Respi Physio MCQ Flashcards
(82 cards)
1
Q
- Increased parasympathetic activity causes the resistance to airflow in the bronchioles to:
A. Increase
B. Decrease
C. Stay the same
A
A. Increase
2
Q
- Which of the following is true?
A. Intrapleural pressure is always greater than intrapulmonary pressure
B. Intrapulmonary pressure is always greater than atmospheric pressure
C. Intrapleural pressure is always less than atmospheric pressure
D. Intrapulmonary pressure is always less than atmospheric pressure
A
C. Intrapleural pressure is always less than atmospheric pressure
3
Q
Contraction of the diaphragm and external intercostal muscles causes thoracic volume to \_\_\_\_\_\_\_\_\_\_ which causes lung volume to \_\_\_\_\_\_\_\_\_\_ which causes intrapulmonary pressure to \_\_\_\_\_\_\_\_\_\_. A. Decrease; Increase; Decrease B. Decrease; Decrease; Increase C. Increase; Increase; Decrease D. Increase; Decrease; Increase E. Increase; Increase; Increase
A
C. Increase; Increase; Decrease
4
Q
4. The scalenes and sternocleidomastoids are predominantly involved in: A. Active inspiration B. Active expiration C. Quiet inspiration D. Quiet expiration
A
A. Active inspiration
5
Q
As surfactant production decreases, lung compliance will:
A. Increase
B. Decrease
C. Stay the same
A
B. Decrease
6
Q
- If John’s vital capacity is 4.5L and his tidal volume is 525cc, then what is his inspiratory reserve volume?
A. 3975mL
B. 2075mL
C. 1050mL
D. Cannot be determined from the information given
A
D. Cannot be determined from the information given
7
Q
- What test measures the amount of gas expelled when one takes a deep breath and exhales maximally and rapidly?
A. Forced expiratory volume test
B. Forced vital capacity test
C. Forced residual capacity test
D. Forced internal thoracic volume assessment
A
B. Forced vital capacity test
8
Q
- Which of the following is not a component of the respiratory membrane?
A. Plasma membrane of the alveolar cell
B. Plasma membrane of the capillary endothelial cell
C. Fused basal laminae of the alveolar and the capillary endothelial cell
D. All of the above are members of the respiratory membrane
A
D. All of the above are members of the respiratory membrane
9
Q
- If alveolar PCO2 is high, the diameter of the bronchiole servicing that tissue will:
A. Increase
B. Decrease
C. Stay the same
A
A. Increase
10
Q
The binding of oxygen to haemoglobin is characterized as: A. Compliant B. Irreversible C. Reversible D. Non-compliant
A
C. Reversible
11
Q
11. The dorsal respiratory group of the medulla oblongata is active during: A. Quiet inspiration B. Forced inspiration C. Forced expiration D. A and B E. B and C
A
D. A and B
12
Q
- Lowered plasma oxygen levels are the most powerful respiratory stimulant.
A. True
B. False
A
B. False
13
Q
- Total lung capacity is equal to:
A. Vital capacity x Tidal volume
B. Functional residual capacity + Expiratory reserve volume
C. Anatomical dead space + Alveolar dead space
D. Residual volume + Vital capacity
A
D. Residual volume + Vital capacity
14
Q
- Select the correct statement about oxygen transport in blood.
