Cardiopulomary Final Exam Review Flashcards
1
Q
According to Dalton’s Law, the total or sum of the partial pressures of gases is identified as which of the following?
A
PB
2
Q
Calculate the partial pressure of O2 in this room, if today’s PB is 742 mm Hg.
A
156 mmHg
3
Q
Calculate the PAO2 if a mountain climber has a PaCO2. of 30 mmHg, PB = 500 mm Hg with no supplemental oxygen?
A
59 mmHg
4
Q
A patient with a PaO2 of 55 mmHg would be at risk for what type of hypoxia?
A
Hypoxemic
5
Q
To calculate the A-a DO2 or A-a gradient, the data needed should include which of the following?
- PaO2
- SaO2
- PB
- PaCO2
A
1 and 4 only
6
Q
An increase in the thickness of the Alveolar basement membrane, due to Pulmonary Fibrosis, would result in which of the following?
- A diffusion enhancement and a PaO2 increase
- A diffusion impairment and a PaO2 decrease
- An increase for the A-a DO2
- No change for the A-a DO2
A
2 and 3 only
7
Q
What is the term for the passive movement of gas molecules from a high partial pressure to an area of low partial pressure until equilibrium is reached?
A
diffusion
8
Q
With all other factors remaining constant, according to the alveolar air equation, PAO2:
A
Increases as FIO2 increases
9
Q
The maximum volumetric capacity of one gram of adult hemoglobin for Oxygen is __.
A
1.34 milliliters/gm
10
Q
A patient is on oxygen therapy, with a measured PaO2 of 450 mm Hg. That patient would have ______ of oxygen dissolved in the plasma?
A
1.35 vol%
11
Q
The following data are collected from a patient’s ABG report:
pH 7.33
PaO2 65 torr
PaCO2 52 torr
HCO3 29 mEq/liter
Hb 18 gm%
Which of the following laboratory values is most important in assessing this patient’s oxygen-carrying capacity?
A
Hb
12
Q
A measurement which reflects the % of available oxygen to the patient when inspiring is correctly termed _______.
A
FIO2
13
Q
Calculate the dissolved oxygen content for a pt. in a medical hyperbaric chamber with a PB of 1520 mm Hg, FIO2 = 1.00 and a measured PaO2 = 1420 mm Hg
A
4.3 vols%
14
Q
PAO2 actually represents:
A
Partial pressure of oxygen in the Alveolus
15
Q
A measurement which reflects the total volume of oxygen per dl. of arterial blood is termed:
A
PaO2
16
Q
Calculate the PAO2 for a patient who is hiking to a base camp near Katmandu, Nepal, Altitude 15,000 feet.
[Assume a normal r & PaCO2 of 20 mm Hg and Barometric pressure of 420 mm Hg.]
PAO2 would be predicted to be:
A
53 torr
17
Q
If the patient has a calculated PAO2 of 122 mmHg and a measured PaO2 of 88 mmHg, The A-a gradient is _______________.
A
abnormal
18
Q
The normal equilibration time for an erythrocyte as it crosses the A/C membrane within the pulmonary capillaries is:
A
0.25 second
19
Q
Normally, the vast majority of Oxygen is transported in the blood as:
A
oxyhemoglobin
20
Q
A patient has a PaO2 of 100 mm Hg, Hb of 6.4 gm % and SaO2 of 97 %. The most likely clinical condition would be which of the following?
A
Hypoxemia
21
Q
Calculate the CaO2 for a patient with a PaO2 of 60 mm Hg, Hb of 12 gm% and SaO2 of 90 %;
A
14.7 vols%
22
Q
The normal water vapor pressure in the Human conducting zone airways @ 37o C. is
A
47 mm Hg
23
Q
A patient is experiencing a hypoxemic episode. A decision is made to increase the pt’s FIO2 to 40 %. Calculate the new PAO2 if the PB is 760 and the PaCO2 is 40 mm Hg with a normal r.
A
235 mm Hg
24
Q
A patient at sea level is receiving 50% oxygen and has an arterial blood gas with the following results:
pH 7.48
PaCO2 35 mmHg
PaO2 175 mmHg
Based on this data, calculate the A-a DO2.
A
139 mmHg
25
Approximately how much oxygen is extracted out of the blood at the tissue level?
25%
26
As you ascend in the atmosphere, the FIO2 ____________________.
remains the same
27
Oxygen is normally transported from the pulmonary circulation to the tissue bed in which of the following ways?
1. Bound to hemoglobin
2. Transported via methemoglobin
3. Dissolved in plasma
4. Disguised as bicarbonate
1 and 3 only
28
The barometric pressure is 748 mmHg. What is the partial pressure in mmHg of Nitrogen?
583
29
A patient is on supplemental oxygen at FiO2 of 35% at sea level. Their hemoglobin measures 15gm/dL, SaO2 and PaO2 is measuring 97% and 84 torr, respectively. PaCO2 measures at 42 torr. How much oxygen is dissolved in the arterial blood?
