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    Shams Pulmonary Quiz 1

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    tylermed
    This document contains a physiology quiz with 17 multiple choice questions about pulmonary function and respiratory physiology. The questions cover topics like lung volumes, compliance, ventilation, airway resistance, and obstructive lung diseases. The explanations provided give the rationale for the correct answer to each question and relate it back to key physiological concepts.

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    © All Rights Reserved

    Shams Pulmonary Quiz 1

    Uploaded by

    tylermed
    112 views9 pages
    This document contains a physiology quiz with 17 multiple choice questions about pulmonary function and respiratory physiology. The questions cover topics like lung volumes, compliance, ventilation, airway resistance, and obstructive lung diseases. The explanations provided give the rationale for the correct answer to each question and relate it back to key physiological concepts.

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    Shams Pulmonary Quiz 1 (1)

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    This document contains a physiology quiz with 17 multiple choice questions about pulmonary function and respiratory physiology. The questions cover topics like lung volumes, compliance, ventilation, airway resistance, and obstructive lung diseases. The explanations provided give the rationale for the correct answer to each question and relate it back to key physiological concepts.

    Copyright:

    © All Rights Reserved
    112 views9 pages

    Shams Pulmonary Quiz 1

    Uploaded by

    tylermed
    This document contains a physiology quiz with 17 multiple choice questions about pulmonary function and respiratory physiology. The questions cover topics like lung volumes, compliance, ventilation, airway resistance, and obstructive lung diseases. The explanations provided give the rationale for the correct answer to each question and relate it back to key physiological concepts.

    Copyright:

    © All Rights Reserved
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    The document discusses physiology concepts related to lung volumes, pressures, compliance, and factors affecting airway resistance.

    Lung compliance decreases with conditions like fibrosis due to reduced elasticity of the lungs. The relationship between lung volume and pressure is nonlinear for pathological lungs compared to normal lungs.

    Lung compliance, which is the ratio of change in lung volume to change in pressure, decreases at lower lung volumes like residual volume due to reduced elastic recoil of the lungs.

    Physiology Quiz 1

    1. The relationship between volume and transmural pressure of a normal lung


    is illustrated by curve 3. Which curve or line of the figure represents this
    relationship for the lung of a patient with lung fibrosis?

    (a) 1
    (b) 2
    *(c) 4
    (d) 5

    Explanation: Compliance is reduced by fibrosis and 4 is the only option with a


    reduced Compliance in comparison to normal (curve 3). The line 5 shows a
    reduced compliance as well, but it shows a linear relationship between Volume
    and pressure, which makes it incorrect. Curve 2 does not present the correct
    relationship between lung volume and transmural pressure. Curve 1 indicates
    a higher compliance compared to normal.

    2. A patient inhales 2 L of air ad holds his breath. At the beginning of


    inspiration his lung transmural pressure is + 5 cm H2O. During breath holding
    his lung transmural pressure is + 10 cm H2O. What is his lung compliance
    L /cm H2O?
    (a) 0.5
    (b) 0.2
    (c) 0.1
    *(d) 0.4
    (e) 0.3

    Explanation: Compliance is defined as dV/dP. Inhaling 2 L means that lung


    volume increased by 2L, therefore, dV = 2L. Now pressure before inhalation of
    dV was 5 cm H2O and thereafter 10 cm H2O; therefore, dP = 10 – 5 = 5 cm
    H2O. C = dV/dP = 2L/5cm = 0.4 L/cm H2O.

    3. By which combination of the following respiratory pattern is the alveolar


    ventilation (VA) the greatest?
    Tidal volume (VT) Respiratory frequency (FR)
    (L) (breath / min)
    (A) 0.25 24
    (B) 0.5 12
    (C) 1.0 6
    (D) 2.0 3

    (a) A
    (b) C
    (c) B
    *(d) D

    Explanation: Total ventilation is equal to alveolar ventilation + dead space


    ventilation. It means (FR x VT) = (FR x VA) + (FR x VD). Therefore changes in
    FR affects all three ventilations proportionately, but changes in VT affects VA,
    but not VD (VD is virtually constant). In this question Total ventilation is the
    same by all choices. A decrease in FR decreases both alveolar and dead space
    ventilation, but increases in VT would only increase alveolar ventilation, but
    not dead space ventilation. Therefore a combination of highest VT and lowest
    FR for a given ventilation would result in the highest alveolar ventilation and
    lowest dead space ventilation.

