is the normal CLT?
a. 0.1 L/cm H2O b. 0.2 L/cm H2O c. 0.3 L/cm H2O d. 0.4 L/ cm H2O |
0.1 L/cm H2O
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35. What is the normal CL?
a. 0.1 L/cm H2O b. 0.2 L/cm H2O c. 0.3 L/cm H2O d. 0.4 L/cm H2O |
0.2 L/cm H2O
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36. Which of the following signs is suggestive of diaphragmatic fatigue in critically ill patients?
a. Retractions b. Cyanosis c. Abdominal paradox d. Stridor |
abdominal paradox
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37. What is the partial pressure of oxygen in atmospheric air?
a. 0.228mm Hg b. 159 mm Hg c. 47 mm Hg d. 149 mm Hg |
159 mm Hg
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38. VE is the product of which of the following parameters?
a. VT x VC b. VD x F c. VT x F d. VD x VT |
VT x F
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39. Which of the following terms defines the conducting airways from the mouth and nose down to and including terminal bronchioles?
a. Physiological dead space b. Anatomical dead space c. Anatomical tidal volume d. Gas exchange units |
anatomical dead space
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40. What is the approximate amount of anatomical dead space in normal adults?
a. 1 mL/pound IBW b. 2 mL/pound IBW c. 3 mL/ pound IBW d. 4 mL/ pound IBW |
1 mL/pound IBW
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41. Which of the following determines PCO2 of alveolar gas and thus the PCO2 of the blood leaving the lung?
I. Metabolic CO2 production per minute II. VA III. CO2 rate of elimination IV. pH |
Metabolic CO2 production per minute, VA, CO2 rate of elimination
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42. Which of the following terms describes the rise in PaCO2 above normal?
a. Normal ventilation b. Hypocapnia c. Hypercapnia d. Acidosis |
hypercapnia
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43. What is the amount of CO2 produced under normal resting conditions?
a. 50 mL b. 100 mL c. 150 mL d. 200 mL |
200 mL
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44. Normally, approximately what percentage of the VE is dead space ventilation?
a. 5% to 10% b. 15% to 20% c. 20% to 30% d. 30% to 40% |
30% to 40%
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45. What is the primary purpose of the respiratory system?
a. Continuous absorption of oxygen and excretion of carbon dioxide b. Filtering to prevent allergens and microbes from reaching the lungs c. Transport oxygenated blood to the tissues d. Warm and humidify inspired gas |
continuous absorption of oxygen and excretion of cabon dioxide
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46. What is meant by “internal respiration”?
a. Any gas exchange that occurs inside the body b. Consumption of oxygen in the mitochondria c. Continuous absorption of oxygen and excretion of carbon dioxide d. Exchange of gases between the blood and the tissue |
exchange of gases between the blood and the tissue
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47. By what mechanism does gas exchange across the lung occur?
a. Active transport b. Facilitated diffusion c. Facilitated transport d. Simple diffusion |
simple diffusion
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48. What is rather unique regarding the blood supply to the lung?
a. It receives blood from right and left ventricles b. It requires no dedicated blood supply as it exists in a gas environment c. Pulmonary venous drainage contributes to the normal anatomic shunt d. The pulmonary arteries are the primary source of oxygen for lung structures |
it receives blood from right to left ventricles
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49. Running vertically down each hemithorax anteriorly is an imaginary line that is used as an anatomical landmark. What is that line called?
a. Anterior axillary line b. Midaxillary line c. Midclavicular line d. Midsternal line |
midclavicular line
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50. Which of the following muscles are considered primary muscles of ventilation?
I. Diaphragm II. Intercostals III. Scalene IV. Sternomastoid |
diaphragm and intercostals
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51. How far is the diaphragm pulled down during tidal breathing?
a. 1 to 2 cm b. 3 to 5 cm c. 6 to 8 cm d. 8 to 10 cm |
1 to 2 cm
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52. What is the lowest level on the spinal cord that an injury could cause diaphragmatic impairment or paralysis?
a. C3 b. L2 c. S5 d. T4 |
C3
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53. The pulmonary arterial circulation does which of the following?
I. Delivers oxygenated blood back to the heart II. Delivers unoxygenated blood to the lungs III. Originates on the left side of the heart IV. Originates on the right side of the heart |
delivers unoxygenated blood to the lungs, originates onthe right side of the heart
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54. What is your primary concern if you discover that a patient does not have a gag reflex?
a. Fear of aspiration of bacteria or food b. That their tonsilar tissues are grossly swollen c. That they will not be able to breathe adequately d. Tracheal collapse |
fear of aspiration of bacteria or food
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55. What is the leaf shaped cartilage that extends from the base of the tongue and is attached by ligaments to the thyroid cartilage?
a. Arytenoids cartilage b. Cricoids cartilage c. Cuneiform cartilage d. Epiglottis |
epiglottis
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56. What portion of the left lung corresponds anatomically to the middle lobe of the right lung?
a. Cardiac notch b. Lingual c. Medial segment d. Superior segment |
lingula
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57. What is the most common cell type found in the mucosa of the larger airways?
a. Pseudostratified ciliated columnar epithelium b. Pseudostratified ciliated cuboidal epithelium c. Stratified ciliated squamous epithelium d. Stratified unciliated serous endothelium |
pseudostratified ciliated columnar epithelium
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58. What is the name given to the action produced by the forward stroking of millions of cilia?
a. Coughing b. Mucociliary escalator c. Mucus stroking d. The wave |
mucociliary escalator
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59. The patency of small airways is maintained by which of the following mechanisms?
I. Cartilaginous support II. Traction of surrounding elastic tissue III. Transmural pressure gradients |
traction of surrounding elastic tissue, transmural pressure gradients
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60. During each cycle of normal resting ventilation, a volume of gas is moved into and out of the respiratory tract. This cyclical volume is called the:
a. Inspiratory reserve volume (IRV) b. Vital capacity (VC) c. Residual volume (RV) tidal volume (VT) |
tidal volume (VT)
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61. Which of the following pressures vary throughout the normal breathing cycle?