0.25
30
What is the normal arterial content of oxygen?
20 vols %
31
For an adult, what is the normal PaO2 range?
80-100 torr
32
An increase in interstitial fluid in the alveolar/capillary membrane can cause ___________________________________.
A slower rate of diffusion. It has to go through 8 layers already and with more fluid in the membrane it can cause a slower rate of diffusion.
33
What gas has the greatest partial pressure in the alveolus when a patient is breathing room air?
N2
34
What is the best expression of the respiratory exchange ratio?
CO2 excretion / O2 uptake
35
What is the significance of Henry’s and Graham’s Laws as it relates to O2 and CO2 exchange?
CO2 diffuses at a faster rate than O2
36
If PaCO2 increases,
PAO2 will decrease
37
Match the atmospheric gas to the % found in a sample of room air gas.
Oxygen =
Nitrogen =
Trace gases =
Oxygen = 21%
Nitrogen = 78%
Trace gases = 1%
38
A patient is at sea level has an FiO2 = 40%. What is the partial pressure of oxygen in mmHg of their breath (dry)?
304
39
As a breath travels from the mouth to the alveolus,
1. the FiO2 decreases
2. the FiO2 increases
3. the partial pressure of oxygen increases
4. the partial pressure of oxygen decreases
4 only
40
The total time that a capillary is normally in contact with an alveoli __________ is seconds. BUT, it only takes __________ seconds for oxygen to diffuse across.
0.75 & 0.25
41
As gas travels down the airway to the alveoli, the partial pressure of oxygen ____________________.
decreases
42
List 2 diseases or findings that can impair the diffusion of oxygen across the a-c membrane.
Hypoxemia, Fibrosis, and Pulmonary Fibrosis.
43
IF a patient has a V/Q mismatch, due to a ventilation issue, what will happen to the PaO2?
The PaO2 will decrease since there is no equilibrium of ventilation. At this point, we would supply the patient with oxygen to allow them to breathe more easily.
44
What does it mean if a oxygen is perfusion limited?
Oxygen transfer into the blood depends on how fast the blood is flowing through the lungs.
45
Name 2 components of the Fick diffusion equation.
Two components of the Fick's diffusion equation would be (P1 - P2) / T .
46
A patient, with no history of Cardiopulmonary disease, presents to the E.D. She is in pain and appears to be hyperventilating. You would confirm this assessment if the ABG reflects changes are as follows
decreased PaCO2, increased pH
47
When compared to Stomach Acid (HCl), Carbonic Acid (H2CO3):
is a weak acid
48
Which of the following statements most accurately describes the pH in circulatory physiology?
pH is indirectly proportional to H+ concentration
49
In general, the pH measurement for an ABG enables the clinician to determine_______:
Acidemia or alkalemia
50
During acute alveolar hyperventilation (as a result of anxiety), the arterial blood:
1. PaO2 increases
2. pH increases
3. HCO3- increases
4. PaCO2 decreases
1,2, and 4
51
In acute alveolar hypoventilation (as a result of a drug overdose with opiates), the arterial blood:
1. PaO2 decreases
2. pH increases
3. HCO3- increases
4. PaCO2 increases
1 and 4 only
52
Chronic (compensated) alveolar hypoventilation (as seen in COPD) will usually result in a(n)___.
high plasma bicarbonate
53
Acute hyperventilation in response to a metabolic acidosis will result in a(n)___.
low arterial PaCO2
54
Plasma HCO3- buffering activity, for a developing metabolic acidosis begins in:
3-5 seconds
55
Acute Metabolic Alkalosis indicates a condition in which there is a(n):
increased HCO3-
56
Complete metabolic compensation for a respiratory acidosis would result in a pH of:
7.36
57
A 12 y.o. obese, diabetic patient is brought to the emergency dept. Her arterial blood gas analysis (ABG) results are below: [Note 1 torr = 1 mm Hg.]
pH 7.23
PaCO2 20 torr
HCO3- 8 mEq/liter
PaO2 110 torr
SaO2 99%
The data above indicates that the patient:
is hyperventilating because of an acid-base disturbance
58
What is the function of buffers?
They readily combine with H+ ions, removing them from solution.
59
A patient has the ABG results below:
pH = 7.36
PaCO2 = 60 mm Hg
HCO3- = 33 mEq/L
PaO2 = 60 mm Hg
On the basis of these findings, in addition to mild hypoxemia, this patient’s Acid-Base assessment is:
completely compensated (chronic) respiratory acidosis
60
The following blood gases are obtained for a 36-year-old female patient in the ED:
pH = 7.45
PaCO2 = 47mm Hg
HCO3- = 30mEq/L
PaO2 = 90 mm Hg
What is the interpretation of these results?
