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E-lfh FRCA Primary: Physiology - Respiratory Physiology > Primary FRCA Course Resp Physiology Exam Prep Questions > Flashcards

Primary FRCA Course Resp Physiology Exam Prep Questions Flashcards

1
Q

The functional residual capacity

is increased in the obese

A

False. Common causes of reduced FRC include general anaesthesia, abdominal masses (inc pregnancy and obesity), supine position and in children or the elderly.

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2
Q

The functional residual capacity

is approximately 10 per cent higher in men than in women

A

True

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3
Q

The functional residual capacity

falls with general anaesthesia

A

True. Common causes of reduced FRC include general anaesthesia, abdominal masses (inc pregnancy and obesity), supine position and in children or the elderly.

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4
Q

The functional residual capacity

increases on changing from the supine to the standing position

A

True. Common causes of reduced FRC include general anaesthesia, abdominal masses (inc pregnancy and obesity), supine position and in children or the elderly.

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5
Q

The functional residual capacity

falls with increasing age

A

False. Common causes of reduced FRC include general anaesthesia, abdominal masses (inc pregnancy and obesity), supine position and in children or the elderly.

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6
Q

Vital capacity

is the volume of air expired from full inspiration to full expiration

A

True

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7
Q

Vital capacity

increases gradually with age in adults

A

False. VC decreases with age

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8
Q

Vital capacity

is greater in men than in women of similar age and height

A

True

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9
Q

Vital capacity

is equal to the sum of the inspiratory and expiratory reserve volumes

A

False. This would not include tidal volume

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10
Q

Vital capacity

may be measured by spirometry

A

True

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11
Q

Closing capacity

is larger than functional reserve capacity

A

False. When closing capacity is greater than FRC, small airways closure occurs during normal tidal breathing. This can occur, but is by no means normally the case

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12
Q

Closing capacity

may be determined by single breath N2 curve following a deep breath of oxygen

A

False. This method determines closing volume. Residual volumes would need to be added to calculate closing capacity. Fowler’s method (multiple breath N2 curve) can do this.

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13
Q

Closing capacity

is high in young children and decreases progressively with advancing age

A

False. It is low in infancy and increases with age

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14
Q

Closing capacity

if high, may be responsible for arterial hypoxaemia

A

True. Due to shunt caused by small airways closure.

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15
Q

Closing capacity

is unaffected by bronchomotor tone

A

False.

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16
Q

Closing volume

increases with age

A

True

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17
Q

Closing volume

decreases during anaesthesia

A

True. This offers a degree of protection against the drop in FRC seen. Once FRC reaches Closing Capacity (the sum of Closing Volume and Residual Volume) small airways closure begins

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18
Q

Closing volume

is increased in the upright position

A

False. It increases in the supine position

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19
Q

Closing volume

is decreased in obesity

A

False. It increases in obesity, compounding the problem of reduced FRC

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20
Q

Closing volume

can be measured by a single breath nitrogen technique

A

True. Unlike closing capacity.

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21
Q

FRC can be measured using

Helium wash-in

A

True. The three methods of measuring FRC are plethysmography, nitrogen wash-out and helium wash-in. Spirometry will measure all lung volumes except FRC, residual volume and TLC. Intra-oesophageal balloons are used to measure intra-pleural pressure.

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22
Q

FRC can be measured using

Nitrogen wash-out

A

True. The three methods of measuring FRC are plethysmography, nitrogen wash-out and helium wash-in. Spirometry will measure all lung volumes except FRC, residual volume and TLC. Intra-oesophageal balloons are used to measure intra-pleural pressure.

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23
Q

FRC can be measured using

Body plethysmography

A

True. The three methods of measuring FRC are plethysmography, nitrogen wash-out and helium wash-in. Spirometry will measure all lung volumes except FRC, residual volume and TLC. Intra-oesophageal balloons are used to measure intra-pleural pressure.

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24
Q

FRC can be measured using

Spirometry

A

False. The three methods of measuring FRC are plethysmography, nitrogen wash-out and helium wash-in. Spirometry will measure all lung volumes except FRC, residual volume and TLC. Intra-oesophageal balloons are used to measure intra-pleural pressure.

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25
Q

FRC can be measured using

Intra-oesophageal balloon

A

False. The three methods of measuring FRC are plethysmography, nitrogen wash-out and helium wash-in. Spirometry will measure all lung volumes except FRC, residual volume and TLC. Intra-oesophageal balloons are used to measure intra-pleural pressure.