I. Alveolar pressure (Palv) II. Body surface pressure (Pbs) III. Mouth pressure (Pao) IV. Pleural pressure (Ppl) |
alveolar pressure (Palv), pleural pressure (Ppl)
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62. Which of the following pressure gradients is responsible for the actual flow of gas into and out of the lungs during breathing?
a. Transcanadian pressure gradient (Ppc – Pks) b. Transpulmonary pressure gradient (Palv – Ppl) c. Transrespiratory pressure gradient (Palv – Pao) d. Transthoracic pressure gradient (Ppl – Pbs) |
transrespiratory pressure gradient (Palv - Pao)
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63. Which of the following pressure gradients is responsible for maintaining alveolar inflatioin?
a. Transpulmonary pressure gradient (Palv – Ppl) b. Transthoracic pressure gradient (Ppl – Pbs) c. Transcanadian pressure gradient (Pca – Pks) d. Transrespiratory pressure gradient (Palv – Pao) |
transpulmonary pressure gradient (Palv - Ppl)
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64. During expiration, why does gas flow out from the lungs to the atmosphere?
a. Palv is less than at the airway opening b. Palv is the same as at the airway opening c. Palv is greater than at the airway opening d. Airway pressure is greater than Palv |
Palv is greter than at the airway opening
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65. What term is used to note the difference between inspiratory lung volume and expiratory lung volume at any give pressure?
a. Alveolar aphasia b. Hysteresis c. Pleural pressure variance d. Transpulmonary pressures |
hysteresis
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66. Total lung thorax compliance in normal subjects is about what level?
a. 0.1 L/cm H2O b. 0.2 L/cm H2O c. 1.0 L/cm H2O d. 2.0 L/cm H2O |
0.1 L/cm H2O
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67. What is the term for the impedance to ventilation caused by the movement of gas through the conducting system of the lungs?
a. Airway resistance b. Lung compliance c. Surface tension d. Tissue elastance |
airway resistance
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68. How is airway resistance (Raw) computed?
a. Change in pressure/change in volume b. Change in pressure /flow c. Change in volume x change in pressure d. Change in volume/change in pressure |
change in pressure/flow
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69. Which of the following factors affects Raw?
I. Pattern of gas flow (e.g., laminar versus turbulent) II. characteristics of the gas being breathed III. diameter and length of the airways IV. variations in lung compliance |
patter of gas flow, characteristics of the gas being breathed, diameter and length of the airways
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70. If a patient has a Vt of 370 ml and a respiratory rate of 20 breaths per minute, what is the minute ventilation?
a. 2.40 L/min b. 3.70 L/min c. 6.45 L/min d. 7.40 L/min |
7.40 L/min
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71. A patient has a Vt of 625 ml and a physiological dead space of 275 ml and is breathing at a frequency of 16 per minute. What is the alveolar ventilatioin (VA)?
a. 3000 ml/min b. 4400 ml/min c. 5600 ml/min d. 7000 ml/min |
5600 ml/min
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72. In clinical practice measuring the physiologic dead space ventilation is achieved by using which formula?
a. Bernoulli’s equation b. Modified Bohr equation c. Modified shunt equation d. Reynold’s equation |
modified Bohr equation
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73. Which of the following ventilator patterns would result in the MOST wasted ventilation per minute (assume constant physiologic dead space)?
Frequency Tidal Volume a. 8 800 b. 16 220 c. 25 200 d. 30 170 |
30 170
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74. Which of the following ventilator patterns would result in the greatest VA per minute (assume constant dead space)?
Frequency Tidal volume a. 8 840 b. 18 220 c. 24 250 d. 30 160 |
8 840
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75. What is the single best indicator of the adequacy of effectiveness of VA?
a. PaO2 b. PAO2 c. PaCO2 d. Vt |
PaCO2
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76. Which of the following statements are true of the bronchial vasculature?
I. Bronchial systemic venous blood drains directly into the pulmonary veins II. Oxygen poor blood mixes with freshly oxygenated pulmonary venous blood on its way to the left ventricle III. Bronchial blood flow is only 1% to 2% of the cardiac output IV. The anatomical shunt from this source is usually approximately 10% |
bronchial systemic venous blood drains directly into the pulmonary veins, oxygen poor blood mixes with freshly oxygenated pulmonary venous blood on its way to the left ventricle, bronchial blood flow is only 1% to 2% of the cardiac output
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77. Which of the following statements are true of the pulmonary circulation?
I. It is a low resistance system compared with systemic circulation II. Its pressures are lower even though it receives the same cardiac output as the systemic circulation III. The resistance to blood flow in the pulmonary circulation is approximately one fourth as great as it is in the systemic circulation IV. The resistance to blood flow in the pulmonary circulation is approximately one tenth as great as it is in the systemic circulation |
it is a low resistance system compared with the systemic circulation, its pressures are lower even though it recieves the same cardiac output as the systemic circulation, the resistance to blood flow inthe pulmonary circulation is approximately one tenth as great as it is in the systemic circulation.
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78. In which of the following groups of patients has NO bee especially beneficial in treating pulmonary hypertension?
a. Toddlers b. Infants c. Adults d. Elderly |
infants
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79. Which of the following is the most important chemical factor causing pulmonary vasoconstriction?
a. Alveolar hypoxia b. Tissular hypoxia c. Acidosis d. Hypercapnia |
alveolar hypoxia
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80. Which of the following will inhibit HPV?
I. Alkalemia II. Nitric oxide and prostacyclin III. Alpha adrenergic blockers IV. Beta adrenergic stimulants |
all the above
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81. All of the following are some of the alternatives to inhales NO for lowering PVR, except:
a. Prostacyclin (PGI2) b. Sildenafil (Viagra) c. Nitroprusside d. Captopril |
captopril
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82. Which of the following are causes of pulmonary edema?
I. Increased hydrostatic pressure II. Increased capillary permeability III. Decreased plasma oncotic pressure IV. Insufficient lymphatic drainage |
all the above
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83. Which of the following are true of the respiratory exchange ratio?
I. It is the ratio of alveolar CO2 excretion of blood oxygen uptake II. R = vCO2/vO2 III. It is the ratio of oxygen uptake to blood alveolar CO2 excretion IV. Its value is normally approximately 0.8 |
it is the ratio of alveolar CO2 excretion to blood oxygen uptake, R = vCO2/vO2, its value is normally approximately 0.8
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84. What is the PAO2 of a person breathing room air at sea level, with a PaCO2 equal to 40 mm Hg and an R equal to 0.8?
a. Approximately 80 mm Hg b. Approximately 90 mm Hg c. Approximately 100 mm Hg d. Approximately 110 mm Hg |
approximately 100 mm Hg
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85. Which of the following statements apply to Fick’s law?
I. Gas diffusion increases with increased membrane surface area II. Gas diffusion increases with decreased membrane surface area III. Gas diffusion increases with increased pressure gradient IV. Gas diffusion decreases if membrane thickness increases |
gas diffusion increases with increased membrane surface area, gas diffusion increases with decreased membrane surface area, gas diffusion decreases if membrane thickness increases
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86. When combining Graham’s law and Henry’s law, how many times faster does carbon dioxide diffuse across the alveolar capillary membrane than oxygen?
a. 10 b. 20 c. 30 d. 40 |
20
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87. What is the most common cause of resting hypoxemia?
a. A mismatch between ventilation and diffusion b. A mismatch between ventilation and permeability c. A mismatch between ventilation and dead space d. A mismatch between ventilation and blood flow |
a mismatch between ventilation and blood flow
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88. The DLCO is useful in differentiating emphysema from what other obstructive diseases?
a. Asthma b. Pneumonia c. ARDS d. Bronchiectasis |
asthma
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89. Which of the following are true of the DRG?
I. It consists of mainly inspiratory neurons II. It sends impulses to the phrenic and external intercostals motor nerves in the spinal cord III. It provides the main stimulus for inspiration IV. These neurons are involved in the Hering –Breuer and Head’s reflex |
all the above
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90. Which of the following are true of the caudal neurons for the VRG?
