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Formative questions > RESP > Flashcards

RESP Flashcards

1
Q

which statement is true about chemoreceptors?

  1. they are only based in the central nervous system
  2. they are only based in the large main arteries
  3. they all sense PaO2 levels as their main function
  4. they all sense PaCO2 levels
  5. they act in isolation of each other
A
  1. they all sense PaCO2 levels
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2
Q

in the control of human breathing:

  1. only the centres in the pons are important in the basic breathing rhythm
  2. centres in both the pons and medulla oblongata are important
  3. the dorsal respiratory group has no function during inspiration
  4. the ventral respiratory group has no function in inspiration
  5. the DRG and VRG are unilateral structures
A
  1. centres in both the pons and medulla oblongata are important
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3
Q

which statement is true about the larynx?

  1. it has 10 cartilages, all in pairs
  2. its main function is to humidify the inspired air
  3. its main motor function is taken from the recurrent laryngeal nerve
  4. its main motor function is taken from the external branch of the superior laryngeal nerve
  5. recurrent laryngeal nerve damage does not normally lead to significant hoarseness
A
  1. its main motor function is taken from the recurrent laryngeal nerve
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4
Q

when considering an emergency chest drain position

  1. the third rib is always lateral to the angle of Louis of the sternum
  2. the third intercostal space is always lateral to the angle of Louis of the sternum
  3. a chest drain can be inserted just lateral to the sternum anteriorly with complete safety
  4. a chest drain can be inserted at the cardiac apex completely safely
  5. the second intercostal space is below the second rib
A
  1. the second intercostal space is below the second rib
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5
Q

the right main bronchus

  1. is less vertically disposed than the left main bronchus
  2. is closely applied to the arch of the aorta
  3. always divides immediately after the carina into two main lobar bronchi
  4. is equally vertically disposed to the left main bronchus
  5. is more vertically disposed than the left main bronchus
A
  1. is more vertically disposed than the left main bronchus
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6
Q

gas exchange between alveolus and haemoglobin:

  1. most often occurs through the thin walls of the terminal bronchioles
  2. is an entirely passive process
  3. occurs through a membrane approx. 10 microns thick
  4. occurs through a membrane approx. 1 micron thick
  5. depends almost entirely on supplying bulk gas to the alveoli
A
  1. occurs through a membrane approx. 1 micron thick
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7
Q

during inspiration, the diaphragm:

  1. relaxes and descends
  2. contracts and descends
  3. relaxes and ascends
  4. contracts and ascends
  5. does not normally move in quiet respiration
A
  1. contracts and descends
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8
Q

expiration is:

  1. largely an active process with contraction of the hemi diaphragm
  2. largely an active process with relaxation of the hemi diaphragm
  3. largely a passive process with contraction of the hemi diaphragm
  4. largely a passive process with relaxation of the hemi diaphragm
A
  1. largely a passive process with relaxation of the hemi diaphragm
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9
Q

the physiological dead space is defined as:

  1. the volume of air in the trachea that does not contribute to gas exchange
  2. the volume of air in the alveoli that does not contribute to gas exchange
  3. the volume of air in the trachea that does not contribute to gas exchange minus the volume of air in the alveoli that does not contribute to gas exchange
  4. the volume of air in the trachea that does not contribute to gas exchange plus the volume of air in the alveoli that does not contribute to gas exchange
  5. the volume of air in the alveoli that contributes to gas exchange
A
  1. the volume of air in the trachea that does not contribute to gas exchange plus the volume of air in the alveoli that does not contribute to gas exchange
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10
Q

hypoxia (low oxygen levels):

  1. in the lung causes vasodilation
  2. in the lung causes vasoconstriction
  3. in the systemic circulation causes vasoconstriction
  4. in the lung causes the bronchi to dilate
  5. in the lung causes the bronchi to constrict
A
  1. in the lung causes vasoconstriction
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11
Q

arterial PaCO2 depends on:

  1. a constant, the production of CO2 and alveolar ventilation
  2. alveolar ventilation only
  3. the production of CO2 only
  4. a constant, the production of CO2, alveolar ventilation and PaO2
  5. PaO2 only
A
  1. a constant, the production of CO2 and alveolar ventilation
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12
Q

the oxygen/haemoglobin dissociation curve:

  1. is almost linear
  2. is not influenced by 2,3 DPG
  3. is influenced by changing affinity for sequential oxygen molecule binding
  4. is not influenced by temperature
  5. is not influenced by (H+) concentration
A
  1. is influenced by changing affinity for sequential oxygen molecule binding
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13
Q

in respiratory acidosis:

