1.

) Major peripheral chemoreceptor

A.) Vagal inputs from lungs and airways

B.) Carotid body

C.) Pulmonary baroreceptors

D.) RTN

(chapter 21, page 558)

2.) Which of the following is associated with an increased DLco?

A.) Severe anemia

B.) Polycythemia

C.) Emphysema

D.) Pulmonary hypertension

(chapter 13, page 366)

3.) In what zone does pulmonary artery pressure exceeds alveolar pressure which in turn exceeds
venous pressure

A.) Zone I

B.) Zone II

C.) Zone III

D.) Zone IV

(Chapter 13, page 363)

4.) What zone of the lungs is perfusion evident throughout systole and diastole (and inspiration and
expiration)?

A.) Zone I

B.) Zone II

C.) Zone III

D.) Zone IV

(Chapter 13, page 363)

5.) The shift of the CO2-hemoglobin dissociation curve which occurs in response to changes in
PaO2 is known as the:

A.) Haldane effect

B.) Fick Principle

8
C.) Bohr Effect

D.) Law of Laplace

E.) Le Chatelier Principle

(Chapter 13, page 355)

6.) The leftward shift of the oxyhemoglobin dissociation curve caused by hypocarbia is known as
the:

A.) Haldane Effect

B.) Law of Laplace

C.) Fick Principle

D.) Bohr Effect

(Chapter 13, page 355)

7.) The predominant stimulus for activation of HPV is:

A.) decreased PaO2

B.) increased PaO2

C.) decreased PaCO2

D.) increase PaCO2

Chapter 13, page 364

8.) Ventilation and lung volumes in a healthy subject with normal lungs (label the ff. RV, TLC, ERV, VC)

A.) ERV

B.) VC

C.) TLC

D.) RV

8
 Forced Expiration Forced Inspiration Maximum Voluntary Ventilation

9.) Which of the ff. is much more resistant to supplemental oxygen? And hypoxemia may remain
despite administration of 100% oxygen:

A.) V/Q mismatch

B.) Shunt

C.) Diffusion Impairment

D.) Hypoventilation

(chapter 13, page 379)

10.) The most important mechanism for the transport of CO2 from peripheral tissues to the lungs is:

A.) Carbonic acid

B.) coupled to proteins in the form of carbamino compounds

C.) dissolved in plasma

D.) as bicarbonate

(Chapter 13, page 355)

11.) A partition coefficient can be viewed as the affinity of anesthetic for one particular tissue versus
another, indicating the quantitative ratio of anesthetic distributed between two phases when partial
pressures are equal. What volatile anesthetic has a blood-gas partition coefficient of 0.65, meaning that
the concentration in the alveolus is 1 and 0.65 in blood at equilibrium.

A.) Halothane

B.) Desflurane

C.) Isoflurane

8
D.) Sevoflurane

(chapter 21, page 541 table)

12.) Which of the ff. statements is TRUE regarding the effects of anesthetic agents on HPV:

A.) There is a good evidence suggesting a direct effect of neuraxial blockade on HPV

B.) Direct surgical manipulation may cause the release of vasoactive substances, such as
thromboxane and prostacyclin (PGI2), promoting local vasodilatation and promoting HPV

C.) Intravenous anesthetics, such as thiopental, ketamine, morphine, and fentanyl, have a
direct effect on HPV

D.) Inhalational anesthetics have been shown to inhibit HPV in a dose-related fashion but
usually at concentrations much higher than clinically used

(chapter 21, page 552)

13.) What is the volume above the RV at which small airways begin to close during expiration.

A.) VC

B.) CC

C.) ERV

D.) CV

(Chapter 13, page 362)

14.) Which of the following statements would help you distinguish obstructive lung disease from
restrictive lung disease by spirometry:

A.) Decreased residual volume in Obstructive Lung Disease, increased residual volume in Restrictive
Lung Disease

B.) The TLC is increased in both obstructive lung disease and restrictive lung disease

C.) The FEV1/FVC is grossly reduced because the airway resistance is high in Obstructive Lung disease

D.) The FVC is increased in Restrictive Lung Disease

15.) Inspiratory capacity (IC) is the maximum amount of gas that can be inhaled from the resting
expiratory position after a normal exhalation. It is the sum of IRV and:

A.) ERV

B.) VC

C.) VT

D.) FRC

8
16.) This volatile anesthetic inactivates methionine synthase (the enzyme that regulates vitamin B 12
and folate metabolism):

A.) Nitrous Oxide

B.) Sevoflurane

C.) Xenon

D.) Isoflurane

(chapter 21, page 566)

17.) Which of the following statements concerning the distribution of alveolar ventilation (Va) in the
upright lungs is true?