I. They have mostly expiratory discharge patterns II. They drive the internal intercostals and abdominal expiratory muscles III. These neurons are involved in the Hering-Breuer and Head’s reflexes IV. These neurons are normally active only at high ventilator rates when expiration muscle activity is required |
I, II, IV
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91. The inhibitory neurons that switch off the inspiratory ramp arise from which of the following areas?
I. VRG II. DRG III. Pulmonary stretch receptors IV. Pneumotaxic |
III, IV
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92. Which of the following statements describes apneusis?
a. Prolonged inspiratory gasps interrupted by occasional expirations b. Prolonged inspiratory gasps interrupted by apnea c. Prolonged inspiratory gasps interrupted by frequent expirations d. Short inspiratory gasps interrupted by occasional expirations |
prolonged inspiratory gasps interrupted by occasional expirations
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93. When stimulated, the stretch receptors will have which of the following effects on respiration?
a. Produce apnea b. Prolong inspiration c. Prolong expiration d. Stop further inspiration |
stop further inspiration
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94. Which of the following reflexes may be involved in periodic deep sighs and stimulating the first breaths of a newborn baby?
a. Hering-Breuer reflex b. Head’s reflex c. Stretch reflex d. Botzinger reflex |
head's reflex
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95. All of the following reflexes are caused by stimulation of the irritant receptors, except:
a. Bronchoconstriction b. Coughing c. Bradypnea d. Narrowing of the glottis |
bradypnea
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96. Which of the following conditions produce stimulation of the J receptors?
a. Pneumonia b. Pneumothorax c. Pleural effusion d. Lung cancer |
pneumonia
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97. Stimulation of which of the following receptors explains the stimulation of ventilation after splashing cold water on the skin?
a. Stretch receptors b. Peripheral proprioceptors c. Irritating receptors d. Cough receptors |
peripheral proprioceptors
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98. What is the primary mechanism that drives ventilation in humans?
a. PCO2 b. HCO3 c. H d. pH |
PCO2
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99. which of the following peripheral chemoreceptors has the greatest influence over the respiratory centers?
a. Aortic bodies b. Carotid bodies c. Femoral bodies d. Brachial bodies |
carotid bodies
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100. Arterial hypoxemia does not stimulate ventilation until PO2 reaches which level?
a. < 60 mm Hg b. < 70 mm Hg c. < 80 mm Hg d. < 90 mm Hg |
< 60 mm Hg
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101. Which of the following mechanisms explains ventilator stimulation caused by hypoxemia?
a. Hypoxemia raises the peripheral chemoreceptors sensitivity to [H+] b. Hypoxemia stimulates central chemoreceptors c. Hypoxemia raises the central chemoreceptors sensitivity to [H+] d. Hypoxemia raises the peripheral chemoreceptors sensitivity to [CO2] |
hypoxemia raises the peripheral chemoreceptors sensitivity to [H+]
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102. Oxygen should never be withheld from acutely hypoxemic COPD patients for fear of inducing hypoventilation and hypercapnia.
a. True b. False |
true
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103. Which of the following describes Cheyne – Stokes breathing?
a. Tidal volume gradually increases and then gradually decreases to complete apnea without changes in respiratory rate. Then the tidal volume gradually increases again b. Respiratory rate and tidal volume gradually increases and then gradually decrease to complete apnea. Then the tidal volume and breathing frequency gradually increase again. c. Respiratory rate gradually increases and then gradually decreases to complete apnea but tidal volume has essentially the same depth. Then the breathing frequency gradually increases again d. Tidal volume gradually decreases to complete apnea. Then the tidal volume gradually increases again, repeating the cycle. |
respiratory rate and tidal volume gradually increase and then gradually decrease to complete apnea. Then the tidal volume and breathing frequency gradually increase again.
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104. Which of the following are true of CO2 and cerebral blood flow?
I. Increased PCO2 dilates cerebral vessels, raising cerebral blood flow II. Normal ICP is less than 10 mm Hg III. To sustain the cerebral blood flow, a cerebral perfusion pressure (CPP) of approximately 60 mm Hg must be maintained IV. Increased PCO2 constricts cerebral vessels, decreasing cerebral blood flow |
I, II, III
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105. 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 |
gaseous diffusion
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106. Which of the following are true regarding the PACO2?
I. Directly proportional to whole body carbon dioxide production II. Inversely proportional to alveolar ventilation (VA) III. Normally maintained at about 35 to 45 mm Hg |
I, II, and III
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107. 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. 6000 ml/min |
200 ml/min
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108. Calculate the approximate PAO2 given the following conditions (assume R = 0.8) FIO2 = 0.41, Pb = 770 mm Hg, PACO2 = 31 mm Hg
a. 100 mm Hg b. 135 mm Hg c. 250 mm Hg d. 723 mm Hg |
250 mm Hg
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109. A normal person breathing 100% oxygen at sea level would have PAO2 of about what level?
a. 149 mm Hg b. 670 mm Hg c. 713 mm Hg d. 760 mm Hg |
670 mm Hg
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110. Which of the following best represents the partial pressures of all gases in the normally ventilated and perfused alveolus when breathing room air at sea level?
a. PO2 = 40 mm Hg; PCO2 = 100 mm Hg; PN2 = 573 mm Hg; PH2O = 47 mm Hg b. PO2 = 100 mm Hg; PCO2 = 40 mm Hg; PN2 = 573 mm Hg; PH2O = 47 mm Hg c. PO2 = 100 mm Hg; PCO2 = 40 mm Hg; PN2 = 713 mm Hg; PH2O = 47 mm Hg d. PO2 = 149 mm Hg; PCO2 = 40 mm Hg; PN2 = 573 mm Hg; PH2O = 47 mm Hg |
PO2 = 100 mm Hg; PCO2 = 40 mm Hg; PN2 = 573 mm Hg; PH2O = 47 mm Hg
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111. Assuming a constant FIO2 and carbon dioxide production, which of the following statements are correct?
a. An increased PACO2 will result in and increased PAO2 b. Increased FIO2 blows off carbon dioxide c. Increases in VA decrease the PACO2 and increase the PAO2 d. The PAO2 varies proportionally with PACO2 |
increases in VA decrease the PACO2 and increase the PAO2
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112. 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 |
110 to 120 mm Hg
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113. Which of the following conditions must exist for gas to move between the alveolus and pulmonary capillary?
a. Adequate alveolar ventilation (VA) b. Difference in partial pressures (pressure gradient) c. Normal central nervous system (CNS) control mechanism d. Sufficient amount of blood hemoglobin (Hb) |
difference in partial pressures (pressure gradient)
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114. Which of the following “layers” must be traversed by gases moving across the alveolar capillary membrane?
I. Alveolar epithelial membrane II. Capillary endothelial membrane III. Interstitial space IV. Transbronchial radial tethering mechanisms |
I, II and III
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115. 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 |
PO2 = 40 mm Hg; PCO2 = 46 mm Hg
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116. Which of the following gases would diffuse fastest across the alveolar-capillary membrane?
a. Air b. Carbon dioxide c. Oxygen d. Nitrogen |
carbon dioxide
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117. What is the minimum amount of time that blood must take for pulmonary capillary transit for equilibration of oxygen to occur across the alveolar-capillary membrane?
a. 0.15 second b. 0.25 second c. 0.35 second d. 0.45 second |
0.25 second
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118. 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 |
5 to 10 mm Hg
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119. An area of the lung has no blood flow but is normally ventilated. Which of the following statements are true about this area?