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26
Q

The following are required to calculate the pulmonary shunt fraction (Qs/QT)

FiO2

A

True. This appears in the alveolar gas equation.

To calculate the end capillary oxygen content, PAO2 is assumed to be equal to, and substituted into, the oxygen content equation in place of PcO2. PAO2 is calculated using the alvealor gas equation.

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27
Q

The following are required to calculate the pulmonary shunt fraction (Qs/QT)

Cardiac output

A

False. Cardiac output (QT) is part of the Shunt Fraction. If you were calculating QS alone you would need to know QT

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28
Q

The following are required to calculate the pulmonary shunt fraction (Qs/QT)

PaCO2

A

True. This is taken as being equal to PACO2 (which appears in the alveolar gas equation).

To calculate the end capillary oxygen content, PAO2 is assumed to be equal to, and substituted into, the oxygen content equation in place of PcO2. PAO2 is calculated using the alvealor gas equation.

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29
Q

The following are required to calculate the pulmonary shunt fraction (Qs/QT)

arterial O2 content

A

True. This appears directly in the shunt equation

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30
Q

The following are required to calculate the pulmonary shunt fraction (Qs/QT)

mixed venous O2 content

A

True. This appears directly in the shunt equation

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31
Q

Surfactant

is a mucopolypeptide

A

False. It is a phoshpholipid

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32
Q

Surfactant

causes a decrease in surface tension

A

True.

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33
Q

Surfactant

equilibrates surface tension for different sized alveoli

A

False. It equilibrates alveolar pressure by differentially reducing surface tension more in small alveoli.

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34
Q

Surfactant

causes an increase in compliance

A

True.

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35
Q

Surfactant

production is reduced after a prolonged reduction in pulmonary blood flow

A

True. It it synthesised from free fatty acids, extracted from the blood.

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36
Q

Pulmonary Surfactant

is a mixture of phospholipids and proteins

A

True.

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37
Q

Pulmonary Surfactant

causes an increase in chest wall compliance

A

False. It does not affect the chest wall

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38
Q

Pulmonary Surfactant

prevents transudation of fluid from the blood into the alveoli

A

True. High surfance tension would tend to draw fluid into the alveoli

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39
Q

Pulmonary Surfactant

deficiencies in babies born to diabetic mothers is due to fetal hyperinsulinism

A

True.

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40
Q

Pulmonary Surfactant

concentration per unit area is directly proportional to surface tension

A

False. It is indirectly proportional

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41
Q

Alveolar - arterial oxygen difference (A-a DO2

is normally 2-3 kPa while breathing room air

A

True

42
Q

Alveolar - arterial oxygen difference (A-a DO2

is increased under anaesthesia due to increased V/Q mismatch

A

True. The major causes of and increased A-a difference are Shunt / low V/Q ratio and diffusion defects.

43
Q

Alveolar - arterial oxygen difference (A-a DO2

is decreased in one lung ventilation

A

False. Due to large shunt created. The major causes of and increased A-a difference are Shunt / low V/Q ratio and diffusion defects.

44
Q

Alveolar - arterial oxygen difference (A-a DO2

is increased in the presence of right to left intracardiac shunts

A

True. These represent true shunts. The major causes of and increased A-a difference are Shunt / low V/Q ratio and diffusion defects.

45
Q

Alveolar - arterial oxygen difference (A-a DO2

is decreased in severe exercise

A

False. The A-a difference widens at high intensity levels of exercise. The major causes of and increased A-a difference are Shunt / low V/Q ratio and diffusion defects.

46
Q

PaCO2-EtCO2 gradient

is up to 0.7 kPa in patients wihout significant disease

A

True.

47
Q

PaCO2-EtCO2 gradient

increases in venous air embolism

A

True. The PaCO2-EtCO2 gradient increases with any cause of increased dead space.

48
Q

PaCO2-EtCO2 gradient

is greater in high frequency ventilation

A

True.

49
Q

PaCO2-EtCO2 gradient

is greater in high V/Q areas of the lungs

A

True. The PaCO2-EtCO2 gradient increases with any cause of increased dead space.

50
Q

PaCO2-EtCO2 gradient

is greater in patients with poor cardiac output

A

True. The PaCO2-EtCO2 gradient increases with any cause of increased dead space.

