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Which of the following increases the likelihood of pulmonary edema?
- A) Hypoproteinemia
- B) Left heart failure
- C) Systemic hypertension
- D) Leaky alveolar capillary membranes
- E) All of the above
Correct Answer(s): E
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D-dimer test is useful to detect:
- A) Excessive clotting
- B) Excessive bleeding
- C) Anemia
- D) Vasculitis
Correct Answer(s): A
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The origin of pulmonary embolism may be:
- A) Breast cancer cells
- B) Bone marrow fragments
- C) Local pulmonary infarct
- D) A and B
Correct Answer(s): D
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Pulmonary hypertension may develop as a result of:
- A) Scleroderma
- B) Liver cirrhosis
- C) Left sided heart failure
- D) All of the above
Correct Answer(s): D
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With alveolar hyperventilation, which of the following would you expect?
- A) Higher PaO2 and higher PaCO2
- B) Higher PaO2 and lower PaCO2
- C) Lower PaO2 and higher PaCO2
- D) Lower PaO2 and lower PaCO2
- E) Normal PaO2 and lower PaCO2
Correct Answer(s): B
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Which of the following is true about blood gas transport?
- A) Quantitatively there is more O2 than CO2 per liter of blood
- B) Carbon dioxide only exists in the plasma as bicarbonate
- C) Hemoglobin is a tertiary protein structure with molecular weight of 48,000 Daltons
- D) The CO2 dissociation curve is linear in the physiological range
- E) Henry’s law determines that O2 is more soluble than CO2
Correct Answer(s): D
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Which of the following statements is true of terminal bronchioles?
- A) They are part of the transitional zone of the lung
- B) They are about 1 mm in diameter
- C) They are about 5 mm in diameter
- D) They are supported by cartilage
- E) There are 19 altogether in the two lungs
Correct Answer(s): B
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A patient has the following pulmonary function measurements: FEV1 1.0 liters (predicted 3.2 liters); FVC 3.8 liters (predicted 4.0 liters). DLCO 100% of predicted. What is the problem?
- A) Pulmonary fibrosis
- B) Asthma
- C) Emphysema
- D) Reduced compliance
- E) Chest wall deformity
Correct Answer(s): B
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The Haldane effect is:
- A) Dissociation of carbonic acid to form hydrogen ion and bicarbonate
- B) Buffering of hydrogen ion by hemoglobin
- C) Ability of deoxygenated hemoglobin to transport more carbon dioxide
- D) Greater affinity of hemoglobin for CO2 in the lung
- E) Ability of blood to transport more CO2 than O2
Correct Answer(s): C
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The diffusing capacity of the lung is influenced by
- A) Anemia
- B) Thickness of the alveolar-capillary membrane
- C) Surface area of the alveolar-capillary membrane
- D) Pumonary capillary blood volume
- E) All of the above
Correct Answer(s): E
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Which of the following is a non-respiratory function of the lungs?
- A) Conversion of renin to angiotensin I
- B) Exchange of nitrogen across the alveolar-capillary membrane
- C) Protein degradation for energy generation
- D) Secretion of growth hormone
- E) Filtration of debris in the circulation
Correct Answer(s): E
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The following data were obtained when inflating isolated lungs. What accounts for the difference between air and saline inflations?
- A) Chest wall compliance
- B) Airway resistance
- C) Elastic forces
- D) Surface forces
- E) Higher flow with saline
Correct Answer(s): D
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Which of the following pathways influences the “respiratory centers” in the medulla oblongata?
- A) Apneustic signals from the spinal cord
- B) Vagal efferents from stretch receptors in the chest wall
- C) Vagal afferents from golgi organs in the diaphragm
- D) Cardiovascular motorneurons in the medulla
- E) Vagal afferents from the carotid body
Correct Answer(s): C
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You collect expired air from a human subject for 1 minute, mix it and measure the concentration of CO2 which is 3.3%. You draw and arterial blood gas at the same time and find the PaCO2 is 40 mm Hg. If the barometric pressure is 760 mm Hg and there is no humidity, what is the dead space to tidal volume ratio?