A. During normal activity, a molecule of Hb returning to the lungs contains one molecule of oxygen
B. As pH decreases, oxygen’s affinity for Hb increases
C. A 50% oxygen saturation level of blood returning to the lungs might indicate a higher activity level than normal
D. All of the above
E. None of the above
A
C. A 50% oxygen saturation level of blood returning to the lungs might indicate a higher activity level than normal
15
Q
16. Which of these values would normally be the highest? A. Tidal volume B. Inspiratory reserve volume C. Expiratory reserve volume D. Residual volume E. Vital capacity
A
E. Vital capacity
16
Q
17. Most CO2 is transported in the blood in the form of: A. Dissolved gas B. Carbaminohemoglobin C. Bicarbonate ion D. Carboxyhemoglobin
A
C. Bicarbonate ion
17
Q
- As plasma PCO2 increases, plasma pH will:
A. Increase
B. Decrease
C. Stay the same
A
B. Decrease
18
Q
As plasma PCO2 increases, both the rate and depth of respiration will:
A. Increase
B. Decrease
C. Stay the same
A
A. Increase
19
Q
- Stimulating the cephalic end of a cut vagus nerve would cause respiration to:
A. Cease because of the lung stretch receptor reflex
B. Increase in rate because of the increased activity of the dorsal respiratory group
C. Increase in depth because of the increased sympathetic activity
D. None of the above
A
A. Cease because of the lung stretch receptor reflex
20
Q
- The loudness of a person’s voice depends on:
A. The thickness of the vestibular folds
B. The length of the vocal folds
C. The strength of the intrinsic laryngeal muscles
D. The force with which air rushes through the glottis
E. The thickness of the true vocal folds
A
D. The force with which air rushes through the glottis
21
Q
Surfactant causes alveolar surface tension to:
A. Increase
B. Decrease
C. Stay the same
A
B. Decrease
22
Q
- Inspiratory capacity is:
A. The total amount of air that can be inspired after a tidal expiration
B. The total amount of exchangeable air
C. Another name for functional residual capacity
D. The amount of air inspired after a tidal inspiration
E. A and C are correct
A
A. The total amount of air that can be inspired after a tidal expiration
23
Q
24. The most powerful respiratory stimulant in a healthy person is: A. Decreased tissue oxygen concentration B. Increased plasma PCO2 C. Increased CSF pH D. Decreased CSF pH
A
D. Decreased CSF pH
24
Q
Which of the following changes occur as conducting tubes become smaller?
A. Cartilage rings are replaced by irregular cartilage plates
B. Mucosal epithelium changes
C. Smooth muscle content increases
D. All of the above
E. 2 of the above
A
D. All of the above
25
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26. A premature baby usually has trouble breathing. However, the respiratory system is completely developed by:
A. 17 weeks
B. 22 weeks
C. 24 weeks
D. 28 weeks
E. 20 weeks
```
C. 24 weeks
| D. 28 weeks
26
```
27. Possible causes of hypoxemia include:
A. Decreased atmospheric oxygen content
B. Tracheal obstruction
C. Pneumonia
D. A and B are correct
E. A, B and C are correct
```
E. A, B and C are correct
27
28. Tidal volume is air:
A. Remaining in the lungs after forced expiration
B. Exchanged during normal breathing
C. Inhaled after quiet inspiration
D. Forcible expelled after normal expiration
B. Exchanged during normal breathing
28
29. The RBC count increases after an individual spends significant time at a higher altitude because:
A. Temperature is lower at higher altitudes
B. Basal metabolic rate is lower at higher altitudes
C. Basal metabolic rate is higher at higher altitudes
D. Atmospheric PO2 is higher at higher altitudes
E. Atmospheric PO2 is lower at higher altitudes
E. Atmospheric PO2 is lower at higher altitudes
29
```
30. Most oxygen carried in the blood is:
A. In solution with the plasma
B. Combined with plasma proteins
C. Chemically combined with a heme group
D. Carried as HCO3-
E. Bound to the amino acid valine on the beta chain of hemoglobin
```
C. Chemically combined with a heme group
30
31. When the inspiratory muscles contract:
A. The diameter of the thoracic cavity increases
B. The length of the thoracic cavity increases
C. The volume of the thoracic cavity is decreased
D. The diameter and length of the thoracic cavity both increase
E. None of the above
D. The diameter and length of the thoracic cavity both increase
31
```
32. Damage to which of the following would result in cessation of breathing?
A. The pneumotaxic centre
B. The medulla
C. Lung stretch receptors
D. The apneustic centre
E. The pons
```
B. The medulla
32
33. Compliance of the lungs is:
A. Decreased due to an increase in collagen fibres
B. Decreased due to pulmonary hypertension
C. Increased due to increased sympathetic stimulation of lung smooth muscles
D. Higher in the fetus than newborn
E. Increased during exercise
A. Decreased due to an increase in collagen fibres
33
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34. Which respiratory muscles would contract as you blow air into a balloon?