Completely compensated (chronic) metabolic alkalosis, normal oxygenation
61
Analysis of arterial blood reveals:
pH = 7.53
PaCO2 = 25mm Hg
HCO3- = 22 mEq/L
PaO2 = 175 mm Hg
The best explanation is which of the following?
hyperventilation while breathing an increased FIO2
62
Match the following Arterial blood gas results with the interpretations. choices may be used more than once
pH = 7.27 PaCO2 = 40 torr HCO3- = 16.5 mEq/L
pH = 7.13 PaCO2 = 80 torr HCO3- = 26 mEq/L
pH = 7.56 PaCO2 = 20 torr HCO3- = 22 mEq/L
pH = 7.52 PaCO2 = 40 torr HCO3- = 32 mEq/L
pH = 7.10 PaCO2 = 88 torr HCO3- = 24 mEq/L
Metabolic acidosis (uncompensated)
Respiratory acidosis (uncompensated)
Respiratory alkalosis (uncompensated)
Metabolic alkalosis (uncompensated)
Respiratory acidosis (uncompensated)
63
Interpret the following arterial blood gas data for this pt., taken 10 minutes after resuscitation:
pH = 7.19
PaCO2 = 55 mm Hg
PaO2 = 31 mm Hg
HCO3 = 19 mEq/L
combined respiratory and metabolic acidosis
64
What is the 1st physiological compensatory response to metabolic acidosis?
acid buffering by circulating plasma HCO3-
65
A lethargic patient arrives at the E.D. of the hospital. Her respirations are slow and shallow. If the ABGs are
pH = 7.24
PaCO2 = 70 mm Hg
HCO3- = 24 mEq/L
What is the correct interpretation of these results?
acute respiratory acidosis
66
A patient presents with the following ABG values:
pH of 7.35
PaCO2 = 60 torr
HCO3- = 32 mEq/L
and a PaO2 = 59
This Patient’s primary ventilatory stimulus is probably governed by:
Hypoxic drive peripheral chemoreceptors
67
Which of the following are causes of acute hypoventilation?
Drug induced respiratory center depression
68
The arterial blood gas results below are from a distressed, 22 year old patient in the emergency room.
pH = 7.25
PaCO2 = 66 mmHg
HCO3 = 25 mEq/L
PaO2 = 55 mmHg
From this data we can conclude the patient’s:
Hypoventilation is causing an acute respiratory acidosis and Hypoxemia
69
A 57 year old apparently healthy male is evaluated in the emergency dept., after ingesting an unknown substance. His arterial blood gases are:
pH = 7.49
PaCO2 = 42 mmHg
PaO2 = 85, mmHg
HCO3 = 30 mEq/liter
You could conclude from this data that the patient:
has an uncompensated metabolic alkalosis
70
The HCO3- level, in mEq/L, required to normalize the pH when the PaCO2 is 60 torr is:
30
71
An arterial blood gas analysis of a 35 y.o. patient breathing room air provides these results:
pH = 7.28
PaCO2 = 68 mm Hg
and PaO2 = 55 mm Hg
Without other clinical data, this information suggests that the patient:
is hypoxemic secondary to hypoventilation
72
Metabolic alkalosis is associated with all of the following except:
diarrhea
73
Hypoxic Drive results when the primary autonomic trigger for ventilation originates in the:
Peripheral Chemoreceptors in the aortic and carotid sinuses
74
What does an arterial pH of 7.30 indicate, with no other data?
acidosis
75
When partially compensated respiratory acidosis is present, which of the following would be true?
PaCO2 above normal range, pH below normal range, HCO3- above normal range
76
When acute alveolar hyperventilation is present, which of the following would occur?
PaCO2 is below normal limits, pH is above normal limits, and HCO3- is within normal limits
77
What is the primary mechanism that drives ventilation in humans?
PaCO2
78
Which of the following organs is responsible for the physical removal of H+?
kidneys
79
What is the normal range for arterial pH?
7.35-7.45
80
What is the normal range for arterial oxygen?
80-100 mmHg
81
Match the normal ranges of an arterial blood gas with its component
pH =
PaCO2 =
PaO2 =
HCO3- =
7.35 - 7.45
35 - 45
80-100
22-26
82
A patient has a PaO2 = 65 mmHg, this is considered __________________.
mild hypoxemia
83
Explain in your own words, what changes does a patient make when they are moderately hypoxic? explain your answer.
84
According to Dalton’s Law, the total or sum of the partial pressures of gases is identified as which of the following?
PB
85
Calculate the partial pressure of O2 in this room, if today’s PB is 742 mm Hg .
156 mmHg
86
Calculate the PAO2 if a mountain climber has a PaCO2. of 30 mmHg, PB = 500 mm Hg with no supplemental oxygen?
59 mmHg
87
A patient with a PaO2 of 55 mmHg would be at risk for what type of hypoxia?
hypoxemic
88
A patient with a PaO2 of 55 mmHg would be at risk for what type of hypoxia?
1 and 4 only
89
An increase in the thickness of the Alveolar basement membrane, due to Pulmonary Fibrosis, would result in which of the following?