I. The alveolar gas is like air (PO2 = 150; PCO2 = 0) II. The area represents alveolar dead space III. The V/Q is elevated |
all the above
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120. Regarding pulmonary blood flow in the upright lung, which of the following statements is true?
a. The apexes receive about 20 times more blood flow than the bases b. The bases receive about 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 |
the bases receive about 20 times more blood flow than the apexes
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121. How is the vast majority of oxygen carried in the blood?
a. As bicarbonate ion (HCO3) b. As carbamino compounds c. Chemically combined with Hb d. In physical solution |
chemically combined with Hb
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122. Under normal physiological circumstances, how many milliliters of oxygen are capable of combining with 1 g of Hb?
a. 0.003 ml b. 0.450 ml c. 0.820 ml d. 1.340 ml |
1.340 ml
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123. At a PaO2 of 65 mm Hg, what is the approximate saturation of Hb with oxygen?
a. 73% b. 80% c. 90% d. 97% |
90%
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124. Why is it necessary to keep the patient’s PaO2 greater than 60 mm Hg?
a. A level of 60 mm Hg marks the beginning of the steep part of O2Hb dissociation curve b. Below the 60 mm Hg level, tissue hypoxia is ensured c. Oxygen deprivation will cause severe cerebral vasoconstriction below 60 mm Hg d. The PaCO2 will start to rise precipitously if the PaO2 falls further |
a level of 60 mm Hg marks the beginning of the steep part of O2Hb dissociation curve
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125. Given the following blood parameters, compute the total oxygen content (dissolved + HbO2) of the blood in ml/dl: Hb = 16; PO2 = 625 Hg; SO2 = 100%
a. 17.8 ml/dl b. 19.4 ml/dl c. 21.4 ml/dl d. 23.3 ml/dl |
23.3 ml/dl
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126. According to the Bohr effect, when the pH drops (blood becomes more acidic), what happens?
I. The affinity of Hb for oxygen decreases II. The Hb saturation for a given PO2 falls III. The Hb saturation for a given PO2 rises |
I and II
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127. What role does the Bohr effect play in oxygen transport?
a. Describes the affect of varying enzyme levels on Hb and oxygen affinity b. Diminishes tissue oxygenation due to electrolyte imbalances c. Enhances oxygen delivery to tissues and oxygen pickup at lungs d. Explains the affect that oxygen levels have on carbon dioxide transport |
enhances oxygen delivery to the tissues and oxygen pickup at lungs
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128. What is the affect of an elevated intracellular 2,3-DPG concentration?
a. Decreases the availability of oxygen to the tissues b. Increases the affinity of Hb for oxygen c. Increases the availability of oxygen to the tissues d. Shifts the HbO2 dissociation curve to the left |
increases the availability of oxygen to the tissues
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129. 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 |
banked blood
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130. The oxidation of the Hb molecule’s iron ions to the ferric state (Fe3+) results in which of the following?
I> Form of anemia called sickle cell anemia II> Formation of methemoglobin (metHb) III> Inability of metHb to bind with oxygen |
II and III
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131. The affinity of Hb for carbon monoxide (CO) is approximately how many times greater than its affinity for oxygen?
a. 10 to 50 times greater b. 50 to 90 times greater c. 100 to 190 times greater d. 200 or greater |
200 or greater
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132. Which of the following does NOT increase the affinity of Hb for oxygen?
a. Decreased 2,3 DPG b. Decreased PCO2 c. Increased pH d. increased temperature |
increased temperature
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133. the largest percentage of carbon dioxide transported in the blood occurs as which of the following?
a. Carbamino –Hb b. Carbonic acid (H2CO3) c. HCO3 d. Physically dissolved carbon dioxide |
HCO3
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134. 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 |
hamburger phenomenon
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135. When Hb saturation with oxygen is high, less carbon dioxide is carried in the blood. What is this relationship called?
a. Bohr effect b. Chloride shift c. Dissociation constant d. Haldane effect |
haldane effect
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136. Which of the following equations best describes oxygen delivery to the tissues?
a. Arterial oxygen content ÷ cardiac output b. Arterial oxygen content x cardiac output c. Cardiac output + arterial oxygen content d. Cardiac output x vascular resistance |
arterial oxygen content x cardiac output
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137. Hypoxia is best defined as a condition in which what occurs?
a. Blood Hb levels are less than normal (15 g/dl) b. The arterial PCO2 is greater than normal (45 mm Hg) c. The arterial PO2 is greater than normal (100 mm Hg) d. Tissue oxygen delivery is inadequate to meet cellular needs |
tissue oxygen delivery is inadequate to meet celluar needs
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138. An abnormal metabolic state in which the tissues are unable to utilize the oxygen made available ot them best describes which of the following?
a. Diffusion hypoxia b. Dysoxia c. Hemic hypoxia d. Physiologic shunt |
dysoxia
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139. What is the most common cause of hypoxemia?
a. Diffusion defect b. Hypoventilation c. Right to left shunt d. V/Q mismatch |
V/Q mismatch
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140. What is the most important component in the oxygen transport system?
a. Dissolved oxygen in ml/dl b. HCO3 c. Hb d. PaO2 |
Hb
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141. Under which of the following conditions may carbon dioxide removal be impaired?
I. When a V/Q imbalance exists II. When the dead space ventilation /min is increased III. When the minute ventilation is inadequate |
I, II, and III
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1. Where can the PMI be felt and sometimes seen?
a. At the intersection of the third intercostals space and the midclavicular line b. At the intersection of the fourth intercostals space and the midclavicular line c. At the intersection of the fifth intercostals space and the midclavicular line d. At the intersection of the sixth intercostals space and the midclavicular line |
at the intersection of the fifth intercostal space and the midclavicular line
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2. Which of the following conditions cause a shift in the PMI?
a. Pneumothorax b. Pneumonia c. Pulmonary fibrosis d. Segmental atelectasis |
pneumothorax
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3. Which of the following terms describes coronary artery occlusion that causes hypoxemia to the myocardium?
a. Infarction b. Apoptosis c. Hypoxia d. Ischemia |
ischemia
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4. While at rest, the whole body extracts approximately 25% of the oxygen from its arterial blood flow, and the myocardium extracts approximately what percentage?
a. 40% b. 50% c. 60% d. 70% |
70%
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5. During which part of the cardiac cycle does most coronary perfusion occur?
a. Systole b. Diastole c. It is unaffected by the phase of the cardiac cycle d. Only the first third of the systolic phase |
diastole
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6. Which of the following is the main type of adrenergic receptor in the heart?
a. α b. β1 c. β2 d. nicotine |
β1
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7. Which of the following statements is true of the Frank-Starling mechanism?