A. Diaphragm
B. Internal intercostals
C. External intercostals
D. All of the above
```
B. Internal intercostals
34
35. Which statement about CO2 is incorrect?
A. Its concentration in the blood is decreased by hyperventilation
B. Its accumulation in the blood is associated with a drop in pH
C. More CO2 dissolves in the blood plasma than is carried on RBCs
D. [CO2]venous is greater than [CO2]arterial
C. More CO2 dissolves in the blood plasma than is carried on RBCs
35
```
36. Which substance(s) can cross the blood-brain barrier?
A. H+
B. CO2
C. O2
D. HCO3-
E. B and C
```
E. B and C
36
```
Which substance directly affects medullary chemoreceptors?
A. H+
B. CO2
C. O2
D. HCO3-
E. Na+
```
A. H+
37
```
38. Diaphragm contraction causes the thoracic volume to _________ and the thoracic pressure to _________.
A. Increase; Increase
B. Decrease; Decrease
C. Increase; Decrease
D. Decrease; Increase
```
C. Increase; Decrease
38
```
The most important receptors for respiration regulation are:
A. Located in the brachial artery
B. Most sensitive to changes in PO2
C. Affected by changes in pH
D. Not found in the medulla
```
C. Affected by changes in pH
39
As plasma pH decreases, hemoglobin’s O2 affinity will:
A. Increase
B. Decrease
C. Stay the same
B. Decrease
40
As acetylcholine is injected intravenously, bronchiole diameter will:
A. Increase
B. Decrease
C. Stay the same
B. Decrease
41
```
You begin to hyperventilate. Your plasma PCO2 will _________ and your plasma pH will _________.
A. Increase; Increase
B. Increase; Decrease
C. Decrease; Increase
D. Decrease; Decrease
```
C. Decrease; Increase
42
As blood flows through the pulmonary capillaries, Cl- in the plasma will:
A. Increase
B. Decrease
C. Stay the same
A. Increase
43
44. Which of the following are functions of components of the respiratory system?
A. Warming and moistening of inhaled air
B. Delivering oxygen to and removing carbon dioxide from the blood
C. Assisting in the maintenance of blood pH
D. All of the above
E. 2 of the above
D. All of the above
44
As pulmonary edema progresses during congestive heart failure, the rate of O2 diffusion in the lung:
A. Increases
B. Decreases
C. Stays the same
B. Decreases
45
As pleural space pressure increases, lung volume:
A. Increases
B. Decreases
C. Stays the same
B. Decreases
46
As the presence of dipalmitoylphosphatidylcholine in the alveoli decreases, lung compliance:
A. Increases
B. Decreases
C. Stays the same
B. Decreases
47
As exhalation proceeds, alveolar wall tension:
A. Increases
B. Decreases
C. Stays the same
B. Decreases
48
50. Which of the following is true with regards to the airways of the respiratory system?
A. Sympathetic stimulation causes bronchoconstriction
B. Respiratory bronchioles may be involved in gas exchange
C. The bronchial system receives its air supply directly from alveoli capillaries
D. When PO2 is decreased, bronchoconstriction redirects air to well-oxygenated area
E. The bronchi and bronchioles are innervated by the somatic nervous system
B. Respiratory bronchioles may be involved in gas exchange
49
51. Respiratory compensation for metabolic alkalosis cannot be complete as:
A. Low PaCO2 stimulates respiration
B. High PaCO2 stimulates respiration
C. Low PaCO2 inhibits respiration
D. High PaCO2 inhibits respiration
E. None of the above (respiratory compensation for metabolic alkalosis can be complete)
B. High PaCO2 stimulates respiration
50
Which is not a protective mechanism by the respiratory system?
