Block 3 Phys Flashcards
(306 cards)
1
Q
ADH V1 receptor is
A
alpha q– smooth muscle
2
Q
ADH V2 receptor is
A
alpha s – kidney
3
Q
90% of filtered water is reabsorbed in the _____ tubule by _______
A
proximal
AQP1
4
Q
only AQP responsive to ADH
A
AQP2
5
Q
How does water leave the basolateral membrane of the collecting duct?
A
AQP 3&4
6
Q
Which is more sensitive to dehydration (leading to AVP release) baroreceptors or osmoreceptors?
A
osmoreceptors
7
Q
which neurons sends hormones to the posterior pituitary?
A
magnocellular
8
Q
somatostatin stimulates the release of what hormone from anterior pituitary?
A
GH
9
Q
AVP and oxytocin are made in what hypothalamnic nuclei?
A
SON and PVN
10
Q
Ca-calmodulin activates ________
A
MLCK
11
Q
what is SIADH
A
syndrome of inappropriate ADH secretion
12
Q
bad taste in mouth is a symptom of what syndrome?
A
SIADH
13
Q
decreased ADH release is often a complication of
A
diabetes insipidus
14
Q
anterior pituitary is derived from _____derm
A
ecto
15
Q
the 3 glycoprotein hormones of the anterior pituitary
A
TSH FSH and LH
16
Q
all 3 glycoprotein hormones of the anterior pituitary have similar __ subunits and dissimilar ___ subunits
A
- alpha
- beta
17
Q
pro-opiomelanocortin is cleaved into what hormones
A
ACTH, beta endorphin, alpha/beta/gamma melanocyte stimulating hormones
18
Q
Growth hormone release is stimulated by _____glycemia and suppressed by ____glycemia
A
- hypo
- hyper
19
Q
major players in GH release
A
GHRH and ghrelin
20
Q
minor regulators of GH release
A
acetylcholine, alpha-adrenergic agonists, dopamine, serotonin
21
Q
GH release is inhibited by
A
somatostatin and IGF-1
22
Q
a long term increase in GH has what effect on adipose tissue?
A
anti insulin effect
23
Q
laron’s syndrome
A
GH resistance
24
Q
low GH in adults is associated with
A
CV risk and muscle loss
25
Hypothalamus controls prolactin by maintaining inhibitory tone via
dopamine
26
Prolactin requires what other 2 things for milk production
insulin and cortisol
27
Long term increases in prolactin lead to
infertility and gonadal dysfunction
28
Increase in prolactin leads to decreases in what hormones?
LSH, FSH, gonadal steroidogenesis, estrogen, testosterone, progesterone
29
What inhibits release of TSH from anterior pituitary?
dopamine, somatostatin, and high levels of glucocorticoids
30
Thyroglobulin is made in _______. Then it's ______ residues are iodinated in the colloid
thyroglobulin
| tyrosine
31
How many Na+ are transported per Iodine into the basolateral membrane of the follicular cells
2
32
which form of thyroid hormone is very inactive
rT3
33
when the inner ring of T4 is deiodinated it becomes
rT3
34
Type 1 deiodinase converts T4 into
T3, rT3, and T2
35
Type 2 deiodinase converts T4 into
T3
36
Type 3 deiodinase converts T4 into
rT3 and T2
37
____ increases the expression of uncoupling proteins and mitochondria
TH
38
thyroid hormone _____ vascular resistance
decreases
39
too much Iodide intake decreases
TSH receptor activated pathways
40
Iodide deficiency in utero is called
cretinism
41
primary hypothyroidism involves
the thyroid gland directly
42
an increase in thyroid tissue, such as a goiter, etc leads to
hypothyroidism
43
Lab tests will show a decrease in both ___ and ___ in hypothyroidism
rT3 and T3
44
starvation and critical illness will show an increase in what form of thyroid hormone?
rT3
45
when using imaging, "cold spots" are usually
malignant
46
DLCO =
diffusion capacity of carbon monoxide
47
RQ =
respiratory quotient
48
above anabolic threshold, your RQ will go
above 1
49
normal body temperature range in celcius and farenheit
36-37.5 and 97-99
50
cutaneous circulation can range between what percent of CO?