a. The greater the preload, the greater the force of contraction b. The greater the afterload, the greater the force of contration c. The greater the venous return, the lower the force of contraction d. The greater the afterload, the greater the venous return |
the greater the preload, the greater the force of contraction
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8. Which of the following statements is true of the ventricular diastole or filling?
a. Approximately 50% of ventricular filling is passive; the remaining 50% is caused by the atrial kick b. Approximately 60% of ventricular filling is passive; the remaining 40% is caused by the atrial kick c. Approximately 70% of ventricular filling is passive; the remaining 30% is caused by the atrial kick d. Approximately 80% of ventricular filling is passive; the remaining 20% is caused by the atrial kick |
approximately 80% of ventricular filling is passive; the remaining 20% is caused by the atrial kick
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9. What causes the first heart sound (S1)?
a. Contraction of the atria rapidly builds up pressure, forcefully snapping the atrioventricular valves closed b. Contraction of the ventricles rapidly builds up pressure, forcefully opening the atrioventricular valves c. Contraction of the atria rapidly builds up pressure, forcefully opening the atrioventricular valves d. Contraction of the ventricles rapidly builds up pressure, forcefully snapping the atrioventricualr valves closed |
contraction of the ventricles rapidly builds up pressure, forecfully snapping the atrioventricular valves closed
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10. Which of the following terms better describes afterload?
a. The resistance to blood ejection immediately after aortic and pulmonary semilunar valves open b. The resistance to blood ejection immediately after tricuspid and mitral semilunar valves open c. The resistance to blood ejection immediately after aortic and pulmonary semilunar valves close d. The resistance to blood ejection immediately after tricuspid and mitral semilunar valves close |
the resistance to blood ejection immediately after aortic and pulmonary semilunar valves open
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11. What is the average stroke volume (SV) and ejection fraction (EF)?
a. SV: 70 mL; EF: 50% b. SV: 70 mL; EF: 60% c. SV: 90 mL; EF: 50% d. SV: 90 mL; EF: 60% |
SV: 70 mL; EF: 60%
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12. What is the primary effect of parasympathetic stimulation over the atria?
a. It slows the heart rate b. It decreases the force of contraction c. It speeds the heart rate d. It increases the force of contraction |
it slows the heart rate
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13. Which of the following terms describes the difference between systolic and diastolic blood pressure?
a. Mid systolic pressure b. Mid diastolic pressure c. Pulse pressure d. Mean arterial pressure |
pulse pressure
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14. A high SVR in the patient is an indicator of which of the following?
a. Increased left ventricular afterload b. Increased right ventricular afterload c. Increased left ventricular preload d. Increased right ventricular preload |
increased left ventricular afterload
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15. Which of the following terms describes the percentage of blood volume composed of cells?
a. Hemoglobin b. Hematocrit c. Mean corpuscular volume d. Plasma concentration |
hematocrit
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16. Which of the following physical signs are consistent with right ventricular failure?
I. Hepatomegaly II. Jugular venous distension III. Ascites IV. Pedal edema |
all the above
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17. Which of the following phenomena is responsible for the initiation of muscle contraction?
a. Electrochemical repolarization b. Membrane depolarization c. Membrane repolarization d. Membrane permeability |
membrane depolarization
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18. Which of the following statements are true of potassium?
I. Hyperkalemia decreases the heart rate II. Hyperkalemia decreases the stroke volume III. Hyperkalemia causes heart block IV. Hyperkalemia increases heart conductivity |
I, II, III
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19. Which of the following causes flaccid paralysis of the heart muscle?
a. Hyperkalemia b. Hypokalemia c. Hypercalcemia d. Hypocalcemia |
hypokalemia
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20. Which of the following conditions are associated with increased heart muscle excitability?
I. Hypocalcemia II. Hyperkalemia III. Hypercalcemia IV. Hypokalemia |
I, II
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21. Changes in which extracellular ion has little effect on the RMP of cardiac muscle?
a. Na b. K c. Ca d. Cl |
Na
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22. Which of the following are known effects of catecholamines?
I. They increase the influx of Ca into the myocardial cell during the plateau phase of the action potential II. They activate beta-receptors in the cardiac cell membrane III. They raise intracellular levels of the cyclic AMP IV. They raise intracellular levels of cyclic GMP |
I, II, III
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23. Which of the following are properties of the cardiac tissue?
I. Automaticity II. Rhythmicity III. Excitability IV. Contractility |
all the above (RACE)
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24. Which of the following areas of the heart is the most excitable?
a. Bundle branch b. Purkinje fibers c. AV node d. SA node |
SA node
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25. What is the normal sinus rhythm rate?
a. 70 to 80 beats/min b. 80 to 100 beats/min c. 40 to 60 beats/min d. 50 to 70 beats/min |
70 to 80 beats/min
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26. Which of the following factors may produce premature beats?
I. Local areas of tissue hypoxia II. Mechanical irritation of the tissue III. Toxic irritation IV. Drugs |
all the above
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27. What is the normal AV nodal rate?
a. 70 to 80 beats/min b. 80 to 100 beats/min c. 40 to 60 beats/min d. 50 to 70 beats/min |
40 to 60 beats/min
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28. What is the normal rate of the Purkinje fibers?
a. 70 to 80 beats/min b. 15 to 40 beats/min c. 40 to 60 beats/min d. 50 to 70 beats/min |
15 to 40 beats/min
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29. Which of the following conducts SA nodal impulses to the left atrium?
a. AV bundle b. Bachmann’s bundle c. Right bundle branch d. Left bundle branch |
Bachmann's bundle
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30. The electrocardiogram (ECG) is primarily used to evaluate the patient with symptoms suggestive of acute myocardial disease.
a. True b. False |
true
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31. What term us used to define the ability of certain cardiac cells to depolarize without stimulation?
a. Automaticity b. Polarization c. Contraction d. Repolarization |
automaticity
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32. What structure normally paces the healthy heart?
a. Atrioventricular (AV) node b. Sinoatrial (SA) node c. Bundle of His d. Purkinje fibers |
sinoatrial (SA) node
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33. What structure serves as the backup pacemaker of the heart?
a. Atrioventricular (AV) node b. Sinoatrial node c. Bundle of his d. Purkinje fibers |
atrioventricular (AV) node
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34. Why is the electrical impulse temporarily delayed at the atrioventricular (AV) node?
a. To allow complete emptying of the ventricles b. To allow more sodium buildup in the myocardial cells c. To allow better filling of the ventricles d. To allow complete filling of the atria |
to allow better filling of the ventricles
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35. What is the normal maximum length of the P wave?
a. 1 mm b. 3 mm c. 5 mm d. 7 mm |
3mm
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36. Which of the following waves represents depolarization of the ventricles?
a. P wave b. QRS wave c. T wave d. U wave |
QRS wave
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37. What is the width of the normal QRS complex?
a. Not wider than 1 mm b. Not wider than 3 mm c. Not wider than 5 mm d. Not wider than 7 mm |
not wider than 3mm
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38. Which of the following waves represents repolarization of the ventricles?
a. P b. QRS c. T d. U |
T
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39. What is the normal period of time for the PR interval?