- A) 12.5%
- B) 25%
- C) 32.5%
- D) 37.5%
- E) 50%
Correct Answer(s): D
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A patient has the following pulmonary function measurements: FEV1 2.3 liters (predicted 3.2 liters); FVC 2.8 liters (predicted 4.0 liters). What is the problem?
- A) Asthma
- B) Obstructive pulmonary disease
- C) Emphysema
- D) Increased compliance
- E) Restrictive pulmonary disease
Correct Answer(s): E
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The following diagram represents forced expiratory flow from a model lung. The pleural pressure is +20 cm H2O and the static recoil pressure of the lung is 10 cm H2O. Which letter indicates the equal pressure point?
- A) (a)
- B) (b)
- C) (c)
- D) (d)
- E) (e)
Correct Answer(s): C
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Study the following spirogram from a normal subject.
- A) C is expiratory reserve volume and F is functional residual capacity
- B) E is inspiratory reserve volume and I is total lung capacity
- C) C is functional residual capacity and G is tidal volume
- D) B is tidal volume and G is inspiratory capacity
- E) G is vital capacity and H is functional residual capacity
Correct Answer(s): A
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The normal pleural pressure gradient from the apex to the base of the lung causes:
- A) Basal alveoli to be larger than apical alveoli
- B) Apical alveoli to receive the largest portion of the tidal volume
- C) The compliance of apical alveoli to be less than basal alveoli
- D) Pulmonary blood flow to be unevenly distibuted
- E) Ventilation-perfusion ratios to be generally higher at the base of the lung
Correct Answer(s): C
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Oxygen molecules
- A) Are larger than CO2 molecules
- B) Diffuse more slowly through alveolar gas
- C) Diffuse more rapidly across the alveolar-capillary membrane
- D) Move up their partial pressure gradient
- E) Are less soluble than CO2 molecules in plasma
Correct Answer(s): E
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What is the main reason for a decrease in expiratory flow as lung volume decreases during normal exhalation?
- A) Reduced effort
- B) Bronchial smooth muscle contraction
- C) Lower pleural pressure
- D) Reduced chest wall recoil
- E) Reduced lung recoil
Correct Answer(s): E
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Which of the following increases the oxygen content of the blood?
- A) Anemia
- B) Polycythemia (increased number of red blood cells)
- C) Carbon monoxide poisoning
- D) Acidosis
- E) Exercise
Correct Answer(s): B
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Pulmonary vascular resistance:
- A) Is usually greater than systemic vascular resistance
- B) Inversely proportional to cardiac output
- C) Inversely proportional to mean pulmonary arterial pressure
- D) The same as systemic vascular resistance in normal subjects
- E) Calculated using the Fick equation
Correct Answer(s): B
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A deficiency of pulmonary surfactant would:
- A) Decrease airway resistance
- B) Decrease lung compliance
- C) Decrease the work of breathing
- D) Decrease the change in pleural pressure (Ppl) required to achieve a given tidal volume
- E) Decrease surface tension in the alveoli
Correct Answer(s): B
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The alveolar-capillary membrane consists of an alveolar epithelial cell and its basement membrane, the interstitium, a capillary endothelial cell and its basement membrane. What is the thickness of this alveolar-capillary membrane?
- A) 10 micrometers
- B) 200 micrometers
- C) 0.4 micrometers
- D) 0.1 micrometers
- E) 100 micrometers
Correct Answer(s): C
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Diffusion equilibrium for CO2
- A) Is complete after about 0.33 seconds
- B) Varies according to cardiac output
- C) Is faster than for O2
- D) Is a frequent limitation in gas exchange
- E) Is impaired by altitude
Correct Answer(s): C
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Which of the following would increase to ability of a part of the lung to empty?