0-30%
51
most abundant blood flow to the skin is via
venous plexus
52
what controls cutaneous circulation
AV anastomoses
53
epi and norepi do what to blood flow to the skin?
open anastomoses, decreasing flow to skin, conserving heat
54
most drastic change in capillary caliber will occur in what range of temp
75-110 F
55
what is the relationship btw the cooling effect of air convection to wind velocity?
cooling effect = the square root of wind velocity
56
what part of the hypothalamus regulates temperature?
anterior
57
which produce a more powerful response? heat or cold sensitive neurons?
cold sensitive
58
pyrogen
substance that produces fever by resetting the hypothalamus's thermostat
59
where are lipid soluble vitamins stored?
liver
60
what is added to bilirubin to conjugate it?
sulfate or glucuronic acid
61
Phase 1 biotransformation is catalyzed by
p450
62
what is the purpose of phase 2 biotransformation
increase solubility
63
what is the Na+ independent transporter?
OATP
64
is bile salt transport to canaliculi active or passive?
active
65
what does bile salt transport rely on?
ATP
66
what pumps bile salts into canaliculi?
bile salt export pump
67
interference with what transporters can result in jaundice?
multi drug resistance proteins
68
what Ig is in bile?
IgA
69
what is the purpose of phospholipids in bile?
soulbilize cholesterol and decrease bile acid toxicity
70
cholesterol is converted to primary bile acids by
7a hydroxylase
71
2 principal bile acids
cholic acid and chenodeoxycholic acid
72
before bile acids are transported into canaliculi, they are conjugated to what?
glycine or taurine. This makes them bile salts
73
name 2 secondary bile acids
deoxycholic and lithocholic acid
74
the 2 most important components of bile
cholesterol and bilirubin
75
what cells reuptake glucose and amino acids from bile?
cholangiocytes
76
what do cholangiocytes secrete into bile?
bicarbonate and IgA
77
toxic damage to the brain from bilirubin is called
kernicterus
78
common risk factors for gallbladder disease:
fat forty fertility female
79
hormones that stimulate bile release from the gallbladder:
CCK, PSNS, gastrin, and glucagon
80
where are bile salts reabsorbed?
terminal ileum
81
alchoholism increases gut barrier permeability, causing an increase in bacterial activation of ____ cells
kupffer
82
Hepatocytes release ______ in response to high kupffer cell activity
C reactive proteins
83
what cells cause liver fibrosis
stellate cells found in the space of disse
84
why does liver failure lead to edema?
less albumin production
85
why does acetamionphen fuck your liver up?
it gets conjugated with glutathione and depletes it, leaving your liver susceptible to ROS
86
glutathione levels can be restored with
acetylcysteine
87
how does cholesterol get to peripheral tissues that need it?
the liver packages it as cholesteryl esters
88
statins inhibit
HMG CoA reductase
89
fast twitch oxidative fibers are what color?
have low or high myoglobin?
have low or high mitochondrial content?
red
high
high
90
Fick principle
the total amt of oxygen that someone will consume per minute depends on the amt of blood pumped by heart per minute time amt of oxygen extracted
91
arterial oxygen content doesn't change during exercise, so the only 2 ways to increase oxygen consumption is through an increase in
cardiac output and oxygen extraction in tissues
92
stroke volume increases until you get to ____% of max capacity. Any increase in CO thereafter comes from ___
30-40
| HR
93
SV is influenced by
preload, contractility, and afterload
94
contractility has to do with avaliability of
Ca++
95
MABP=
(systolic pressure x (2x diastolic))/3
96
changes in pulmonary ventilation have a linear increase with exercise up to _____% of maximum effort
60-70%
97
minute volume =
tidal volume x breathing frequency
98
we can increase our minute volume by how much?
20 fold
99
breathing frequency can increase:
4 fold
100
tidal volume can increase:
4 fold
101
how do we maintain arterial O2 content during exercise?
decrease the Vd/Vt ratio
102
Karvonen formula
used to decide how hard to exercise in order to achieve aerobic or anaerobic exercise. HR during exercise = HR at rest + .6 x (HRmax - HRrest)
103
HRmax =
220 - age
104
young individuals have lower stroke volumes because
older people have larger EDV
105
Rate pressure product-
HR x MABP (good indicator of myocardial O2 consump.)