A. Phagocytic activity of the macrophages
B. Constriction of bronchioles in response to noxious gases
C. Coughing induced by dust particles
D. Mucus trapping of particles
E. Opening of glottis during swallowing
E. Opening of glottis during swallowing
51
Total peripheral resistance decreases during exercise because of the effect of:
A. Parasympathetic stimulation to skeletal muscles
B. Local metabolites on skeletal muscle arterioles
C. Increase in cardiac output
D. Increase in blood pressure
E. Histamine on skeletal muscle arterioles
B. Local metabolites on skeletal muscle arterioles
52
Type II alveolar epithelial cells secrete pulmonary surfactant which:
A. Removes microorganisms from the alveoli
B. Reduces volume of alveoli
C. Reduces alveolar surface tension
D. Provides structural stability to the respiratory tract
E. Regulates luminal diameter of the airways
C. Reduces alveolar surface tension
53
55. An arterial partial pressure of CO2 (PaCO2) of 32 mmHg may:
A. Arise due to the depression of medullary respiratory center
B. Arise due to low pulmonary compliance
C. Arise due to hysterical hyperventilation
D. Result in low plasma pH
E. Lead to increased formation of carbaminohaemoglobin
C. Arise due to hysterical hyperventilation
54
```
A patient has arterial blood gas of PO2 = 105mmHg and PCO2 = 30mmHg. What is he suffering from?
A. Hyperventilation
B. Hypoventilation
C. Respiratory alkalosis
D. Metabolic acidosis
```
A. Hyperventilation, C. Respiratory alkalosis
55
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59. What cannot be measured by spirometry?
A. Total lung capacity
B. Tidal volume
C. Vital capacity
D. Functional vital capacity
E. Inspiratory respiratory volume
```
A. Total lung capacity
56
60. During exercise:
A. Arterial PCO2 increases in a normal person
B. Arterial PO2 increases in a normal person
C. Peripheral vasoconstriction occurs to increase blood pressure
D. Pulmonary vasoconstriction occurs to regulate blood flow
E. There is an increase in pulmonary blood flow
E. There is an increase in pulmonary blood flow
57
61. Which of the following occurs upon ascent to high altitudes?
A. Hb concentration increases within 1 hour
B. Hyperventilation due to stimulation of central chemoreceptors
C. Viscosity of blood increases
D. Upon 1 week of acclimatization, the O2/Hb dissociation curve is the same as that of the sea
E. At PO2 = 40 mmHg, blood releases more O2 into tissues than at the same PO2 at sea level
C. Viscosity of blood increases
| E. At PO2 = 40 mmHg, blood releases more O2 into tissues than at the same PO2 at sea level