1. A diffusion enhancement and a PaO2 increase
2. A diffusion impairment and a PaO2 decrease
3. An increase for the A-a DO2
4. No change for the A-a DO2
2 and 3 only
90
What is the term for the passive movement of gas molecules from a high partial pressure to an area of low partial pressure until equilibrium is reached?
diffusion
91
With all other factors remaining constant, according to the alveolar air equation, PAO2:
Increases as FIO2 increases
92
The maximum volumetric capacity of one gram of adult hemoglobin for Oxygen is __.
1.34 milliliters/gm
93
A patient is on oxygen therapy, with a measured PaO2 of 450 mm Hg. That patient would have ______ of oxygen dissolved in the plasma?
1.35 vol%
94
The following data are collected from a patient’s ABG report:
pH 7.33
PaO2 65 torr
PaCO2 52 torr
HCO3 29 mEq/liter
Hb 18 gm%
Which of the following laboratory values is most important in assessing this patient’s oxygen-carrying capacity?
Hb
95
A measurement which reflects the % of available oxygen to the patient when inspiring is correctly termed _______.
FIO2
96
Calculate the dissolved oxygen content for a pt. in a medical hyperbaric chamber with a PB of 1520 mm Hg, FIO2 = 1.00 and a measured PaO2 = 1420 mm Hg
4.3 vols%
97
PAO2 actually represents:
Partial pressure of oxygen in the Alveolus
98
A measurement which reflects the total volume of oxygen per dl. of arterial blood is termed:
CaO2
99
Calculate the PAO2 for a patient who is hiking to a base camp near Katmandu, Nepal, Altitude 15,000 feet.
[Assume a normal r & PaCO2 of 20 mm Hg and Barometric pressure of 420 mm Hg.]
PAO2 would be predicted to be:
53 torr
100
If the patient has a calculated PAO2 of 122 mmHg and a measured PaO2 of 88 mmHg, The A-a gradient is _______________.
abnormal
101
The normal equilibration time for an erythrocyte as it crosses the A/C membrane within the pulmonary capillaries is:
0.25 second
102
Normally, the vast majority of Oxygen is transported in the blood as:
oxyhemoglobin
103
A patient has a PaO2 of 100 mm Hg, Hb of 6.4 gm % and SaO2 of 97 %. The most likely clinical condition would be which of the following?
Hypoxemia
104
Calculate the CaO2 for a patient with a PaO2 of 60 mm Hg, Hb of 12 gm% and SaO2 of 90 %
14.7 vols%
105
The normal water vapor pressure in the Human conducting zone airways @ 37o C. is
47 mm Hg
106
A patient is experiencing a hypoxemic episode. A decision is made to increase the pt’s FIO2 to 40 %. Calculate the new PAO2 if the PB is 760 and the PaCO2 is 40 mm Hg with a normal r.
235 mm Hg
107
A patient at sea level is receiving 50% oxygen and has an arterial blood gas with the following results:
pH: 7.48
PaCO2: 35 mmHg
PaO2: 175 mmHg
Based on this data, calculate the A-a DO2.
139 mmHg
108
Approximately how much oxygen is extracted out of the blood at the tissue level?
25%
109
As you ascend in the atmosphere, the FIO2 ____________________.
remains the same
110
Oxygen is normally transported from the pulmonary circulation to the tissue bed in which of the following ways?
1. Bound to hemoglobin
2. Transported via methemoglobin
3. Dissolved in plasma
4. Disguised as bicarbonate
1 and 3 only
111
The barometric pressure is 748 mmHg. What is the partial pressure in mmHg of Nitrogen?
583
112
A patient is on supplemental oxygen at FiO2 of 35% at sea level. Their hemoglobin measures 15gm/dL, SaO2 and PaO2 is measuring 97% and 84 torr, respectively. PaCO2 measures at 42 torr. How much oxygen is dissolved in the arterial blood?
0.25
113
What is the normal arterial content of oxygen?
20 vols %
114
For an adult, what is the normal PaO2 range?
80-100 torr
115
An increase in interstitial fluid in the alveolar/capillary membrane can cause ___________________________________.
A slower rate of diffusion. It has to go through 8 layers already and with more fluid in the membrane it can cause a slower rate of diffusion.
116
What gas has the greatest partial pressure in the alveolus when a patient is breathing room air?
N2
117
What is the best expression of the respiratory exchange ratio?
CO2 excretion / O2 uptake
118
What is the significance of Henry’s and Graham’s Laws as it relates to O2 and CO2 exchange?
CO2 diffuses at a faster rate than O2
119
If PaCO2 increases,
PAO2 will increase
120
Match the atmospheric gas to the % found in a sample of room air gas.
Oxygen =
Nitrogen =
Trace gases =
21%
78%
1%
121
A patient is at sea level has an FiO2 = 40%. What is the partial pressure of oxygen in mmHg of their breath (dry)?