106
Whipple's triad-
hypoglycemia, low plasma glucose conc. and relief of symptoms after glucose is raised
107
whipple's triad indicates-
hypoglycemia
108
nesidioblastosis-
non malignant beta cell overgrowth
109
hypoglycemia = plasma glucose <
45 mg/dl
110
biguanides (metformin) MOA-
inhibit gluconeogenesis and glycogenolysis, increase insulin sensitivity
111
Alpha-glucosidase inhibitor MOA-
delay intestinal carb absorption through inhib. of brush border enzymes
112
Thiazolidinedione MOA-
reduce insulin resistance
113
GLP-1 Agonist MOA-
amplify glucose induced insulin release and synthesis, suppresses glucoagon release
114
Dipeptidyl peptidase 4 inhibitors MOA-
inactivate DPP-4, which leads to increase in endogenous incretin levels
115
sodium glucose co-transporter 2 (SGLT2) inhibitors MOA-
inhibit glucose reabsorption from kidneys
116
2 things needed to cause diabetic ketoacidosis-
severe insulin deficiency and glucagon excess
117
Kussmaul's respiration is associated with
metabolic acidosis from diabetic ketoacidosis. effort to eliminate excess CO2
118
"leaky vessel" retiopathy
non-proliferative
119
"too many vessels" retinopathy
proliferative
120
The ABCDE's of trauma
airway, breathing, circulation, disability, exposure
121
what is more dire, bleeding or brain trauma?
bleeding. it will kill you faster
122
intubate if a pt has a GCS score of
8 or below
123
a T is annotated to a GCS if...
pt cant talk due to intubation
124
GCS Eye Opening score breakdown:
4- spontaneous
3- only to verbal command
2- only to pain
1- not at all
125
GCS verbal response breakdown:
```
5- oriented and conversing
4- confused conversation
3- inappropriate words or mumbling
2- incomprehensible sounds
1- no sound
```
126
GCS motor response breakdown:
```
6- obeys commands
5- localized pain
4- withdraws to pain
3- decorticate
2- decerebrate
1- No posture at all
```
127
give _____ to decrease ICP from brain injury
mannitol
128
3 important variables of trauma pt instability
CO, Hb, and O2 satuation
129
what causes trauma pt instability?
shock
130
if a trauma pt isn't urinating much, urine and plasma Na+ conc. are compared. a prerenal problem would be indicated if urine Na+ was _____. A renal problem would be indicated if urine Na+ was ______
low
| high
131
>3% creatinine in urine means
renal failure
132
>20% Na+ in urine means
renal failure
133
CPP=
MABP - ICP
134
SIADH-
syndrome of inappropriate ADH
135
SIADH presents as-
increased water retention
136
CSW-
cerebral salt wasting
137
CSW presents as
not enough water retention. treat with mineralocorticoids
138
when splanchnic blood flow decreases, organs compensate by
increasing O2 extraction
139
3 factors that regulate splanchnic blood flow during stress
SNS, RAS, Vasopressin
140
increased plasma Ca++ binds to parathyroid calcium sensor. describe the cascade
phospholipase A2--> arachidonic acid--> leukotrienes--> increase in PTH degradation
141
most important PTH receptor
PTHR1
142
PTHR1 binds
PTH and PTHrP
143
the culprit in malignant hypercalcemia
PTHrP
144
how does Vit D enhance Ca++ reabsorption
stimulates calbindin synthesis and Ca++ ATPase activity
145
PTH causes an increase in renal excretion of ___ in the _____ tubule
phosphate
| proximal
146
PTH also causes increase in renal excretion of Phophate by causing internalization of
Na+/P IIa cotransporters (degraded in lysosome)
147
how doe high phosphate level cause hypocalcemia?
it complexes with Mg. Mg is needed for proper PTH release
148
how does PTH stimulate bone resorption
binds PTHR1 on osteoblasts, leading to expression of RANKL. osteoclast precursors bind RANKL to mature.