- A) Reduced compliance
- B) Increased airway resistance
- C) Tachypnea
- D) Airway collapse
- E) Shift of equal pressure point towards alveoli
Correct Answer(s): A
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A subject is breathing at a rate of 10 breaths/min with a tidal volume of 600 ml and a dead space of 200 ml. She changes her breathing pattern to a rate of 20 breaths/min with a tidal volume of 400 ml. Assuming that the dead space remained the same, what would happen to alveolar ventilation?
- A) Increased by 2.0 L/min
- B) Unchanged
- C) Decreased by 2.0 L/min
- D) Increased by 0.5 L/min
- E) Decreased by 0.5 L/min
Correct Answer(s): C
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The ventilation-perfusion ratio is:
- A) 1.0 considering the lungs as a single unit model
- B) Independent of gravity
- C) More uniform in pulmonary fibrosis
- D) Greater at the top of the lung when upright
- E) Higher with physiological shunt
Correct Answer(s): D
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The carotid bodies:
- A) Are located at the bifurcation of the iliac arteries
- B) Have a low perfusion per gram of tissue
- C) Respond primarily to high CO2
- D) Send impulses to the medulla oblongata via the glossophaygeal (IX) nerve
- E) Are activated by breathing supplemental oxygen
Correct Answer(s): D
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The central nervous system areas involved with control of breathing:
- A) Are located in the midbrain
- B) Have the highest blood flow of all human tissues
- C) Subserve both voluntary and involuntary breathing
- D) Are involved in the reflex contraction of skeletal muscles on stretching
- E) Include a midline “pacemaker” made up of spontaneously depolarizing cells
Correct Answer(s): C
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The fluid filtered from the blood in the glomerular capillaries travels sequentially through which segments of the juxtamedullary nephron and collecting ducts?
- A) Afferent arteriole →Proximal tubule→ Descending limb of the loop of Henle → Ascending limb of the loop of Henle →Distal convoluted tubule → Cortical collecting duct → Medullary collecting duct.
- B) Proximal tubule→ Descending limb of the loop of Henle → Ascending limb of the loop of Henle →Distal convoluted tubule → Cortical collecting duct → Medullary collecting duct.
- C) Proximal tubule→ Ascending limb of the loop of Henle → Descending limb of the loop of Henle → Distal convoluted tubule → Cortical collecting duct → Medullary collecting duct
- .D) Proximal tubule→ Descending limb of the loop of Henle → Ascending limb of the loop of Henle →Distal convoluted tubule → Medullary collecting duct Cortical collecting duct.
- E) Proximal tubule→ Ascending limb of the loop of Henle → Descending limb of the loop of Henle → Distal convoluted tubule → Medullary collecting duct Cortical collecting duct.
Correct Answer(s): B
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During sleep, which of the following respiratory disturbances tend to be seen?
- A) Tachypnea during rapid eye movement sleep
- B) Upper airway obstruction due to reduced tidal volume
- C) Increased ventilatory drive at deeper levels of sleep
- D) Hypopnea during rapid eye movement sleep
- E) All of the above
Correct Answer(s): D
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Which of the following statements regarding glomerular filtration is correct?
- A) It will occur when the hydrostatic pressure in the glomerulus exceeds the sum of the fluid pressure in the capsule plus the osmotic force due to proteins in the plasma
- B) GFR is increased by constriction of the afferent glomerular arterioles
- C) GFR is increased by dialation of the efferent glomerular arterioles
- D) Both it will occur when the hydrostatic pressure in the glomerulus exceeds the sum of the fluid pressure in the capsule plus the osmotic force due to proteins in the plasma and GFR is increased by constriction of afferent glomerular arterioles are correct
- E) Both it will occur when the hydrostatic pressure in the glomerulus exceeds the sum of the fluid pressure in the capsule plus the osmotic force due to proteins in the plasma and GFR is increased by dialation of efferent glomerular arterioles are correct
Correct Answer(s): A
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Genetic alterations involving the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genes have an impact on the selection of therapy for patients with metastatic non-small cell lung cancer (T/F)
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What class of organism is shown in this picture?