    4. Physiological dead space calculated by Bohr equation is:


    (a) Always equal to anatomical dead space
    (b) Always smaller than anatomical dead space
    (c) Always greater than anatomical dead space
    (d) Either smaller or equal to anatomical dead space
    *(e) Either greater or equal to anatomical dead space.

    Explanation: Physiologic dead space = anatomic dead space + those alveolar


    regions that have no gas exchange. Therefore, physiologic dead space is greater
    than anatomic dead space if some alveoli are not ventilated or perfused with
    blood. On the other hand, if all alveoli take part in gas exchange, then
    physiologic dead space is equal to anatomic dead space (minimum value), but
    it’s never smaller than anatomic dead space.

    5. What is the volume of one mol ideal gas under STPD condition?
    (a) 15.2 L
    *(b) 22.4 L
    (c) 31.0 L
    (d) 10.5 L
    (e) 36.4 L

    Explanation: This value can be calculated from ideal gas law under STPD
    conditions.
    6. The following may reduce the FEV 1 in a patient with chronic obstructive
    pulmonary disease:
    (a) Administration of a bronchodilator drug
    (b) Hypertrophy of the diaphragm
    (c) Increased recoil force of the lung
    (d) Increased inspiratory effort
    *(e) Loss of radial traction on the airway

    Explanation: Radial traction of the airway means that the airway is pulling
    outwards (increasing transmural pressure) which in turn dilates the airway.
    Therefore, a loss of this force produces a narrowing of the airway and results in
    a decreased FEV1.

    7. By a routine examination of respiratory functions, a spirometer is used to


    measure lung volumes. Which lung volume or lung capacity cannot be
    determined by this method?
    (a) Expiratory reserve volume (ERV)
    (b) Vital Capacity (VC)
    *(c) Total lung capacity (TLC)
    (d) Inspiratory reserve volume (IRV)
    (e) Inspiratory capacity (IC)

    Explanation: Total lung capacity is the only choice here that includes residual
    volume and therefore cannot be measured with a spirometer alone.

    8. A patient consults the doctor and complains over breathlessness. The doctor
    thinks he is suffering from lung emphysema. Therefore, he decides to measure
    the residual volume of the lung. After a maximal expiration, the Patient is
    connected with a bag containing a mixture of 2 liters air (Vbag = 2 l) with 2%
    He (FHe = 0.02). Helium concentration decreases to 1% (FHe = 0.01) after
    mixing of lung volume with the volume of the bag. What is the residual volume
    (RV) of the patient?
    (a) 1.0 L
    (b) 1.5 L
    (c) 0.5 L
    *(d) 2.0 L
    (e) 3.0 L

    Explanation: FHe (before connection with the lung) x Vbag = FHe (after
    connection with the lung) x (Vbag + RV). It means: 0.02 x 2L = 0.01 x (2L + RV).
    Solving this equation for RV reveals: RV = 2L.

    9. The compliance of the respiratory system is changing with lung volume. At


    which lung volume has the respiratory system its greatest compliance?
    (a) RV
    (b) TLC
    (c) Minimal lung volume (below RV)
    *(d) FRC
    Explanation: The slope of Volume/Pressure curve for the respiratory system
    thus the compliance of respiratory system is highest at FRC (Look at the curve
    in your handouts).

    10. A patient has a skeletal abnormality (Kyphoscoliosis). You are interested to


    verify the compliance of his chest wall. You are measuring changes in lung
    volume by a spirometer. Which pressure change you have to measure in
    addition to ΔV to be able to determine the compliance of his chest wall?
    *(a) Changes in pleural pressure (ΔPpl)
    (b) Changes in alveolar pressure (ΔPA)
    (c) Changes in alveolar O2-partial pressure (ΔPAO2)
    (d) Changes in airway pressure (ΔPaw)
    (e) Changes in inspired O2-partial pressure (ΔPIO2)
    Explanation: For measuring compliance you need to know changes in lung
    volume and changes in transmural pressure difference. Transmural pressure
    for chest wall is the pleural pressure minus outside pressure (considered as
    zero). Therefore, pleural pressure gives you the transmural pressure for the
    chest wall.