  1. the PaCO2 initially rises
  2. the PaO2 initially rises
  3. the kidneys excrete more bicarbonate
  4. the pH rises
  5. H+ concentration falls in arterial blood
A
  1. the PaCO2 initially rises
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14
Q

the FEV1:

  1. is the flow rate of air generated maximally one second after the start of forced expiration
  2. is not related to height
  3. is not related to age
  4. is the volume of air expelled after one second of forced expiration
  5. is always reduced in patients with asthma
A
  1. is the volume of air expelled after one second of forced expiration
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15
Q

peak flow variation:

  1. is typically seen in COPD
  2. is typical in asthma, and measured at less than 5% normally
  3. is typical in asthma, and measured at less than 10% normally
  4. is typical in asthma, and measured at more than 20% normally
  5. is typically 20% in hypersensitivity pneumonitis
A
  1. is typical in asthma, and measured at more than 20% normally
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16
Q

a patient with breathing problems has the following lung function: FEV1 1.6l (predicted value 3.2l) and FVC 4.8l (predicted value 4.7l). Which is the most accurate:

  1. the patient has airways obstruction and a normal FEV1
  2. the patient has airways obstruction and a reduced FEV1
  3. the patient has a normal FEV1 and FVC
  4. the patient has airways restriction
  5. the patient has both airways obstruction and restriction
A
  1. the patient has airways obstruction and a reduced FEV1
17
Q

the carbon monoxide single breath transfer factor:

  1. is a good estimate of small airway function
  2. is a good estimate of tracheal dimensions
  3. is a good measure of the anatomical dead space
  4. is a good measure of gas exchange into the alveolar capillary
  5. is a good measure of diaphragmatic function during quiet breathing
A
  1. is a good measure of gas exchange into the alveolar capillary
18
Q

the FEV1:

  1. is the volume of air that can be expelled at a constant 1 litre/min
  2. is the volume of air that can be expelled in a relaxed manner in one second
  3. is the volume of air that can be expelled in a forced manner in one second
  4. is the total volume of air that can be expelled in a forced manner
A
  1. is the volume of air that can be expelled in a forced manner in one second
19
Q

when a climber ascends a mountain, which statement best describes the physiology:

  1. the pressure of inspired oxygen falls
  2. the fraction of inspired oxygen falls
  3. the pH of the arterial blood falls
  4. the PAO2 rises
  5. the PaCO2 rises
A
  1. the pressure of inspired oxygen falls
20
Q

which of the following is NOT a feature of pulmonary oxygen toxicity (Lorraine Smith effect):

  1. shortness of breath
  2. cough
  3. chest tightness
  4. convulsions
  5. sub sternal pain
A
  1. convulsions
21
Q 
Which of these cells provides cilia for the mucociliary escalator?
A. Macrophages
B. Columnar Epithelial Cells
C. Goblet Cells
D. Mast cells
E. Vascular Endothelial Cells
A

B. Columnar Epithelial Cells

22
Q 
The Vagus Nerve supplies voluntary motor function to which of these structures?             
A. Bronchiole
B. Larynx
C. Nostril
D. Trachea
E. Main Bronchus
A

B. Larynx

23
Q 
Changes in which of these blood parameters stimulates carotid chemoreceptors?
A. Carbon dioxide only
B. Oxygen, carbon dioxide and H+ ions
C. Carbon dioxide and HCO3- ions
D. Carbon dioxide and H+ ions
E. Oxygen and HCO3- ions
A

B. Oxygen, carbon dioxide and H+ ions

24
Q 
Central chemoreceptors are located in the ventral medulla and respond to:                        
A. CSF haemoglobin
B. CSF pH
C. CSF bicarbonate
D. CSF oxygen
E. CSF carbon dioxide
A

B. CSF pH

25
Q 
Which nerve supplies motor function to the diaphragm?
A. Intercostal Nerves
B. Lateral Thoracic Nerves
C. Vagus Nerve
D. Accessory Nerve
E. Phrenic Nerve
A

E. Phrenic Nerve

26
Q 
If an adult inhales a peanut, where is it most likely to become lodged in their airway?
A. Right main bronchus
B. Alveoli
C. Trachea
D. Left Main Bronchus
E. Terminal bronchiole
A

A. Right main bronchus
Trachea too large
Terminal bronchiole and alveoli too small
Bronchus just right. Preferentially goes down Right main bronchus due to the angle it comes off trachea.