a. Not longer than 0.20 second b. Not longer than 0.30 second c. Not longer than 0.45 second d. Not longer than 0.50 second |
not longer than 0.20 second
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40. Which of the following ECG abnormalities is most life threatening?
a. Narrow QRS complex b. Shortened PR interval c. Elevated ST segment d. Peak P waves |
elevated ST segment
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41. What is suggested by inverted T waves on the ECG?
a. Atrial enlargement b. Myocardial ischemia c. Ventricular hypertrophy d. Dextrocardia |
myocaridal ischemia
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42. Which of the following clinical conditions is not associated with tachycardia?
a. Anxiety b. Hypoxemia c. Pain d. Hypothermia |
hypothermia
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43. Which of the following medications is used to treat sinus bradycardia?
a. Atropine b. Digitalis c. Propranolol d. Lidocaine |
atropine
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44. For which of the following arrhythmias would an electronic pacemaker be indicated?
a. First degree block b. Sinus tachycardia c. Third degree block d. Ventricular fibrillation |
third degree block
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45. Atrial flutter is considered to be a life threatening arrhythmia
a. True b. False |
false
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46. What is a possible serious complication associated with atrial fibrillation?
a. Pulmonary edema b. Atrial thrombi c. Cardiac tamponade d. Cardiac standstill |
atrial thrombi
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47. Sources for the electrical impulse that triggers cardiac contraction that lie outside the sinoatrial node are referred to as ectopic foci.
a. True b. False |
true
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48. An occasional premature ventricular complex (PVC) is not of major concern.
a. True b. False |
true
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49. What medication is most useful for the treatment of premature ventricular contractions?
a. Digoxin b. Atropine c. Lidocaine d. Digitalis |
lidocaine
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50. Which of the following is the only parameter that the ECG measures?
a. Electrical events b. Contraction force c. Heart muscle mass d. Heart position |
electrical events
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51. Which of the following conditions are detected by the ECG?
I. Abnormal heart rhythms II. Conduction problems III. Location of damaged heart muscle IV. Force of contraction |
I, II, III
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52. Atrial depolarization is represented by which of the following waves in the ECG?
a. P b. ORS c. T d. U |
P
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53. Which of the following are features of the PR interval?
I. It is measured from the beginning of the P wave to the first ventricular deflection II. It is measured from the beginning of the P wave to the S wave III. The normal PR interval is between 0.12 and 0.20 second IV. The PR interval is normally shorter in fast heart rates than in slow heart rates. |
I, III, IV
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54. How long does it normally take for the ventricles to depolarize?
a. 0.08 to 0.1 second b. 0.1 to 0.2 second c. 0.25 to 0.3 second d. 0.3 to 0.4 second |
0.08 to 0.1 second
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55. An abnormally elevated ST segment is indicative of which of the following?
a. Myocardial ischemia b. Myocardial tissue injury c. Myocardial abnormal contraction d. Myocardial ectopy |
myocardial tissue injury
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56. What is the normal variation between the shortest and longest R-R interval in a regular sinus rhythm?
a. Less than 0.4 second b. Less than 0.3 second c. Less than 0.16 second d. Less than 0.08 second |
less than 0.16 second
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57. Which of the following conditions are associated with sinus bradycardia?
I. Airway suctioning II. Valsalva’s maneuver III. Vomiting IV. Coughing |
I, II, III
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58. What is the most serious potential risk for patients with VT?
a. Hypotension b. Progression into VF c. Bradycardia d. Tachycardia |
progression into VF
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59. What is the most lethal of all cardiac arrhythmias?
a. SVT b. VF c. VT d. Multifocal PVCs |
VF
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60. No relationship exist between P waves and ORS complexes in which type of AV block?
a. First degree b. Type I second degree c. Type II second degree d. Third degree |
third degree
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61. Which of the following defines absolute shunt?
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 |
when ventilation gradually decreases to zero with no change in blood flow
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62. What is the anticipated P(A-a)O2 when 100% oxygen is breathed?
a. 10 mm Hg b. 20 mm Hg c. 40 mm Hg d. 50 mm Hg |
50 mm Hg
|
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63. All of the following are causes of general hypoventilation, except:
a. Muscle paralysis b. Muscle weakness c. Drug-induced respiratory center depression d. Muscle spasm |
muscle spasm
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64. Which of the following are examples of conditions associated with intrapulmonary shunting?
I. Pneumonia II. Pulmonary edema III. Pneumothorax IV. Bronchial occlusion |
all the above
|
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65. Increasing the FiO2 in patients with shunting will have which of the following effects?
a. It will dramatically improve PaO2 b. It will cause little improvement in PaO2 c. It will improve PaO2 d. It will decrease PaO2 |
it will cause little improvement in PaO2
|
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66. What is the hallmark of intrapulmonary shunting?
a. Refractory hypoxemia b. Refractory hypercapnia c. Hypoxemia not refractory to oxygen therapy d. Hypercapnia not refractory to oxygen therapy |
refractory hypoxemia
|
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67. Which of the following is an indicator of the severity of shunt?
a. PaO2 b. P(A-a)O2 c. PaO2/FiO2 d. PECO2 |
P(A-a)O2
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68. Which of the following techniques prevent alveolar collapse even during expiration?
I. PEEP II. CPAP III. IPAP IV. IPPB |
I, II
|
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69. Which of the following is the most common cause of hypoxemia?
a. VA/QC mismatch b. Hypoventilation c. Relative shunt d. Dead space |
VA/QC mismatch
|
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70. Increasing the FiO2 in patients with VA/QC mismatch will have which of the following effects?
a. It will not improve PaO2 b. It will cause little improvement in PaO2 c. It will improve PaO2 d. It will decrease PaO2 |
it will improve PaO2
|
|
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71. Which of the following is the most common cause of chronic hypercapnia?
a. VA/QC mismatch b. Hypoventilation c. Relative shunt d. Dead space |
VA/QC mismatch
|
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72. Which of the following conditions are associated with dead space?
I. Pulmonary embolism II. Severe hypotension III. Alveolar overdistension IV. Auto PEEP |
all the above
|
|
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73. Which of the following statements are true of the PaO2/PAO2?
I. PaO2/PAO2 is more stable than P(A-a)O2 when FiO2 changes II. The lower normal limit of the 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 |
I, II
|
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74. Which of the following statements are true of the PaO2/FiO2?
I. A normal range is approximately 380 to 475 II. Its usefulness as a shunt indicator is limited III. A major problem with PaO2/FiO2 is that changes in PaCO2 affect it IV. PaO2/FiO2 is the least accurate indicator of shunt |
all the above
|
|
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75. Assuming that cardiovascular function is constant, which of the following is the most reliable shunt indicator?
a. PaO2 b. P(A-a)O2 c. PaO2/FiO2 d. PaO2/PAO2 |
PaO2/PAO2
|
|
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76. Assuming that cardiovascular function is unstable, which of the following is the most reliable shunt indicator?
a. Qs b. P(A-a)O2 c. PaO2/FiO2 d. PaO2/PAO2 |
Qs
|
|
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77. The primary goal of acid base homeostasis is to maintain which of the following?
a. Normal HCO3 b. Normal PCO2 c. Normal pH d. Normal PO2 |
normal pH
|
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78. What is the normal arterial blood pH range?
a. 7.25 to 7.35 b. 7.35 to 7.45 c. 7.45 to 7.55 d. 7.55 to 7.65 |
7.35 to 7.45
|
|
|
79. What is the primary buffer system of fixed acids?
a. Cl b. HCO3 c. Phosphate d. Plasma proteins |
HCO3
|
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80. A solution that resists large changes in pH upon addition of an acid or a base best describes which of the following?
a. Acid base excretor b. Buffer solution c. Catabolic regulator d. Homeostatic control |
buffer solution
|
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81. Which of the following are components of the body’s nonbicarbonate buffer system?
