Pulmonary Midterm

Question 1

Which of the following is metabolically unaffected by passing
through the pulmonary circulation
 A: Angiotensin I
 B: Serotonin
 C: Angiotensin II
 D: Bradykinin

Answer 1

Angiotensin II

Question 2

Which of the following would cause pulmonary edema by
increased hydrostatic pressure?
 A: TRALI
 B: ARDS
 C: CHF
 D: Diffuse alveolar hemorrhage

Answer 2

CHF

Question 3

Which of the following is most important in the HPV phenomenon?
 A: PaO2
 B: PvO2
 C: PAO2
 D: PACO2

Answer 3

PAO2

Question 4

At what lung volume would PVR be the lowest?
 A: TV end-exhalation
 B: Vital capacity end-inhalation
 C: Vital capacity end-exhalation
 D: Total lung capacity

Answer 4

TV End-Exhalation

Question 5

At what lung volume would PVR be the highest?
 A: TV end-exhalation
 B: Vital capacity end-inhalation
 C: Vital capacity end-exhalation
 D: Total lung capacity

Answer 5

Vital Capacity End-Inhalation

Question 6

Which of the following would be most consistent with West Zone
2?
 A: Pa > Pv > PA
 B: PA > Pa > Pv
 C: Pa > PA > Pv

Answer 6

 C: Pa > PA > Pv

Question 7

Calculate the PVR for this patient: mPAP 20, PCWP 7, CO 5.5.
 A: 166
 B: 189
 C: 275
 D: 392

Answer 7

PVR = [(mPAP – PCWP)/CO] x 80
 B: 189

Question 8

When floating a pulmonary artery catheter, how can you tell that
you’ve entered the main pulmonary artery?
 A: The systolic and diastolic pressures will increase
 B: The systolic pressure will increase
 C: The diastolic pressure will increase
 D: The systolic and diastolic pressures will decrease

Answer 8

 C: The diastolic pressure will increase
“Diastolic Notch”

Question 9

What is the normal pressure in the right ventricle?
 A: 25/15
 B: 10/0
 C: 15/5
 D: 25/0

Answer 9

 D: 25/0

Question 10

What is a normal pressure in the right atrium?
 A: 5
 B: 10
 C: 15
 D : 20

Answer 10

A- 5

Question 11

The presence of hemoglobin in normal arterial blood increases it’s
oxygen concentration approximately how many times?
A. 10
B. 30
C. 50
D. 70
E. 90

Answer 11

D-70

Question 12

Normal arterial Blood PO2

Answer 12

100 mmHg

Question 13

Concentration of O2 in absence of Hb

Answer 13

00 x 0.003 (0.3 mL O2/100
mL blood)

Question 14

However, normal arterial blood contains about __ g/100 mL
hemoglobin and each gram can combine with ___ mL O2

Answer 14

15
1.39

Question 15

presence of Hb increases O2 concentration by about ___ times

Answer 15

70

Question 16

A patient with CO poisoning is treated with hyperbaric oxygen that
increases the PaO2 to 2000mmHg. The amount of oxygen dissolved
in the arterial blood (in ml/100ml) is:
A. 2
B. 3
C. 4
D. 5
E. 6

Answer 16

E-6
2000x .003=6

Question 17

A patient with severe anemia has normal lungs. You would expect
which of the following:
A. Low arterial PO2
B. Low arterial O2 saturation
C. Normal arterial O2 content
D. Low oxygen content of mixed venous blood
E. Normal tissue PO2

Answer 17

D- D. Low oxygen content of mixed venous blood

Oxygen concentration/content of arterial blood will be reduced (due to reduced amount of hemoglobin)
Therefore, if cardiac output and oxygen uptake are normal, the oxygen concentration of mixed venous blood will also be reduced.

The other choices are incorrect because arterial PO2 and O2 saturation will be normal if the patient has normal respiratory
function (which we were told is true in the question).
Oxygen concentration will be reduced and tissue PO2 will therefore
be abnormally low

Question 18

In CO poisoning, you would expect of which of the following to be
true:
A. Reduced arterial PO2
B. Normal O2 content of arterial blood
C. Reduced oxygen content of mixed venous blood
D. O2 dissociation curve shifted to the right
E. Carbon monoxide has a distinct odor

Answer 18

C. Reduced oxygen content of mixed venous blood

CO shifts the curve to the left (increases O2 affinity for hemoglobin)

Question 19

Most of the CO2 transported in the arterial blood is in which form:
A. Dissolved
B. Bicarbonate
C. Attached to hemoglobin
D. Carbamino compounds
E. Carbonic acid

Answer 19

B- Bicarbonate
90% of CO2 transported in the arterial blood is in the form of
bicarbonate.
5% is dissolved
5% is carbamino compounds

Question 20

A patient with chronic lung disease has arterial pH, PO2 and PCO2
values of 7.35, 50mmHg and 60mmHg. How would his acid-base
status best be described?

A. Normal
B. Partially compensated respiratory alkalosis
C. Partially compensated respiratory acidosis
D. Metabolic acidosis
E. Metabolic alkalosis

Answer 20

C. Partially compensated respiratory acidosis

PCO2 is elevated
pH is normal (but low normal)
Note: After PCO2 rises to 60, no renal compensation, so pH would be less than 7.3. Therefore, there is likely some compensation in this example

Question 21

A patient with chronic pulmonary disease undergoes emergency surgery. Postoperatively, the arterial pH, PO 2, and PCO2 are 7.2, 50mmHg, 50mmHg respectively. How would you describe the patient’s acid/base status?

A. Mixed respiratory and metabolic acidosis
B. Uncompensated respiratory acidosis
C. Fully compensated respiratory acidosis
D. Uncompensated metabolic acidosis
E. Fully compensated metabolic acidosis

Answer 21

A. Mixed respiratory and metabolic acidosis

Question 22

The lab provides the following report on arterial blood from a
patient: pH – 7.25, pCO2 – 32, HCO3 – 25. You conclude that there
is:
A. Respiratory alkalosis with metabolic compensation
B. Acute respiratory acidosis
C. Metabolic acidosis with respiratory compensation
D. Metabolic alkalosis with respiratory compensation
E. A lab error

Answer 22

E. A lab error

Question 23

41yo patient on mechanical ventilation for several days develops a
fever and sepsis. ABG shows PaO2 of 72mmHg, unchanged from
the previous day. What physiologic changes would you expect?
A. Decreased CO2 production
B. Decreased shunt fraction
C. Increased arterial O2 concentration
D. Increased arterial O2 saturation
E. Increased P50 for hemoglobin

Answer 23

E. Increased P50 for hemoglobin