304
122
As a breath travels from the mouth to the alveolus,
1. the FiO2 decreases
2. the FiO2 increases
3. the partial pressure of oxygen increases
4. the partial pressure of oxygen decreases
4 only
123
The total time that a capillary is normally in contact with an alveoli is __________ seconds. BUT, it only takes __________ seconds for oxygen to diffuse across.
0.75 & 0.25
123
As gas travels down the airway to the alveoli, the partial pressure of oxygen ____________________.
decreases
124
List 2 diseases or findings that can impair the diffusion of oxygen across the a-c membrane.
Hypoxemia, Fibrosis, and Pulmonary Fibrosis
125
IF a patient has a V/Q mismatch, due to a ventilation issue, what will happen to the PaO2?
The PaO2 will decrease since there is no equilibrium of ventilation. At this point, we would supply the patient with oxygen to allow them to breathe more easily.
126
What does it mean if a oxygen is perfusion limited?
Oxygen transfer into the blood depends on how fast the blood is flowing through the lungs.
127
Name 2 components of the Fick's diffusion equation.
Two components of the Fick diffusion equation would be (P1 - P2) / T .
128
A patient, with no history of Cardiopulmonary disease, presents to the E.D. She is in pain and appears to be hyperventilating. You would confirm this assessment if the ABG reflects changes are as follows
decreased PaCO2, increased pH
129
When compared to Stomach Acid (HCl), Carbonic Acid (H2CO3):
is a weak acid
130
Which of the following statements most accurately describes the pH in circulatory physiology?
pH is indirectly proportional to H+ concentration
131
In general, the pH measurement for an ABG enables the clinician to determine_______:
Acidemia or alkalemia
132
During acute alveolar hyperventilation (as a result of anxiety), the arterial blood:
1. PaO2 increases
2. pH increases
3. HCO3- increases
4. PaCO2 decreases
1, 2, and 4
133
In acute alveolar hypoventilation (as a result of a drug overdose with opiates), the arterial blood:
1. PaO2 decreases
2. pH increases
3. HCO3- increases
4. PaCO2 increases
1 and 4 only
134
Chronic (compensated) alveolar hypoventilation (as seen in COPD) will usually result in a(n)___.
high plasma bicarbonate
135
Acute hyperventilation in response to a metabolic acidosis will result in a(n)___.
low arterial PaCO2
136
Plasma HCO3- buffering activity, for a developing metabolic acidosis begins in:
3-5 seconds
137
Acute Metabolic Alkalosis indicates a condition in which there is a(n):
increased HCO3-
138
Complete metabolic compensation for a respiratory acidosis would result in a pH of:
7.36
139
A 12 y.o. obese, diabetic patient is brought to the emergency dept. Her arterial blood gas analysis (ABG) results are below: [Note 1 torr = 1 mm Hg.]
pH 7.23
PaCO2 20 torr
HCO3- 8 mEq/liter
PaO2 110 torr
SaO2 99%
The data above indicates that the patient:
is hyperventilating because of an acid-base disturbance
140
What is the function of buffers?
They readily combine with H+ ions, removing them from solution
141
A patient has the ABG results below:
pH = 7.36
PaCO2 = 60 mm Hg
HCO3- = 33 mEq/L
PaO2 = 60 mm Hg
On the basis of these findings, in addition to mild hypoxemia, this patient’s Acid-Base assessment is:
completely compensated (chronic) respiratory acidosis
142
The following blood gases are obtained for a 36-year-old female patient in the ED:
pH = 7.45
PaCO2 = 47mm Hg
HCO3- = 30mEq/L
PaO2 = 90 mm Hg
What is the interpretation of these results?
Completely compensated (chronic) metabolic alkalosis, normal oxygenation
143
Analysis of arterial blood reveals:
pH = 7.53
PaCO2 = 25mm Hg
HCO3- = 22 mEq/L
PaO2 = 175 mm Hg
The best explanation is which of the following?
hyperventilation while breathing an increased FIO2
144
Match the following Arterial blood gas results with the interpretations.
pH = 7.27
PaCO2 = 40 torr
HCO3- = 16.5 mEq/L
pH = 7.13
PaCO2 = 80 torr
HCO3- = 26 mEq/L
pH = 7.56
PaCO2 = 20 torr
HCO3- = 22 mEq/L
pH = 7.52
PaCO2 = 40 torr
HCO3- = 32 mEq/L
pH = 7.10
PaCO2 = 88 torr
HCO3- = 24 mEq/L
Metabolic acidosis (uncompensated)
Respiratory acidosis (uncompensated)
Respiratory acidosis (uncompensated)
Metabolic alkalosis ( uncompensated)
Respiratory acidosis (uncompensated)
145
Interpret the following arterial blood gas data for this pt., taken 10 minutes after resuscitation:
pH = 7.19
PaCO2 = 55 mm Hg
PaO2 = 31 mm Hg
HCO3 = 19 mEq/L
combined respiratory and metabolic acidosis
146
What is the 1st physiological compensatory response to metabolic acidosis?
acid buffering by circulating plasma HCO3-
147
A lethargic patient arrives at the E.D. of the hospital. Her respirations are slow and shallow. If the ABGs are
pH = 7.24
PaCO2 = 70 mm Hg
HCO3- = 24 mEq/L
What is the correct interpretation of these results?
acute respiratory acidosis
148
A patient presents with the following ABG values:
pH of 7.35
PaCO2 = 60 torr
HCO3- = 32 mEq/L
and a PaO2 = 59
This Patient’s primary ventilatory stimulus is probably governed by:
Hypoxic drive peripheral chemoreceptors
149
Which of the following are causes of acute hypoventilation?