I. Hemoglobin II. Plasma proteins III. Organic phosphates IV. Inorganic phosphates |
all the above
|
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82. Of what use is the Henderson Hasselbalch equation for a clinician?
a. It can guide therapeutic decisions for critically ill patients b. It establishes the baseline values for buffer enhancement treatments c. Given H2CO3 and CO2 values, the pH can be computed d. It allows validation of the reported values and a blood gas report |
it allows validation of the reported values on a blood gas report
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83. The majority of the acid the body produces in a day is excreted through the lungs as CO2. What happens to the H ions?
a. They are bound to Hb b. They bind to phosphate c. They form carbamino compounds d. They bind to an OH forming H2) |
they bind to an OH forming H2O
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84. Which organ system actually excretes H from the body?
a. Kidneys b. Liver c. Lungs d. Spleen |
kidneys
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85. If the blood PCO2 is high, the kidneys will do which of the following?
a. Excrete more H and reabsorb more HCO3 b. Excrete less H and reabsorb more HCO3 c. Excrete less H and reabsorb less HCO3 d. Excrete more H and reabsorb less HCO3 |
excrete more H and reabsorb more HCO3
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86. What affect does hyperventilation have on HCO3 recovery in the kidneys?
a. Less H excretion, greater HCO3 loss b. No affect as these involve two independent systems c. Vicious cycle of worsening alkalemia as hyperventilation stimulates increased HCO3 retention d. Escalating retention of other buffer bases along the HCO3 |
less H excretion, greater HCO3 loss
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87. Which organ system maintains the normal level of HCO3 at 24 mEq/L?
a. Liver b. Lung c. Renal d. Spleen |
renal
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88. According to the Henderson Hasselbalch equation, the pH of the blood will be normal as long as the ratio of HCO3 to dissolved CO2 is which of the following?
a. 10:1 b. 20:1 c. 24:1 d. 30:1 |
20:1
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89. According to the Henderson Hasselbalch equation, the blood pH will rise (alkalemia) under which of the following conditions?
I. The buffer capacity increases II. The volatile acid (CO2) increases III. The volatile acid (CO2) decreases IV. The buffer capacity decreases |
I and III
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90. When does a state of alkalemia exist?
I. The HCO3/CO2 ratio exceeds 20:1 II. The blood pH exceeds 7.45 III. The blood PCO2 exceeds 54 mm Hg |
I and II
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91. What is the primary chemical even in respiratory acidosis?
a. Decrease in blood CO2 levels b. Decrease in blood HCO3 levels c. Increase in blood CO2 levels d. Increase in blood HCO3 levels |
increase in blood CO2 levels
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92. What is the primary chemical event in metabolic alkalosis?
a. Decrease in blood CO2 levels b. Decrease in blood HCO3 levels c. Increase in blood CO2 levels d. Increase in blood HCO3 levels |
increase in blood HCO3 levels
|
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93. What is a normal response of the body to a failure in one component of the acid base regulatory mechanism?
a. Autoregulation b. Compensation c. Correction d. Homeostasis |
compensation
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94. Compensation for respiratory acidosis occurs through which of the following?
a. Decrease in blood CO2 levels b. Decrease in blood HCO3 levels c. Increase in blood CO2 levels d. Increase in blood HCO3 levels |
increase in blood HCO3 levels
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95. Compensation for metabolic acidosis occurs through which of the following?
a. Increase in blood CO2 levels b. Decrease in blood CO2 levels c. Decrease in blood HCO3 levels d. Increase in blood HCO3 levels |
decrease in blood CO2 levels
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96. An ABG result shows the pH to be 7.56 and the HCO3 to be 23 mEq/L. Which of the following is the most likely disorder?
a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis |
respiratory alkalosis
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97. An ABG result shows pH of 7.35, PaCO2 of 30 mm Hg, and HCO3 of 18 mEq/L. Which of the following is the patient’s most likely primary disorder?
a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis |
metabolic acidosis
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98. An ABG result shows pH of 7.35, PaCO2 of 30 mm Hg, and HCO3 of 18 mEq/L. What compensatory measure has the body taken to at least partially compensate for the acid base disorder?
a. Blown off CO2 b. Retained HCO3 c. Retained H d. Not enough information to determine |
blown off CO2
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99. Which of the following clinical findings would you expect in a fully compensated respiratory acidosis?
I. Elevated HCO3 II. pH below 7.35 III. pH between 7.35 and 7.39 IV. elevated PO2 |
I and III
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100. In the face of uncompensated respiratory acidosis, which of the following blood gas abnormalities would you expect to encounter?
I. Decreased pH II. Increased HCO3 III. Increased PCO2 IV. Increased pH |
I and III
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101. Which of the following are potential causes of respiratory alkalosis?
I. Anxiety II. Central nervous system depression III. Hypoxemia IV. pain |
I, III, and IV
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102. Compensation for respiratory alkalosis occurs through which of the following?
a. Renal excretion of H b. Renal excretion of HCO3 c. Renal excretion of NH4 d. Renal reabsorption of HCO3 |
renal excretion of HCO3
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103. Metabolic acidosis may be caused by:
I. An increase if fixed (nonvolatile) acids II. An increase in blood carbon dioxide (CO2) III. Excessive loss of bicarbonate (HCO3) |
I and III
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104. What is the main compensatory mechanism for metabolic acidosis?
a. Excretion of HCO3 b. Hyperventilation c. Hypoventilation d. Retention of CO2 |
hyperventilaton
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105. A patient with Kussmaul’s respirations most likely has:
a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis |
metabolic acidosis
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106. What compensates for a metabolic alkalosis?
a. Hyperventilation b. Hypoventilation c. Renal excretion of HCO3 d. Renal retention of H |
hypoventilation
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107. Based on the following ABG results, what is the most likely acid base diagnosis? pH = 6.89, PCO2 = 24 mm Hg, HCO3 = 4.7 mEq/L
a. Acute (uncompensated) metabolic acidosis b. Acute (uncompensated) respiratory acidosis c. Partially compensated metabolic acidosis d. Partially compensated respiratory acidosis |
partially compensated metabolic acidosis
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1. Based on the following ABG results, what is the most likely acid base diagnosis? pH = 6.89, PCO2 = 24 mm Hg, HCO3 = 4.7 mEq/L
a. Acute (uncompensated) metabolic acidosis b. Acute (uncompensated) respiratory acidosis c. Partially compensated metabolic acidosis d. Partially compensated respiratory acidosis |
this gas is completely accurate
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109. When has full acid bas compensated occurred?