51
Q

When the ventilation/perfusion ratio of a lung unit increases

the alveolar PO2 rises

A

True. Alveolar PO2 will tend towards inspired PO2 in areas of dead space

52
Q

When the ventilation/perfusion ratio of a lung unit increases

the alveolar CO2 rises

A

False. Alveolar CO2 falls in areas of dead space

53
Q

When the ventilation/perfusion ratio of a lung unit increases

end capillary PO2 increases

A

True. Due to the increased alveolar PO2

54
Q

When the ventilation/perfusion ratio of a lung unit increases

arterial PO2 increases

A

True. Contrary to intuition, this is true, although the cause of dead space in one lung unit may cause shunt in another with the net effect being hypoxia, such as seen after a PE

55
Q

When the ventilation/perfusion ratio of a lung unit increases

hypoxic pulmonary vasoconstriction will compensate for any change in gas exchange

A

False. It will provide a degree of compensation only

56
Q

The distribution of ventilation of an upright subject is related to

regional airways diameters

A

True.

At normal lung volumes, the intrapleural pressure is greater (less negative) in the dependent part of the lung (this greater pressure provides support to the weight of lung suspended above it). This gareter pressure results in the lung being at lower volume in the dependent parts. Although lung volume is lower in the non-dependent parts, ventilation is greater as it sits on the steep part of the compliance curve.

57
Q

The distribution of ventilation of an upright subject is related to

regional differences in compliance

A

True.

At normal lung volumes, the intrapleural pressure is greater (less negative) in the dependent part of the lung (this greater pressure provides support to the weight of lung suspended above it). This gareter pressure results in the lung being at lower volume in the dependent parts. Although lung volume is lower in the non-dependent parts, ventilation is greater as it sits on the steep part of the compliance curve.

58
Q

The distribution of ventilation of an upright subject is related to

inspired oxygen concentration

A

False. This is not related to ventilation.

59
Q

The distribution of ventilation of an upright subject is related to

gravitational forces on the lung

A

True.

At normal lung volumes, the intrapleural pressure is greater (less negative) in the dependent part of the lung (this greater pressure provides support to the weight of lung suspended above it). This gareter pressure results in the lung being at lower volume in the dependent parts. Although lung volume is lower in the non-dependent parts, ventilation is greater as it sits on the steep part of the compliance curve.

60
Q

The distribution of ventilation of an upright subject is related to

intrathoracic pressure

A

True.

At normal lung volumes, the intrapleural pressure is greater (less negative) in the dependent part of the lung (this greater pressure provides support to the weight of lung suspended above it). This gareter pressure results in the lung being at lower volume in the dependent parts. Although lung volume is lower in the non-dependent parts, ventilation is greater as it sits on the steep part of the compliance curve.

61
Q

In an awake, healthy individual in the lateral position, the:

dependent lung has less ventilation

A

False. The dependent (lower) lung will have better ventilation due to falling on the steeper part of the compliance curve.

62
Q

In an awake, healthy individual in the lateral position, the:

dependent lung has more perfusion

A

True

63
Q

In an awake, healthy individual in the lateral position, the:

V/Q ratio is higher in the dependent lung

A

False. The dependent lung will have a small degree of shunt (low V/Q ratio) whilst the non-dependent lung will have a degree of dead space (high V/Q).

64
Q

In an awake, healthy individual in the lateral position, the:

PAO2 is higher in the lower lung

A

False. The degree of shunt will lower PAO2 and raise PACO2.

65
Q

In an awake, healthy individual in the lateral position, the:

PACO2 is lower in the lower lung

A

False. The degree of shunt will lower PAO2 and raise PACO2

66
Q

The following vessels are important in physiological shunt

bronchial veins

A

True.

67
Q

The following vessels are important in physiological shunt

thebesian veins

A

True. drain into the left ventricle

68
Q

The following vessels are important in physiological shunt

coronary sinus

A

False. drains into the right atrium

69
Q

The following vessels are important in physiological shunt

ductus venosus

A

False.

70
Q

The following vessels are important in physiological shunt

azygos veins

A

False. drain into the superior vena cava

71
Q

An area in the lung with increased V/Q ratio:

represents dead space

A

True.

72
Q

An area in the lung with increased V/Q ratio:

represents shunt

A

False.