149
mature osteoclasts bind to bone using
beta-integrins
150
PTH acts on intestines to increase the activity of _________, which is needed to form active vitamin D
1 alpha hydroxylase
151
most protein bound calcium is bound to
albumin
152
vitamin D precursors:
cholecalciferol (skin) and ergocalciferol (diet)
153
activation steps for Vit D
precursors are transported to liver--> hydroxylated at C-25 to become 25-hydroxyvitamin D3--> transported to kidneys--> hydroxylated at C-1 to 1,25 dihydroxyvitamin D3 (active)
154
how is vitamin D regulated?
increases in plasma Ca++ levels inhibit hydroxylation at C1 and stimulate hydroxylation at C24. This makes 24,25 dihydroxyvitamin D (inactive)
155
sex steroids stimulate an increase in 2 things that decrease bone resorption:
1 alpha hydroxylase and osteoprotegrin activity
156
primary hyperparathyroidism-
PT gland problem
157
secondary hyperparathyroidism-
renal failure. decreased P excretion, hypocalcemia, increased PTH excretion
158
pseudohypoparathyroidism-
defect in PTH receptor. low plasma Ca++, high P levels, and elevated PTH.
159
zona fasiculata produces
glucocorticoids
160
zona reticularis produces
androgens
161
Corticotrophs in the pituitary make
proopiomelanocirtin (POMC)
162
POMC is posttranslationally cleaved into
ACTH, beta endorphin, and MSH
163
ACTH binds GPCR at the adrenal cortex, downstream activates PKA, causes activation of what 2 enzymes
cholesteryl ester hydrolase and STAR
164
role of cholesteryl ester hydrolase-
frees cholesterol
165
STAR role
moves cholesterol into inner mito. mem.
166
DHEA is a precursor for-
testosterone and estradiol
167
pregnenolone (previously synth in IMM then sent to ER) is made into 1 of 2 products:
progesterone or 17 alpha hydroxypregnenolone
168
progesterone is a precursor for
mineralocorticoids and glucocorticoids
169
17 alpha hydroxypregnenolone is a precursor for
androgens
170
11 beta hydroxysteroid dehydrogenase type 2 isoform does what?
converts cortisol to cortisone
171
11 beta hydroxysteroid dehydrogenase type 1 isoform does what?
converts cortisone into cortisol in adipose tissue
172
increased circulating K+ causes a release of
aldosterone
173
aldosterone is made in less amts than cotisol and mostly circulates in its ____ form
free
174
aldosterone is excreted in the urine as:
acid labile metabolite (18- glucuronide), intact, or tetraglucuronide
175
Type 1 corticoid receptor binds
aldosterone and cortisol
176
Type 2 corticoid receptor binds
just cortisol
177
How do we fix the issue of type 1 receptors binding cortisol?
the same tissues express 11 beta hydroxysteroid dehydrogenase
178
what does cortisol do to vasculature?
ensures integrity/responsiveness by helping regulate blood fluid volume and Na+ retention
179
principal cells-
respond to aldosterone to increase Na+ reabsorption
180
intercalated cells-
respond to aldosterone to increase H+ ATPase, contributing to the Cl-/HCO3- exchanger on basolateral membrane
181
2 main androgens of the adrenal gland-
DHEA and androstenedione
182
2 enzymes act on androstenedione-
17 beta hydroxysteroid dehydrogenase makes testosterone and estradiol
aromatase makes estrone
183
deficiency of 11b hydroxylase result-
impaired cortisol production, shifts precursors to aldosterone sythesis
184
deficiency in 21 hydroxylase result-
cant convert progesterone to gluco and mineralo corticoids. leads to more DHEA
185
Cushings syndrome-
excess in circulating levels of cortisol regardless of cause
186
cushing disease-
pituitary tumor causes excess CRH release`
187
Addison's disease-
destroyed adrenal cortex, no cortisol or aldosterone. leads to increased melanin production by MSH
188
secondary adrenal insufficiency-
decrease in ACTH release
189
tertiary adrenal insufficiency-
decrease in hypothalamic function
190
Conn's sydrome
primary hyperaldosteronism
191
high renin and high aldosterone leads to
hyperreninemic hyperaldosteronism
192
Barter's syndrome
tertiary hyperaldosteronism- defect in Na+ transporters in tubules
193
Barter's syndrome leads to what disease
sodium wasting disease
194
licorice inhibits
11 beta hydroxysteroid dehydrogenase, leads to high cortisol--> binds type II--> hypertension
195
Dexamethasone suppression test-
dex. will mimic glucocorticoids so you should see a decrease in CRH, ACTH, cortisol
196
Pituitary ACTH tumor responds to
Dexamethasone and CRH
197
In a Dexamethasone test a reaction indicates:
| No reaction indicates:
normal function or if there is a tumor the tumor is in the HP axis
ectopic tumor
198
does the adrenal medulla release more epi or norepi
more epi
199
norepi is converted to epi by:
phenylethanolamine N-methyltransferase (PNMT)
200
PNMT synthesis is increased by
cortisol
201
```
Name the kinds of catecholamine receptors on these organs
vasculature-
heart
lungs
kidneys
GI
liver
pancreas
fat
SKM
```
```
vasculature- a1/a2
heart- b1/a1
lungs- b2
kidneys- b1
GI- a1/b2
liver- a1/b2
pancreas- a2
fat b3
SKM b2
```
202
2 enzymes that degrade catecholamines
MAO and COMT
203
ne and epi are broken down into
metanephrine and normetanephrine. both are the broken down into Vanillylmandelic acid (VMA)
204
VMA production does not occur in the
adrenal medulla
205
NE and EPI can be broken down in what 3 tissues?