Drug induced respiratory center depression
150
The arterial blood gas results below are from a distressed, 22 year old patient in the emergency room.
pH = 7.25
PaCO2 = 66 mmHg
HCO3 = 25 mEq/L
PaO2 = 55 mmHg
From this data we can conclude the patient’s:
Hypoventilation is causing an acute respiratory acidosis and Hypoxemia
151
A 57 year old apparently healthy male is evaluated in the emergency dept., after ingesting an unknown substance. His arterial blood gases are:
pH = 7.49
PaCO2 = 42 mmHg,
PaO2 = 85 mmHg
HCO3 = 30 mEq/liter
You could conclude from this data that the patient:
has an uncompensated metabolic alkalosis
152
The HCO3- level, in mEq/L, required to normalize the pH when the PaCO2 is 60 torr is:
30
153
An arterial blood gas analysis of a 35 y.o. patient breathing room air provides these results: pH = 7.28, PaCO2 = 68 mm Hg and PaO2 = 55 mm Hg. Without other clinical data, this information suggests that the patient:
is hypoxemic secondary to hypoventilation
154
Metabolic alkalosis is associated with all of the following except:
diarrhea
155
Hypoxic Drive results when the primary autonomic trigger for ventilation originates in the:
Peripheral Chemoreceptors in the aortic and carotid sinuses
156
What does an arterial pH of 7.30 indicate, with no other data?
acidosis
157
When partially compensated respiratory acidosis is present, which of the following would be true?
PaCO2 above normal range, pH below normal range, HCO3- above normal range
158
When acute alveolar hyperventilation is present, which of the following would occur?
PaCO2 is below normal limits, pH is above normal limits, and HCO3- is within normal limits
159
What is the primary mechanism that drives ventilation in humans?
PaCO2
160
Which of the following organs is responsible for the physical removal of H+?
Which of the following organs is responsible for the physical removal of H+?
161
What is the normal range for arterial pH?
7.35-7.45
162
What is the normal range for arterial oxygen?
80-100 mmHg
163
Match the normal ranges of an arterial blood gas with its component.
pH
PaCO2
PaO2
HCO3-
7.35-7.45
35-45
80-100
22-26
164
A patient has a PaO2 = 65 mmHg, this is considered __________________.
mild hypoxemia
165
Explain in your own words, what changes does a patient make when they are moderately hypoxic? explain your answer.
They would start to breathe faster to bring in more oxygen. Their heart beats faster to move the little bit of oxygen they do have all around the body.
165
For the Oxyhemoglobin Disassociation curve, a PaO2 of 60 mm Hg should result in an arterial oxygen saturation (SaO2) of _____ in the normal adult human population.
85%
166
A patient with a PaO2 of 55 mmHg would be at risk for what type of hypoxia?
hypoxemic
166
An increase in the thickness of the Alveolar basement membrane, due to Pulmonary Fibrosis, would result in which of the following?
1. A diffusion enhancement and a PaO2 increase
2. A diffusion impairment and a PaO2 decrease
3. An increase for the A-a gradient
4. No change for the A-a gradient
2 and 3 only
167
When the H+ Concentration, PaCO2 or temperature increases in a tissue bed, the oxygen dissociation curve shifts to the:
right and the P50 increases
168
In which of the following types of hypoxia will the oxygen partial pressure of the arterial blood (PaO2) typically be below normal limits?
1. Hypoxemic hypoxia
2. Anemic hypoxia
3. Circulatory (stagnant) hypoxia
4. Histotoxic hypoxia
1 and 3 only
168
Hb variants such as Fetal Hb and Methemoblobin primarily affect the measured ____ of O2 in circulation .
SaO2
169
The following data are collected from a patient’s ABG report:
pH 7.33
PaO2 65 torr
PaCO2 52 torr
HCO3 29 mEq/liter
Hb 18 gm%
Which of the following laboratory values is most important in assessing this patient’s oxygen-carrying capacity?
hemoglobin
169
In the RBC the Hydration reaction increases the rate of the reaction of H2CO3 to HCO3- + H+ because
carbonic anhydrase catalyzes the hydration reaction to the left
169
In the RBC plasma, initially, the hydration reaction between H2O + CO2 yields _____
carbonic acid
170
Newly deoxygenated hemoglobin combines with CO2 and _______ in the RBC.