58
62. Narrowing of the airways in bronchial asthma is caused by:
A. damage to the vagus nerve
B. increased stimulation of sympathetic nerve fibres
C. presence of broken-up cartilage plates
D. absence of macrophages
E. contraction of the smooth muscle in bronchioles.
E. contraction of the smooth muscle in bronchioles.
59
63. A plasma pH of 7.32 may
A. lead to inhibition of respiration
B. cause Hb to have a lower affinity for oxygen
C. arise due to lower CO2 content in the blood
D. lead to less renal excretion of H+ ions
E. arise due to pulmonary hypertension
B. cause Hb to have a lower affinity for oxygen
60
64. With regards to the conducting portion of the respiratory tract
A. Constriction of bronchioles occur when PCO2 in airways is increased
B. Drugs that stimulate beta adrenergic receptors will dilate the bronchioles
C. Airway resistance is reduced when lungs are collapsed
D. Respiratory bronchioles have cartilaginous rings to support their walls
B. Drugs that stimulate beta adrenergic receptors will dilate the bronchioles
61
65. Which of the following is true regarding ventilation?
A. Automatic breathing is generated by impulse from the cerebral cortex.
B. Stretch receptors in lung stimulate inspiration efforts
C. PO2 of 80mmHg stimulates increased ventilation
D. Voluntary hyperventilation before breath holding will reduce the duration of breath holding
E. Increase in patient with diabetic ketoacidosis
E. Increase in patient with diabetic ketoacidosis
62
66. Which of the following regarding exchange of gases in lungs is true?
A. CO2 diffuses across the alveoli into the blood more slowly than oxygen
B. Alveolar dead space improves ventilation
C. On ascent to high altitude the diffusion of O2 from alveoli to blood is enhanced
D. Decrease in haemoglobin concentration does not affect arterial PO2
E. Decrease in cardiac output reduces V/Q inequalities in lungs
D. Decrease in haemoglobin concentration does not affect arterial PO2
63
67. Which of the following regarding transport of carbon dioxide is true?
A. It is not carried in red blood cells
B. It is carried mainly as dissolved CO2 in blood.
C. It doesn’t bind to proteins in the blood
D. Causes chloride shift out of RBCs in the tissues
E. Arterial PCO2 in a normal person at rest should not exceed 45 mmHg
E. Arterial PCO2 in a normal person at rest should not exceed 45 mmHg
64
68. With regard to Oxygen and Haemoglobin
A. At arterial PO2 of 60mmHg, the oxygen saturation of Hb is higher at pH 7.2 compared to pH 7.5
B. A drop in arterial PO2 of 10mmHg will result in the same amount of oxygen dissociating from Hb irrespective of the initial arterial PO2
C. The affinity of HB for oxygen is likely to be reduced in a person with COPD.
D. On ascent to high altitudes the level of Hb increases within 24 hours in order to enhance O2 delivery to tissues
E. Less O2 dissociates from Hb when arterial PO2 is increased
C. The affinity of HB for oxygen is likely to be reduced in a person with COPD.
E. Less O2 dissociates from Hb when arterial PO2 is increased
65
69. Which of the following regarding the breathing of 100% O2 at high atmospheric pressures is FALSE?
A. May cause irritation of respiratory passage
B. May cause convulsions
C. May lead to tissue damage due to the generation of free radicals
D. As effective as using 100% O2 at atmospheric pressure of 760 mmHg in the treatment of carbon monoxide poisoning
E. May improve the healing of wounds
D. As effective as using 100% O2 at atmospheric pressure of 760 mmHg in the treatment of carbon monoxide poisoning
66
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70. Compared to a normal person, a patient who suffers from Chronic Obstructive Lung Disease is likely to have the following condition EXCEPT:
A. Increased Hb concentration
B. Increased work of breathing
C. Increased airway resistance
D. Reduced Forced Vital Capacity
E. Reduced Pulmonary Vascular Resistance
```
E. Reduced Pulmonary Vascular Resistance
67
71. Patient with sedative overdose will
A. Hyperventilate; increased PO2, increased PCO2
B. Hyperventilate; increased PO2, decreased PCO2
C. Hyperventilate decreased PO2, increased PCO2
D. Hypoventilate; increased PO2, decreased PCO2
E. Hypoventilate; decreased PO2, increased PCO2
E. Hypoventilate; decreased PO2, increased PCO2
68
72. With regards to compliance of the lungs, which of the following is FALSE?
A. Compliance is reduced in pulmonary oedema
B. Work of breathing increases with reduced compliance
C. Compliance increases when elastic recoil increases
D. Compliance is affected by changes in connective tissues of lungs
E. A reduction in alveolar surface tension increases compliance
C. Compliance increases when elastic recoil increases
69
73. Regarding pulmonary circulation
A. Hypoxia stimulates vasodilation in lungs
B. Exercise induces vasoconstriction in lungs
C. Pulmonary blood flow at any one time is equivalent to cardiac output
D. In a person lying horizontally in bed, the lung bases receive most of the pulmonary blood flow
E. Normal pulmonary arterial pressure is about 90/50mmHg
C. Pulmonary blood flow at any one time is equivalent to cardiac output
70
74. During normal quiet ventilation
A. Abdominal muscles involved in inspiration
B. Diaphragm contracts during expiration
C. Intra-alveolar pressure equivalent to atm pressure during inspiration
D. intra-pleural pressure lower than atm pressure during inspiration
E. Hypothalamus exerts main control over respiratory efforts
D. intra-pleural pressure lower than atm pressure during inspiration
71
75. In asthmatic patient with increased airway resistance
A. FVC is increased
B. Drugs that inhibit beta2 adrenergic receptors cause bronchodilation
C. FEV increases with bronchodilating drug
D. Increase alveolar Dead space
E. Work of breathing is not affected unless in severe condition
C. FEV increases with bronchodilating drug
72
76. Which is true regarding exchange of oxygen in the lungs
A. O2 uptake is not affected by CO
B. CO2 diffuse slower than O2
C. Given that arterial PO2 stays the same, Hb decrease would cause decrease in PO2
D. At high altitude, pH decreases
E. At high altitude, PCO2 would decrease
E. At high altitude, PCO2 would decrease
73
77. What is not likely to cause arterial hypoxaemia
A. Sedative medication
B. Inspiring 70% CO2
C. CO poisoning
D. Pneumonia
E. Ascent up to 2500m from 1500m after acclimatisation at 1500m for 3 weeks
B. Inspiring 70% CO2
| C. CO poisoning (double check this option)