- A) bacteria
- B) fungus
- C) virus
- D) parasite
Correct Answer(s): B
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Which structures are parts of the nephron?
- A) Glomerulus
- B) Tubules
- C) Interstitium
- D) Artertioles
- E) A and B
- F) A and D
Correct Answer(s): E
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Water is reabsorbed from the kidney filtrate at
- A) The proximal tubule
- B) The ascending limb of the loop of Henle
- C) The distal convoluted tubule and the collecting ducts
- D) The proximal tubule and the distal convoluted tubule and the collecting ducts
- E) All of the choices are correct
Correct Answer(s): D
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What is not a component of the glomerular capillary wall?
- A) Endothelium
- B) Basement membrane
- C) Mesangial cell
- D) Visceral epithelial cell
Correct Answer(s): C
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Patients undergoing anesthesia are at increased risk for what type of infection?
- A) community acquired pneumonia
- B) viral pneumonia
- C) aspiration pneumonia
- D) secondary (hematogenously spread) pneumonia
- E) fungal pneumonia
Correct Answer(s): C
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Healthy young people who are immobilized for several hours (and perhaps take oral contraceptives) are at risk for what type of pulmonary vascular disease?
- A) Pulmonary thromboembolism
- B) Pulmonary artery vasculitis
- C) Pulmonary hypertension
Correct Answer(s): A
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The composition of the glomerular filtrate
- A) Is identical to that of blood plasma
- B) Is identical to that of urine
- C) Changes as the filtrate passes through the tubule
- D) Is both is identical to that of blood plasma and is identical to that of urine
- E) Is both is identical to that of blood plasma and changes as the filtrate passes through the tubule
Correct Answer(s): A
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During incremental exercise breathing frequency and minute ventilation both increase rapidly just before exhaustion and the subjet feels noticeable more short of breath. What physiological mechanism accounts for this?
- A) Increased CO2 production from aerobic muscle metabolism
- B) Central chemoreceptor coupling of CO2 output and minute ventialtion
- C) Central chemoreceptor coupling of O2 uptake and minute ventialtion
- D) Peripheral chemoreceptor response to metabolic acidosis
- E) Peripheral chemoreceptor response to hypoxemia
Correct Answer(s): D
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At altitude, a mountaineer is inclined to produce more alkaline urine. What physiological mechanism accounts for this?
- A) Increased aerobic metabolism due to hypoxia
- B) Renal compensation for respiratory alkalosis
- C) Renal compensation for metabolic acidosis
- D) Increased cardiac output
- E) Diversion of blood flow from the kidneys to exercising muscle
Correct Answer(s): B
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What staging parameter has the worst prognosis for lung cancer?
- A) Tumor size
- B) Invasion into local structures (chest wall)
- C) Distant metastases
- D) Lymph node involvement
Correct Answer(s): C
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Which of the following does not correctly describe kidney function? The kidneys
- A) Contribute significantly to long-term regulation of arterial blood pressure by maintaining the proper plasma volume
- B) Produce urine of a fixed composition in order to maintain homeostasis of extracellular fluid
- C) Excrete metabolic waste products
- D) Assist in maintaining proper acid-base balance in the body
- E) Secrete hormones
Correct Answer(s): B
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The most common type of lung cancer is small cell lung cancer (T/F).
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What is seen in the following image?
- A) Normal lung parenchyma
- B) Non-invasive, well differentiated benign tumor
- C) Invasive glandular tumor (adenocarcinoma)
- D) Invasive squamous cell carcinoma
- E) Small cell carcinoma
Correct Answer(s): C
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Which is a stimulus for renin excretion from the juxtaglomerular apparatus (JGA)?