H+
171
Which of the following are ways carbon dioxide is transported in human blood plasma?
1. in a dissolved form
2. as Bicarbonate
3. as Carbamino-Hb
1 and 2 only
172
A cellular environment with an increased CO2 and H+ concentration results in a(n)____
decreased pH
173
A patient is hypothermic. This will have which of the following effects on hemoglobin an oxygen affinity?
increased affinity
174
For a fetus, dependent on the mother’s placenta for gas exchange, their unique Oxygen Disassociation curve (see diagram below) predicts the P50 at _____?
18-19 mmHg
175
Which of the following is a cause of anemic hypoxia?
1. Hemorrhage
2. Methemoglobin
3. Pneumonia
4. Congestive heart failure
5. Potassium cyanide
1 and 2 only
176
A patient has been deprived of oxygen due to suffocation. What type of respiration are the tissue/cells experiencing?
anaerobic respiration
177
What is the correct breakdown of carbonic acid?
H2O and CO2
178
When CO2 binds to hemoglobin, it is then termed
carbaminohemoglobin
179
Match the type of hemoglobin with its definition.
hemoglobin bound to oxygen
hemoglobin without oxygen bound to it
hemoglobin bound to carbon monoxide
hemoglobin bound to carbon dioxide
Oxyhemoglobin
Deoxyhemoglobin
Carboxyhemoglobin
Carbaminohemoglobin
180
Choose the correct shift in the oxyhemoglobin dissociation curve for each condition.
increased CO2
increased hydrogen ions
increased pH
decreased temperature
right shift
right shift
left shift
left shift
181
Match the appropriate statements with each other.
Left shift
Right shift
increased P50
decreased P50
Increased affinity for oxygen
Decreased affinity for oxygen
Decreased affinity for oxygen
Increased affinity for oxygen
182
If PaCO2 increases,
PaO2 will decrease
183
Describe what affinity to oxygen is in regards to hemoglobin.
Affinity to oxygen is in regards to hemoglobin is that it is attracted to hemoglobin and wants to carry more oxygen.
184
Give the full interpretation of the following blood gas :
pH 7.28
PaCO2 51 mmHg
PaO2 75 mm Hg
HCO3- 27 mEq/L
Include type of problem, type of compensation (if applicable) and oxygenation.
pH: 7.28 (Acidosis)
PaCO2: 51 mmHg (Acidosis)
PaO2: 75 mmHg (Mild hypoxemia)
HCO3-: 27 mEq/L (Alkalosis)
This patient is having Respiratory acidosis with partial compenstation of metabolic. The patient is having slow breathing having too much CO2 in the body.
185
Give the full interpretation of the following blood gas :
pH 7.51
PaCO2 21 mmHg
PaO2 100 mm Hg
HCO3- 25 mEq/L
Include type of problem, type of compensation (if applicable) and oxygenation
pH: 7.51 (Alkalosis)
PaCO2: 21 mmHg (Alkalosis)
PaO2: 100mmHg (Normal)
HCO3-: 25 mEq/L (Normal)
This patient is having Respiratory alkalosis with uncompensatation. Their oxygen levels are within normal range.
186
Give the full interpretation of the following blood gas :
pH 7.25
PaCO2 55 mmHg
PaO2 62 mm Hg
HCO3- 27 mEq/L
Include type of problem, type of compensation (if applicable) and oxygenation
and how will this affect affinity for oxygen?
This patient is respiratory acidosis with metabolic compensation. Their oxygen levels are mildly hypoxemic. This would make the affinity for oxygen shift to the right.
187
Explain what a fully compensated metabolic acidosis is? (3pts)
What breathing pattern might the patient be exhibiting? (1 pt)
The body has too much acid because of a metabolic problem. The lungs help fix it by breathing out more CO₂ (which is also acidic).
They will breathe fast and deep. (Kussmaul breathing).
188
Contractility of the Ventricles is impaired by which of the following
1. decreased preload
2. frequent PVCs
3. hypertension
4. myocardial hypoxia
1, 2, and 4 only
188
Myocardial cellular perfusion, via the coronary arteries, occurs primarily during __________________.
ventricular diastole
189
A PR interval of 0.12 sec. generally indicates:
normal SA to AV conduction
189
The “a“ wave seen in RA and LA pressure tracings is an indicator
atrial contraction
190
An increased PR interval would lead the clinician to examine the ECG for which of the following?
AV block
191
The actual mechanical effect of Atrial Flutter results in which of the following?
decrease in preload
192
Which of the following statements is (are) true about the ST segment of an ECG?
1. it represents the time when the Aortic and Pulmonic valves are open
2. it represents the ventricular diastole
3. it represents when there is rapid ejection of blood from the ventricles
4. it represents depolarization of the ventricles
1 and 3 only
193
Consider the ECG below, what is the QRS duration?