27
Q 
Type 1 Respiratory Failure is characterised by arterial blood gas picture of:                          
A. normal pO2, low pCO2
B. low pO2, high pCO2
C. high pO2, high pCO2
D. high pO2, normal/low pCO2
E. low pO2, normal/low pCO2
A

E. low pO2, normal/low pCO2
Type 1 respiratory failure is defined as a low level of oxygen in the blood (hypoxaemia) without an increased level of carbon dioxide in the blood (hypercapnia), and indeed the PaCO2 may be normal or low.

28
Q 
Which of these conditions would normally lead to Type 2 Respiratory Failure?
A. Pulmonary embolism
B. Right middle lobe collapse
C. Small Pneumothorax
D. Chronic Obstructive Pulmonary Disease
E. Pneumonia
A

D. Chronic Obstructive Pulmonary Disease
The underlying causes of type 2 include:
Increased airways resistance - chronic obstructive pulmonary disease
Reduced breathing effort (drug effects, brain stem lesion, extreme obesity)
A decrease in the area of the lung available for gas exchange (such as in chronic bronchitis)
Neuromuscular problems

29
Q 
Which of these conditions would normally lead to Type 1 Respiratory Failure?     
A. Pulmonary Embolism
B. Chronic Obstructive Pulmonary Disease
C. Widespread pulmonary tuberculosis
D. Pulmonary Hypertension
E. Severe Motor Neurone Disease
A

A. Pulmonary Embolism
This type of respiratory failure is caused by conditions that affect oxygenation such as:
Low ambient oxygen (e.g. at high altitude)
Ventilation-perfusion mismatch (parts of the lung receive oxygen but not enough blood to absorb it, e.g. pulmonary embolism)
Alveolar hypoventilation due to reduced respiratory muscle activity, e.g. in acute neuromuscular disease (this form can also cause type 2 respiratory failure if severe)
Diffusion problem (oxygen cannot enter the capillaries due to parenchymal disease, e.g. in pneumonia)
Shunt (oxygenated blood mixes with non-oxygenated blood from the venous system, e.g. right to left shunt)

30
Q 
The main peripheral chemoreceptors are located in the:
A. Jugular veins and vena cava
B. Pulmonary veins and left atrium
C. Trachea and main bronchi
D. Carotid arteries and aortic arch
E. Skeletal muscle
A

D. Carotid arteries and aortic arch

31
Q

Vital capacity (VC) is calculated by
A. Functional residual capacity + Inspired reserve volume
B. Tidal volume + Inspired reserve volume + Expired reserve volume
C. Tidal volume + Inspired reserve volume + Expired reserve volume + Anatomical dead space
D. Total lung capacity – Tidal volume

A

B. Tidal volume + Inspired reserve volume + Expired reserve volume

32
Q 
What is the term used to describe a malignant tumour of the pleural membranes?
A. Pleuroma
B. Mesotheliocarcinoma
C. Mesodermocarcinoma
D. Pleurocarcinoma
E. Mesothelioma
A

E. Mesothelioma

33
Q 
Which of these factors will contribute to causing bronchodilation?            
A. Beta-Blockers
B. Adrenaline
C. Parasympathetic stimulation
D. Histamine release
E. Cold dry air
A

B. Adrenaline
Adrenaline causes bronchodilation, by binding to β 2 -receptors in the smooth muscle of the bronchioles and causing their relaxation.
All the other factors are associated with causing bronchoconstriction

34
Q 
Chronic Type 2 Respiratory Failure is characterised by arterial blood gas picture of:          
A. low pO2, high pCO2, low HCO3
B. normal pO2, low pCO2, low-normal HCO3
C. low pO2, low pCO2, low HCO3
D. low pO2, high pCO2, normal-high HCO3
E. low pO2, low pCO2, normal HCO3
A

D. low pO2, high pCO2, normal-high HCO3
Hypoxemia (PaO2 <8kPa) with hypercapnia (PaCO2 >6.0kPa).
Type 2 respiratory failure is caused by inadequate alveolar ventilation; both oxygen and carbon dioxide are affected. Defined as the build-up of carbon dioxide levels (PaCO2) that has been generated by the body but cannot be eliminated.

35
Q 
Which of the following is defined as ‘the amount of air remaining in the lungs after normal quiet expiration’?            
A.  Functional residual capacity
B. Expiratory reserve volume
C. Physiological dead space
D. Residual volume
E. Tidal volume
A

A. Functional residual capacity

Formative questions (9 decks)

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