liver, kidney, adrenal medulla
206
acute effects of hypothalamus turning on the SNS and HPA axis
increase in lipolysis and glycolysis
207
chronic effects of hypothalamus turning on SNS and HPA axis
insulin resistance
208
the price our body pays for constant adaptation to chronic stressors is called
allostatic load
209
after a meal, what changes about insulin release?
pulsatile amplitude and frequency increase
210
pulsatility of insulin is critical for
maintaining insulin responsiveness by giving time for receptors to regroup
211
90% of insulin circulates as ____ form
free
212
half life of insulin:
a few minutes
213
why would an IV injection of IGF-1 cause hypoglycemia?
not enough time for binding proteins to be made to bind IGF-1 and it would cause a hyper-insulin like response
214
what are pancreas beta cell K+ channels sensitive to?
ATP
215
4 hormones that stimulate insulin release:
acetylcholine, CCK, glucagon, GLP-1
216
what is GLP-1 produced by?
the intestines
217
how do sulfonylurea drugs increase insulin release?
mimic ATP in pancreatic beta cells
218
where is GLUT 2 expressed?
pancreas B cells, liver, intestine, and kidney
219
the major neuronal GLUT
GLUT3
220
insulin activates ______ which causes growth of vascular smooth muscle
MAPK
221
pro-glucagon can be cleaved into 2 major products-
glucagon (pancreas) and GLP-1 (intestines)
222
half life of glucagon and GLP-1
minutes
223
GLP-1 is degraded by
dipeptidyl peptidase IV (DPP IV)
224
what do incretins (like GLP-1) do?
stimulate insulin release
225
GLP-1 stimulates insulin release only in the presence of
high glucose levels
226
what doe GLP-1 do to glucaon secretion
decreases it
227
if you are diabetic, would you want to take a drug that increased or decreased GLP-1?
increased
228
_______ degrades DPP4 to prolong the activity of _____
vildagliptin
| GLP-1
229
somatostatin half life
minutes
230
somatostatin is made by
delta cells of pancreas
231
amylin is in the _____ family of hormones
calcitonin
232
amylin suppresses ______ secretion and decreases ______
glucagon
| gastric emptying
233
Syndrome X-
insulin resistance syndrome characterized by hypertension, atherosclerosis, and central obesity
234
defective PI3 kinase pathway can lead to
Type 2 diabetes
235
Diabetic if:
Fasting glucose =
random plasma glucose =
>126
| >200
236
HbA1C levels greater than ___ should be treated
8%
237
Normal oral glucose tolerance levels:
fasting=
1 hour =
2 hour =
60-110
| <140
238
what forms blood-testis barrier?
sertoli cells
239
what cells signal spermatogenesis?
sertoli
240
sertoli cells produce _______
inhibin B
241
what cells produce testosterone?
leydig cells
242
what is used clinically to track the health of the prostate?
prostate specific antigen
243
what does the epididymus secrete?
H+
244
FSH stimulates what testicular cells?
sertoli
245
what hormones inhibit the HPG axis?