A.) the distribution of Va is not affected by body posture

B.) alveoli at the apex of the lungs (nondependent alveoli) are better ventilated than those
at the base

C.) all areas of the lungs are ventilated equally

D.) alveoli at the base of the lungs (dependent alveoli) are better ventilated than those at
the apex

E.) alveoli at the central regions of the lungs are better ventilated than those at the base or
apex

18.) Which of the ff. statements does not help you improve oxygenation during single-lung ventilation:

A.) Set minute ventilation to maintain PaCO2 at 40 mmHg (hypocapnia may inhibit HPV in the
nondependent lung, whereas hyperventilation may increase airway pressure and
promote blood flow to the nonventilated lung).

B.) Apply 30 cm H2O of PEEP. It may be beneficial if larger tidal volumes delivered manually
improved arterial saturation (i.e., recruitable alveoli).

C.) Use medications to augment HPV (phenylephrine, norepinephrine, almitrine) on the

collapsed lung to decrease the shunt

D.) Selective vasodilators (inhaled nitric oxide, inhaled PGI2) to increase perfusion on the
ventilated lung

19.) Which of the ff. statements does not describe the effects of positioning on pulmonary blood flow:

A.) In both upright and supine positions, the right lung receives approximately 45% of the
total blood flow, whereas the left lung receives the remaining 55%.

B.) In the lateral decubitus position, gravity causes a vertical gradient in blood flow
distribution. Therefore, perfusion of the dependent lung is significantly greater than the
nondependent counterpart

8
C.) When the right lung is nondependent, it receives 45% of the total blood flow, whereas
55% perfuses the dependent left lung.

D.) When the left lung is nondependent, it receives 35% of the total blood flow, whereas
right lung receives 65%

20.) The volatile anesthetics relax airway smooth muscle primarily by directly reducing smooth
muscle contractility and indirectly by inhibiting the reflex neural pathways. Which of the ff.
statements is FALSE:

A.) Volatile anesthetic–induced increases in cyclic 3′,5′ adenosine monophosphate (cAMP)

cause decreases in free intracellular calcium

B.) The mechanisms responsible for the direct relaxation effects involve increases in
intracellular calcium

C.) The predominant mechanism appears to be inhibition of cell membrane–associated

voltage- dependent calcium channels

D.) Volatile anesthetics reduce calcium sensitivity as a result of inhibition of protein kinase C
activity and inhibition of G protein function

(chapter 21, page 546)

21.) The Functional Residual Capacity is composed of the :

A.) Inspiratory reserve volume and residual volume

B.) Inspiratory capacity and vital capacity

C.) Expiratory reserve volume and residual volume

D.) Expiratory reserve volume and tidal volume

22.) Each of the following is decreased in elderly patients compared with their younger counterparts
EXCEPT:

A.) FEV1

B.) Ventilatory response to hypercarbia

C.) PaO2

D.) Closing volume

E.) Vital capacity

8
23.) All of the following will increase the closing capacity, EXCEPT:

A.) Smoking

B.) Chronic Bronchitis

C.) Old Age

D.) Right Ventricular failure

24.) Which of the following does not compose your vital capacity:

A.) Functional residual capacity

B.) Inspiratory reserve volume

C.) Tidal volume

D.) Expiratory reserve volume

25.) Which of the following does not shift the oxyhemoglobin dissociation curve to the right?:

A.) Volatile anesthetics

B.) Increased temperature

C.) Decreased pH

D.) Decreased Pao2

E.) Increased red blood cell (RBC) 2,3-DPG content

26.) Which of the following volatile anesthetics does not undergo oxidative metabolism in the liver by
cytochrome P-450 enzymes to produce trifluoroacetate:

A.) Desflurane

B.) Sevoflurane

C.) Isoflurane

D.) Halothane

27.) Which of the ff. volatile anesthetics has a minimal effect on heart rate?

A.) Isoflurane

B.) Sevoflurane

C.) Halothane

D.) Desflurane

8
28.) The only inhaled volatile anesthetic that has any effect on myocardial rhythm. The administration of
this volatile anesthetic may be accompanied by a junctional rhythm, and it sensitizes the myocardium to
premature ventricular extrasystoles, especially in the presence of catecholamines.

A.) Isoflurane

B.) Halothane

C.) Sevoflurane

D.) Desflurane

29.) The first nonflammable potent inhaled anesthetic developed after the Second World War. It
undergoes extensive metabolism via two separate pathways (O-demethylation and dechlorination). Its
clinical use was associated with renal injury, and the degree of injury was positively correlated with
magnitude of plasma fluoride concentration.

A.) Methoxyflurane

B.) Halothane

C.) Desflurane

D.) Enflurane

30.) Which of the following statements correctly defines the relationship between minute
ventilation (Ve), dead space ventilation (Vd), and PaCO2 ?

A.) if VD is constant and VE increases, then PaCO2 will increase

B.) if VE is constant and VD increases, then PaCO2 will increase

C.) if VE is constant and VD increases, then PaCO2 will decrease

D.) if VD is constant and VE increases, then PaCO2 will decrease