0.08
194
In the ECG wave below, what does the RED waveform represent?
atrial depolarization
195
A normal Sat. O2 of 65%, in an adult, is associated which blood vessel or heart chamber?
SVC
196
What outflow vessel or heart chamber would carry a normal pressure of 25/8 mm Hg?
PA
197
What ECG event is indicated with Ventricular Depolarization?
QRS
198
The hemodynamic feature indicated b the arrow in the tracing below represents which of the following?
aortic valve closure
199
All of the following actions are visible for a typical ECG except:
atrial repolarization
200
The distal tip of the S-G catheter in the below illustration is measuring the _____________.
Pulmonary artery pressure
201
The Waveform represented by the arrow in the tracing below is ____________.
LV pressure
202
In the ICU a practical method of evaluating LA pressure and L.Ventricular preload is the:
Wedge Pressure measurement with a Swan Ganz catheter
203
What is the normal sinus rhythm rate?
70-80
204
If the SA node stops firing, what will be the expected heart rate?
40-60
205
Which of the following phenomena is responsible for the initiation of muscle contraction?
membrane depolarization
206
An ECG reveals that all sinus nodal impulses are conducted to the ventricles, but the PR interval is greater than 0.2 second and all QRS complexes have normal configurations. What is the best interpretation of this ECG?
first degree AV block
207
The PR intervals are constant, but with various conduction ratios, in which type of AV block?
second degree, type II
208
Atrial depolarization is represented by which of the following waves in the ECG?
P
209
The PR intervals gradually lengthen until a QRS complex fails to appear after the P wave in which type of AV block?
second degree, type I
210
No relationship exists between P waves and QRS complexes in which type of AV block?
third degree
211
Ventricular depolarization is represented by which of the following waves in the ECG?
QRS
212
Which of the following is the only parameter that the ECG measures?
electrical events
213
Which of the following conditions are detected by the ECG?
1. abnormal heart rhythms
2. conduction problems
3. force of contraction
4. valve abnormalities
1 and 2 only
214
How long does it normally take for the ventricles to depolarize?
0.08 - .01 sec
215
Which of the following is a feature of the PR interval?
It is measured from the beginning of the P wave to the next ventricular deflection.
216
OF the rhythms listed below, which is the most lethal of all cardiac arrhythmias?
VF
217
Ventricular repolarization is represented by which of the following waves in the ECG?
T
218
Stroke volume is determined by which of the following factors?
Contractility, preload, and afterload
219
Which of the following is a clinical indicator of ventricular afterload?
MAP (mean arterial pressure)
220
Which of the following is an essential tool in measuring hemodynamic variables?
Swan Ganz catheter
221
When the balloon-tipped catheter wedges in a small pulmonary arteriole, the blood pressure measured through the distal lumen is approximately the same as which of the following?
Left atrium
222
Which of the following is considered a preload pressure?
LVEDP
223
Please Refer to ECG I for the following question:
What is the ventricular rate for this tracing?
145
224
Please refer to ECG I for the following question:
Which one of the following statements is true regarding this ECG tracing?
The PR interval is uniform with each QRS
225
Please refer to ECG I for the following question:
This rhythm can be defined as which of the following?
Sinus tachycardia
226
Please refer to ECG I for the following question:
The PR interval for this strip is
normal
227
Please refer to ECG II for the following question:
What is the ventricular rate for this tracing?
Supraventricular Tachycardia (SVT)
228
Please refer to ECG III for the following question:
This rhythm can be defined as ________________.
Atrial Fibrillation
229
Please refer to ECG III for the following question:
Which of the following statements is true regarding this rhythm?
The R-R intervals are not regular
230
Please refer to ECG IV for the following question:
The PR interval is _____________.
0.20 sec
231
Please refer to ECG IV for the following question:
This rhythm can be defined as which of the following?
second degree, type II
232
Please refer to ECG V for the following question:
What is the ventricular rate for the strip shown?
78
233
Please refer to ECG V for the following question:
This rhythm can be defined as _______________________.
first degree AV block
234
Please refer to ECG VI for the following question:
This rhythm can be defined as which of the following?
ventricular tachycardia
235
Please refer to ECG VI for the following question:
Though not normal, this rhythm is
regular
236
Please refer to ECG VII for the following question:
This rhythm can be defined as which of the following?
sinus rhythm with unifocal PVCs
237
Please refer to ECG VII for the following question:
The wave at the 3 second mark is which of the following?
T
238
Please refer to ECG VIII for the following question:
This rhythm can be defined as which of the following?
Third degree AV block
239
Please refer to ECG VIII for the following question:
What is the atrial rate?
100
240
Please refer to ECG VIII for the following question:
What is the PR interval for this rhythm?
unable to be determined
241
Please refer to ECG IX for the following question:
This rhythm can be defined as _______________________.
normal sinus rhythm
242
Please refer to ECG IX for the following question:
The PR interval is measured at _______________ second.
0.12