IL-1, beta endorphins, Prl, GABA, and dopamine
246
stress causes CRH release, leads to more beta endorphin, leads to suppression of ________
HPG axis
247
FSH stimulates production of ________ which captures testosterone for spermatogenesis
androgen binding protein
248
inhibin B correlates with:
sperm count and testicular volume
249
most testosterone circulates in blood as ______ form
protein bound
250
17 beta estradiol can be broken down into:
estriol and 2 methoxyestrone
251
testosterone can be converted to _______, a much stronger androgen, via _______
DHT
| 5 alpha reductase
252
DHT is broken down into
3 alpha andrstenediol
253
in utero, testosterone stimulates ______ cell proliferation
leydig
254
what cells secrete mullerian inhibitory factor?
sertoli
255
DHT causes fetal development of
prostate and penis
256
adrenarche-
spike in production of DHEA prparing for puberty
257
spermatogonia become spermatocytes, which then undergo meiosis to become:
spermatids
258
spermatids mature into sperm during
spermiogenesis
259
spermiation-
release of mature sperm into seminiferous tubules
260
5 substances that inhibit GnRH release
beta endorphin, IL-1, prolactin, GABA, DA
261
theca cells are regulated by
LH
262
theca cells are important in
follicle development and ovulation
263
Granulosa cells are regulated by
FSH
264
granulosa cells produce
estrogen and progesterone
265
a rise in estrogen right before ovulation will cause a feed forward release of _____ and an inhibition of _____
LH
| FSH
266
rise in progesterone during menstrual cycle causes feedback inhibition of
LH
267
inhibins released from granulosa cells decrease ___ release
FSH
268
a released oocyte is surrounded by corona radiata, which is formed from ______ cells in the zona pellucida
granulosa
269
LH surge peaks ____ hours before ovulation
12-24
270
corpus luteum contains what 2 types of cells?
small (theca) and large (granulosa)
271
proliferative phase of menstrual cycle controlled by
estrogen
272
secretory phase of menstrual cycle controlled by
progesterone
273
theca cells convert cholesterol into
androgens
274
granulosa cells convert androgens into
estradiol
275
the secretion of ______ parallels estrogen throughout the menstrual cycle
testosterone
276
inhibin A and B are made by the ovary are regulated by
FSH, LH, and growth factors
277
_____ is a marker of corpus luteum function
Inhibin A
278
______ is a marker of granulosa cell function
Inhibin B
279
Inhibin A and B have a negative feedback effect on production of
FSH and LH
280
Activin increases:
graulosa cell proliferation, FSHr expression, and steroidogenesis
281
Activin antagonizes ______ and increases FSH releasse
inhibin
282
the androstenedione made in theca cells goes to _____ cells to be converted into ________
granulosa
| 17 beta estradiol
283
estradiol is broken down into
2 methoxyestrone
284
progesterone is broken down into
pregnandiol
285
estrogen upregulates _____ receptor expression even though it antagonizes this hormone's effects
progesterone
286
non-genomic effects of estrogen are mediated by
MAPK
287
what does human placental lactogen do?
regulates metabolism and development of fetus. STIMULATES SURFACTANT PRODUCTION
288
HGH V role
increases availablility of fetal glucose and amino acids. ONLY ON MATERNAL SIDE OF PLACENTA
289
HGH V replaces what hormone
maternal pituitary growth hormone
290
fetoplacental unit-
cooperation between maternal liver, placenta, and fetal adrenal glands
291
the placenta can convert cholesterol into
pregnenolone then progesterone
292
in fetal adrenal gland, pregnenolone is converted into
DHEA
293
in fetal liver DHEA is hydroxylated then sent
back to the placenta where it is converted into estriol
294
what metabolite, exreted in maternal urine, can be measured as a reflection of the whole fetoplacental unit?
estriol
295
what do these things do to developing breasts:
EGF=
thyroid hormone=
oxytocin=
EGF= ductal elongation and branching
thyroid hormone= ductal branching and budding
oxytocin= expansion and differentiation
296
levels of what hormones will increase significantly during menopause?
FSH and LH
297
A T score of ______ indicates osteoporosis
-2.5 or less
298
Bisphosphonates-
inhibit osteoclast activity and protect osteoblasts
299
anti-progestins-
increase expression of prostaglandins to expel embryo. "the morning after pill"
300
Kallman syndrome-
gonadotropin deficiency
301
How does the Balke protocol increase work load?
increases resistance
302
on an EKG, what indicates ischemia?
severe ST depression
303
what happens to the T wave during exercise?
decreases in height
304
Vd/Vt =
PaCO2-PeCO2/PaCO2
305
breathing reserve =
MVV - Ve max
306
FEV x 35 gives you a rough estimate of
what the max ventilation per minute is