73
Q

An area in the lung with increased V/Q ratio:

is responsible for a decrease in the PAO2 with no change in PACO2

A

False. PAO2 increases, whilst PACO2 decreases

74
Q

An area in the lung with increased V/Q ratio:

will cause a degree of hypoxia

A

False. Dead space per se, is not a cause of hypoxia. It may result in hypoxia if as a result blood is shunted elsewhere with a low V/Q, but this is not a direct result.

75
Q

An area in the lung with increased V/Q ratio:

may be compensated for by an increased minute ventilation

A

True. Dead space reduces CO2 excretion, hence the increased PaCO2 - EtCO2 gradient. This may be compensated for by increasing minute ventilation, although the cause of dead space would be better addressed

76
Q

A pressure-volume curve can be used for measuring

the work of breathing

A

True. Using the area under the curve

77
Q

A pressure-volume curve can be used for measuring

functional residual capacity

A

False. The three methods of measuring FRC are plethysmography, nitrogen wash-out and helium wash-in

78
Q

A pressure-volume curve can be used for measuring

anatomical dead space

A

False. Anatomical dead space measured using the Fowler method (nitrogen wash-out)

79
Q

A pressure-volume curve can be used for measuring

compliance

A

True.

80
Q

A pressure-volume curve can be used for measuring

respiratory quotient

A

False.

81
Q

Lung compliance

is normally 0.2 L/cm H2O

A

True.

82
Q

Lung compliance

is decreased with loss of pulmonary surfactant

A

True.

83
Q

Lung compliance

is increased in emphysema

A

True. Due a reduced elastic recoil that naturally resists alveoalar inflation

84
Q

Lung compliance

is decreased after induction of general anaesthesia

A

True. Due to the reduced FRC, the lung sits on the flatter part of the compliance curve

84
Q

Lung compliance

is different at the apices and bases of lungs

A

True. Compliance (and hence ventilation) is greater in the dependent part of the lung.

85
Q

A body plethysmograph can be used to measure

Compliance

A

True. A body plethysmograph and an oesophageal balloon may be used to measure intrapleural pressure. Measurements of pressure and volume may then be plotted against one another to give pressure: volume compliance loop.

86
Q

A body plethysmograph can be used to measure

Work of breathing

A

True. A body plethysmograph and an oesophageal balloon may be used to measure intrapleural pressure. Measurements of pressure and volume may then be plotted against one another to give pressure: volume compliance loop.

87
Q

A body plethysmograph can be used to measure

Gas exhange

A

False.

88
Q

A body plethysmograph can be used to measure

Airway resistance

A

True. A body plethysmograph and an oesophageal balloon may be used to measure intrapleural pressure. Measurements of pressure and volume may then be plotted against one another to give pressure: volume compliance loop.

89
Q

A body plethysmograph can be used to measure

FEV1

A

False.

90
Q

Concerning lung volumes and capacities

The total volume of both lungs is the vital capacity

A

False. This is the total lung capacity

91
Q

Concerning lung volumes and capacities

Closing capacity is the sum of the closing volume and the functional residual capacity

A

False. Closing capacity is the sum of the closing volume and the residual volume

92
Q

Concerning lung volumes and capacities

The volume which may be forcibly exhaled in 1 sec is greater than 85 per cent of the vital capacity

A

False. This is the FEV1, which is approximately 75-85 per cent of the vital capacity

93
Q

Concerning lung volumes and capacities

The functional residual capacity can be measured with the spirometer

A

False. FRC, RV and TLC cannot be measured by spirometry.

94
Q

Concerning lung volumes and capacities

The sum of the inspiratory reserve volume and the expiratory reserve volume is the vital capacity

A

False. Tidal volume would also be required.

95
Q

Alveolar

dead space exceeds tidal volume at rest

A

False. Dead space is in the region of 2 mls/kg, whilst tidal volume is around 5-7 mls/kg

96
Q

Alveolar

ventilation decreases as tidal volume increases

A

False.

97
Q

Alveolar

partial pressure of water vapour exceeds that of carbon dioxide

A

True. Partial pressure of water vapour in the alveoli is around 6.3 kPa

98
Q

Alveolar

partial pressure of oxygen falls within an increase in physiological dead space

A

False.

99
Q

Alveolar

oxygen uptake exceeds alveolar carbon dioxide output

A

True

E-lfh FRCA Primary: Physiology - Respiratory Physiology (12 decks)

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