    11. You are called to examine a premature early born infant. He is suffering
    from breathlessness and is cyanotic. Your diagnosis is “infant respiratory
    distress syndrome (IRDS).” After treatment with artificial surfactant, the
    situation is under control. What did surfactant do?
    (a) It increased the activity of inspiratory motoneurons
    (b) It increased the concentration of erythrocytes in the blood
    (c) It decreased the lung compliance
    (d) It increased the force of respiratory muscles
    *(e) It decreased surface tension in the lung

    Explanation: It is the main effect of Surfactant to reduce surface tension and


    hereby increase compliance of the lung.

    12. Some diseases cause injury of alveolar surface (gas exchange region).
    Which type of the lung cells repairs this membrane?
    (a) Alveolar macrophage
    *(b) Alveolar epithel cell type II
    (c) Clara cell
    (d) Alveolar epithel cell type I
    (e) Brush cell

    Explanation: Alveolar type II cells normally produce surfactant, but in injury


    they proliferate and repair the alveolo capillary membrane and then
    differentiate to alveolar type 1 cells.
    13. The airway resistance of a healthy person has to be determined. Close to
    which lung volume do you expect to measure his highest resistance to
    expiratory airflow?
    (a) FRC
    (b) 60 % of VC
    (c) TLC
    *(d) RV

    Explanation: One factor affecting airway resistance is the lung volume. The
    higher the lung volume, the lower is airway resistance (see the curve in your
    handouts.) Among choices given here, is residual volume (RV) the lowest lung
    volume and is therefore associated with the highest airway resistance.

    14. A healthy person connected to a spirometer has been asked to take a


    maximum breath in, hold it and then exhale as hard and fast as he can (forced
    vital capacity maneuver). The expiratory volume in 1 second (FEV1) and forced
    vital capacity (FVC) have been measured. What is the normal value of
    FEV1/FVC in %.
    (a) 40
    *(b) 80
    (c) 60
    (d) 100
    (e) 20

    Explanation: You should know the important normal values such as this one.

    15. Breathing is associated with changes in intra pleural pressure (Ppl). During
    which of the following respirations can this pressure become positive (greater
    than atmospheric pressure).
    (a) During forced inspiration of a large volume (3 L)
    (b) During normal expiration
    (c) During normal inspiration
    *d) During forced expiration of a large volume (3 L)
    (e) During breath holding at FRC

    Explanation: Pleural pressure is negative at FRC (-6 cm H2O), and decreases


    further during inspiration. During expiration it becomes less negative as
    compared to FRC, but is still negative. Only during forced expiration
    particularly if expired volume is large, pleural pressure can become positive.

    16. A person can modify his breathing voluntarily. Which of the following
    phases of inspiration or expiration is passive and does not require respiratory
    muscles force?
    (a) Forced inspiration
    (b) Slow inspiration of a small volume
    *(c) Normal expiration
    (d) Normal inspiration
    (e) Forced expiration to values below FRC

    Explanation: Inspiration is always active, because the respiratory system (RS)


    is moved away from its resting volume during inspiration. Only normal
    expiration is passive, because the RS is moved towards its resting point by its
    recoiling force during a normal expiration.

    17. A person connected to a spirometer has been asked to take a minimum


    breath in, hold it and then exhale as hard and fast as he can (forced vital
    capacity maneuver). The expiratory volume in 1 second (FEV1) and forced vital
    capacity (FVC) have been measured. The value of FEV1/FVC is significantly
    below 80% by:
    *(a) Lung obstructive disease
    (b) A healthy person
    (c) Lung fibroids
    (d) Lung restrictive disease
    Explanation: FEV1/FVC is lower than normal (80%) by obstructive diseases,
    because of the higher airway resistance. FEV1 is lower than normal by a
    restrictive disease because VC is smaller than normal, so that the ration of the
    two is normal or slightly increased due to lower compliance and higher
    recoiling force of the lung.

    18. Two bubbles have the same surface tension, but bubble X has 3 times the
    diameter of bubble Y. The ratio of the pressure in bubble X to that in bubble Y
    is:
    (a) 1 : 1
    (b) 9 : 1
    (c) 0.9 : 1
    *(d) 0.3 : 1
    (e) 3 : 1

    Explanation: Pressure in a bubble is = 2 times Surface tension divided by


    radius. Because the radius of bubble X is 3 times greater than radius of bubble
    Y, its pressure must be 1/3 of pressure in bubble Y. Therefore, the ration of
    pressures in 1/3 to 1 or 0.3 to 1.

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