74
78. With regard to Hb and oxygen, which of the following is true?
A. When the partial pressure of oxygen in blood increases from 85mmHg to 100mmHg, the Hb oxygen saturation increases by 50%
B. Oxygen binds to the globin protein of Hb
C. Arterial O2 Partial pressure decreases when Hb level decreases
D. Affinity of oxygen to Hb decreases in anaemia
E. Acidosis shifts the dissociation curve to the left
D. Affinity of oxygen to Hb decreases in anaemia
75
79. A man has been a heavy smoker and is suffering from COPD; his exercise tolerance is _____; his spirometry tests show that FVC is ____; the ratio of FEV1/FVC is _____; his ventilation/perfusion ratio is impaired and this lead to an arterial PO2 of _____;
A. unchanged, reduced, unchanged, 85 mmHg
B. impaired, unchanged, reduced, 65 mmHg
C. impaired, reduced, unchanged, 65 mmHg
D. impaired, reduced, reduced, 65 mmHg
E. impaired, unchanged, increased, 85mmHg
D. impaired, reduced, reduced, 65 mmHg
76
80. With regards to the compliance of the lungs, which of the following is true:
A. Compliance is increased in the absence of surfactant
B. Fibrous tissue decreases work of breathing
C. Lung compliance does not affect work of breathing
D. The presence of fluid in the interstitial space increases compliance
E. The collapse of alveoli decreases compliance
E. The collapse of alveoli decreases compliance
77
Lung infections may occur if ciliary movement in the airways is impaired. True or false?
True
78
What cells help clear small particles that reach the lungs?
A. Lymphocytes in lungs
B. Alveolar epithelial cells
C. Macrophages in lungs
D. Mucus-secreting cells in the lungs
E. Endothelial cells of the lung capillaries
C. Macrophages in lungs
| No mucus-secreting cells in lung parenchyma. Mucus-secreting cells are found in the airways.
79
Bluish discolouration of tissues (cyanosis) can be detected in
A. A patient w high levels of deoxygenated Hb
B. A patient w high levels of carboxy Hb
A. A patient w high levels of deoxygenated Hb
80
Which person has the highest tidal volume?
A. healthy 5 y/o male child crying furiously
B. healthy 35 y/o (60kg) listening to relaxing music
C. healthy 25 y/o male (60kg) awaiting MBBS results
D. healthy 40 y/o male (60kg) jogging
D. healthy 40 y/o male (60kg) jogging
81
A has min ventilation of 6L/min, TV 300ml, RR 20 breaths/min. B has min vent 6L/min, TV 500ml, RR 12. who has higher alveolar ventilation?
B
82
25 y/o lady suffers from asthma since childhood, recently feels more breathless. GP diagnoses acute exacerbation of asthma. What can GP prescribe?
A. alpha-adrenergic agonist via a nebuliser
B. beta-adrenergic agonist via a nebuliser
C. beta-adrenergic antagonist via a nebuliser
B. beta-adrenergic agonist via a nebuliser
| test GP can perform to determine if treatment has been effective: spirometry, measure FEV1 and FEC