- A) High arteriolar blood pressure
- B) Low sodium concentration in urinary filtrate of distal tubule
- C) Immune complex disease
- D) High protein levels in urine
Correct Answer(s): B
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A 65-year-old man presents for dental treatment. He has been a heavy smoker for 40 years. An arterial blood gas shows pH 7.34, PaCO2 60 and HCO3 31. What is the acid-base state?
- A) Uncompensated respiratory acidosis
- B) Uncompensated metabolic acidosis
- C) Compensated metabolic alkalosis
- D) Compensated respiratory acidosis
- E) Compensated metabolic acidosis
Correct Answer(s): D
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A 45-year-old man presents for dental treatment with a three day history of profuse vomiting. An arterial blood gas shows pH 7.53, PaCO2 45 and HCO3 33. What is the acid-base state?
- A) Uncompensated respiratory alkalosis
- B) Uncompensated metabolic alkalosis
- C) Compensated respiratory acidosis
- D) Compensated respiratory alkalosis
- E) Compensated metabolic alkalosis
Correct Answer(s): E
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An 85-year-old woman presents for dental treatment. She has a history of longstanding, poorly-controlled hypertension. An arterial blood gas shows pH 7.28, PaCO2 28 and HCO3 12. What is the acid-base state?
- A) Uncompensated respiratory acidosis
- B) Uncompensated metabolic acidosis
- C) Compensated respiratory alkalosis
- D) Compensated respiratory acidosis
- E) Compensated metabolic acidosis
Correct Answer(s): E
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Water, reabsorbed into the blood returns to the bloodstream via
- A) The Proximal Tubule
- B) Afferent arterioles
- C) Efferent arterioles
- D) Peritubular capillaries
- E) Collecting ducts
Correct Answer(s): D
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The majority of cases of common cold are related to:
- A) Rhinoviruses
- B) Coronaviruses
- C) Parainfluenza viruses
- D) Adenoviruses
Correct Answer(s): A
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Which of the following are features of a benign tumor?
- A) Cells are well differentiated
- B) Can invade local tissues
- C) Are composed of cells without normal cell growth and replication control
- D) May spread to distant sites
- E) A and B
- F) A and C
- G) none of the above
Correct Answer(s): F
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A person who is unable to synthesize vasopressin
- A) Is unable to reabsorb water in the proximal tubule
- B) Will excrete glucose in the urine
- C) Will excrete a hypotonic urine
- D) Will excrete up to 180 L of urine per day
- E) Will do all of these things
Correct Answer(s): C
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Community-Acquired pneumonia is cause by:
- A) Streptococcus pneumonia
- B) Haemophilus influenzae
- C) Cytomegalovirus
- D) Aspergillus
Correct Answer(s): A
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Necrotizing fasciitis may be associated with:
- A) Haemophilus influenza
- B) Influenza virus A
- C) Group A beta hemolytic streptococcus (GAS)
- D) Gonococcus
Correct Answer(s): C
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If a patient has a 4 cm mass in the left lung from non-small cell lung cancer and 2 areas of metastasis to the bone, appropriate therapy would include (select one)
- A) Chemotherapy
- B) Surgical removal of the mass in the lung and attempt to remove the areas of bone metastases
- C) Surgical removal of the mass in the lung and chemotherapy to treat the areas of bone metastases.
Correct Answer(s): A
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The amount of a substance that is excreted in the urine is equal to the amount that is ________ plus the amount that is ________ minus the amount that is ________.
- A) Filtered; reabsorbed; secreted
- B) Reabsorbed; filtered; secreted
- C) Secreted; reabsorbed; filtered
- D) Filtered; secreted; reabsorbed
- E) Reabsorbed; secreted; filtered
Correct Answer(s): D
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Constriction of the ________ decreases hydrostatic pressure in the nephron's filtering structures; the _________.
- A) Afferent arterioles, glomerular capillaries
- B) Efferent arterioles, proximal convoluted tubules
- C) Renal vein, peritubular capillaries
- D) Renal arteries, juxtaglomerular apparatus
- E) Vasa recta, ascending loop of Henle
Correct Answer(s): A
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