a. When PaCO2 and HCO3 go in opposite directions b. When PaCO2 and HCO3 go in the same direction c. When pH remains on the alkaline or acid side close to the normal range d. Whe pH is restored to the normal range even though pH remains on the alkaline or acid side of the range |
this gas is accurate as the calculation pH is 7.23
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110. When has partial acid base compensation occurred?
a. When PaCO2 and HCO3 go in opposite directions b. When PaCO2 and HCO3 go in the same direction c. When pH is within the normal range d. When the noncausative component (either PaCO2 or HCO3) is also abnormal in a way that brings the pH back toward the normal range |
when pH is restored to the normal range even though pH remains on the alkaline or acid side of the range
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111. What is the most common cause of respiratory acidosis?
a. Pneumonia b. ARDS c. Asthma d. COPD |
COPD
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112. Which of the following is an early sign of respiratory alkalosis?
a. Headache b. Blurred vision c. Nausea d. Paresthesia |
paresthesia
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113. Which of the following pH levels is most commonly associated with serious cardiac arrhythmias?
a. Below 7.3 b. Below 7.2 c. Below 7.1 d. Below 7.0 |
below 7.2
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114. Which of the following is the most common cause of metabolic alkalosis?
a. Panic attack b. Hyerventilaiton c. Diarrhea d. Loss of gastric acid |
loss of gastric acid
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115. Which of the following are categories of tissue hypoxia?
I. Hypoxic II, Anemic III. Stagnant IV. Histotoxic |
all the above
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116. What lung problem is ventilation/perfusion (V/Q) scanning used to detect?
a. Asthma b. Pulmonary embolism c. Pneumonia d. Lung cancer |
pulmonary embolism
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117. Which of the following structures will result in the most rediopaque shadow on the chest radiograph?
a. Aorta b. Heart c. Lungs d. Ribs |
ribs
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118. In what pulmonary condition does the chest radiograph often “lab behind” the clinical status of the patient?
a. Pulmonary embolism b. Emphysema c. Pneumonia d. Congestive heart failure |
pneumonia
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119. Which radiographic view of the chest allows the physician to read the best quality film?
a. Anteroposterior b. Posteroanterior c. Lateral d. Lordotic |
posteroanterior
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120. In the standard posteroanterior chest film, what proportion of the chest width should the heart shadow not exceed?
a. 33% b. 40% c. 50% d. 65% |
50%
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121. Which of the following is a major limitation of magnetic resonance imaging (MRI) of the chest?
a. Cannot visualize large vessels b. Cannot be used in patients with pacemakers c. Cannot be used to examine hilar structures d. Interpretation difficult |
cannot be used in patients with pacemakers
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122. What is indicated by rounding of the costophrenic angles seen on the posteroanterior or lateral chest film?
a. Emphysema b. Excess pleural fluid c. Obesity d. Rib fractures |
excess pleural fluid
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123. What chest x-ray view is best used to identify excess pleural fluid?
a. Posteroanterior b. Anteroposterior c. Lateral decubitus d. Apical lordotic |
lateral decubitus
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124. Which of the following statements is NOT true regarding the use of the chest x-ray to detect a pneumothorax?
a. An expiratory film may be best for a small pneumothorax b. The standard chest film is of limited use in detecting a pneumothorax c. The film will show a lack of vascular markings in the affected region. d. The lung margin is often visible with a pneumothorax |
the standard chest film is of limited use in detecting a pneumothorax
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125. Which of the following statements is NOT true regarding the recognition and treatment of a tension pneumothorax as seen on the chest radiograph?
a. The hemidiaphragm on the affected side will be pushed downward b. The mediastinum will be pushed towards the unaffected side c. It requires immediate insertion of a chest tube d. The patient should be intubated |
the pateint should be intubated
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126. What term is used to describe the shadows seen on the chest film when the alveoli fill with pus, fluid, or blood?
a. Consolidates b. Infiltrates c. Alveolar lesions d. Densities |
infiltrates
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127. Which of the following findings on a chest film is most consistent with pulmonary edema seen with acute respiratory distress syndrome (ARDS)?
a. Cephalization b. Kerley B-lines c. Cardiomegaly d. Bilateral patchy infiltrates of edema |
bilateral patchy infiltrates of edema
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128. Which of the following findings on the chest radiograph is considered a secondary sign of emphysema?
a. Flattening of the diaphragm b. Widening of the cardiac shadow c. Narrowing of the space between the ribs d. Blunting of the costophrenic angle |
flattening of the diaphragm
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129. What is the best imaging technique for examining mediastinal masses?
a. Conventional lateral chest radiography b. Chest CT c. MRI d. Ultrasound |
chest CT
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130. What is the optimal position of the endotracheal tube following intubatioini as seen on the chest radiograph?
a. 1 to 2 cm above the carina b. 3 to 4 cm above the carina c. 5 to 7 cm above the carina d. In the upper third of the carina |
5 to 7 cm above the carina
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131. What percentage of the U.S. population is 65 years or older?
a. 6% b. 8% c. 10% d. 12% |
12%
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132. What is the fastest growing age group in the United States, as well as in the world?
a. Those aged 80 years and older b. Those aged 85 years and older c. Those aged 90 years and older d. Those aged 95 years and older |
those aged 80 years and older
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133. How is the lung function of a healthy 70 year old in comparison with that of a 30 year old?
a. Approximately 50% b. Approximately 40% c. Approximately 30% d. Approximately 20% |
approximately 50%
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134. Which of the following structural changes in consistent with aging?
I. the chest wall becomes more compliant II. the chest wall becomes less compliant III. the lungs become more compliant IV. the lungs become less compliant |
II, III
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135. The ventilator response to hypercapnia and hypoxia decreases to approximately which levels in subjects aged 64 years and older?
a. 30% b. 40% c. 50% d. 60% |
50%
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136. All of the following statements are true of changes in airway clearance mechanism in older patients, except:
a. The inflammatory response and humoral and cell mediated immunity decrease b. Mucociliary clearance rates are faster c. Humoral and cell mediated immunity decrease d. Respiratory muscles are weakened |
mucociliary clearance rates are faster
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137. What happens to heart mass between ages 25 and 80 years?
a. It increases gradually b. It decreases gradually c. It remains the same d. It increases only with cardiovascular disease |
it increases gradually
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138. Which of the following is the best explanation for the reduction in heart rate with aging?
a. Decrease in valvular function b. Decline in ventricular filling c. Decline in atrial filling d. Reduction of sinus node pacemaker cells |
reduction of sinus node pacemaker cells
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139. Which of the following are the major age related impairments in the cardiovascular system?
I. increase vascular resistance II. reduced response to beta-adrenergic stimulation III. hampered ventricular relaxation IV. decreased vascular resistance |
I, II, III
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140. Which of the following are the major adaptations to impairments in the cardiovascular system?
I. left ventricular hypertrophy II. increased heart rate III. increased atrial contribution to diastolic filling IV. decreased vascular resistance |
I, III
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