1. Compared to upper regions of the chest, in lower (more “gravity-dependent”) regions of the chest:
   1. Intrapleural pressure is more negative
   2. Alveoli are larger
   3. Alveoli are better ventilated
   4. Alveolar transmural pressure is greater
   5. Alveoli are less compliant

1. Compared to upper regions of the chest, in lower (more “gravity-dependent”) regions of the chest:
   1. Intrapleural pressure is more negative
   2. Alveoli are larger
   3. Alveoli are better ventilated
   4. Alveolar transmural pressure is greater
   5. Alveoli are less compliant

The dorsal respiratory groups

1.  
   1. Are found in the nucleus brachialis medialis
   2. Are primarily expiratory neurons
   3. Mainly innervate the diaphragm
   4. Contains the neurons currently believed to be the pacemakers that generate the respiratory rhythm
   5. All of the above are correct

1. The dorsal respiratory groups
   1. Are found in the nucleus brachialis medialis
   2. Are primarily expiratory neurons
   3. Mainly innervate the diaphragm
   4. Contains the neurons currently believed to be the pacemakers that generate the respiratory rhythm
   5. All of the above are correct

A man with chronic obstructive pulmonary disease has an arterial hemoglobin concentration of 20 grams Hb/100 ml of blood. At his PO₂ of 60, his hemoglobin is 80% saturated with oxygen. What is his arterial oxygen content, including physically dissolved oxygen? 

1. 16.00 ml O₂/100 ml blood
2. 16.18 ml O₂/100 ml blood
3. 21.44 ml O₂/100 ml blood
4. 21.62 ml O₂/100 ml blood
5. 26.98 ml O₂/100 ml blood

1. A man with chronic obstructive pulmonary disease has an arterial hemoglobin concentration of 20 grams Hb/100 ml of blood. At his PO₂ of 60, his hemoglobin is 80% saturated with oxygen. What is his arterial oxygen content, including physically dissolved oxygen?
   1. 16.00 ml O₂/100 ml blood
   2. 16.18 ml O₂/100 ml blood
   3. 21.44 ml O₂/100 ml blood
   4. 21.62 ml O₂/100 ml blood
   5. 26.98 ml O₂/100 ml blood

Compared to arterial blood, venous blood has

1.  
   1. A higher total CO₂ content
   2. More CO₂ transported as carbamino compounds
   3. More CO₂ transported physically dissolved in the plasma
   4. More CO₂ transported as bicarbonate
   5. All of the above are correct

1. Compared to arterial blood, venous blood has
   1. A higher total CO₂ content
   2. More CO₂ transported as carbamino compounds
   3. More CO₂ transported physically dissolved in the plasma
   4. More CO₂ transported as bicarbonate
   5. All of the above are correct

A person with significant areas of alveolar dead space resulting from low right ventricular output

1.  
   1. Will have an arterial end-tidal (alveolar) CO₂ difference
   2. Will have a physiologic dead space equal to his or her anatomic dead space
   3. Will have a low ventilation-perfusion ratio
   4. Will have a lower than normal mixed expired PO₂
   5. All of the above are correct

1.  A person with significant areas of alveolar dead space resulting from low right ventricular output
1. Will have an arterial end-tidal (alveolar) CO₂ difference
2. Will have a physiologic dead space equal to his or her anatomic dead space
3. Will have a low ventilation-perfusion ratio
4. Will have a lower than normal mixed expired PO₂
5. All of the above are correct

Positive pressure ventilation with positive end-expiratory pressure (PEEP) of a closed chest person would likely 

1. Cause positive intrapleural pressure
2. Increase pulmonary vascular resistance in alveolar vessels
3. Increase pulmonary vascular resistance in the extra-alveolar vessels
4. Decrease venous return
5. All of the above are correct

1. Positive pressure ventilation with positive end-expiratory pressure (PEEP) of a closed chest person would likely
   1. Cause positive intrapleural pressure
   2. Increase pulmonary vascular resistance in alveolar vessels
   3. Increase pulmonary vascular resistance in the extra-alveolar vessels
   4. Decrease venous return
   5. All of the above are correct

1. The ventilatory response to hypoxia
   1. Originates in the arterial chemoreceptors
   2. Originates in the central chemoreceptors
   3. Is greater at low arterial PCO₂s
   4. Is maximal at arterial PO₂s between 80 and 150 mmHg
   5. All of the above are correct

1. The ventilatory response to hypoxia
   1. Originates in the arterial chemoreceptors
   2. Originates in the central chemoreceptors
   3. Is greater at low arterial PCO₂s
   4. Is maximal at arterial PO₂s between 80 and 150 mmHg
   5. All of the above are correct

1. The Hering-Breuer reflexes
   1. Are the main factor that determines the tidal volume in adult humans
   2. Have their afferent fibers in the phrenic nerves
   3. Cannot be demonstrated in humans
   4. May play an important role in maintaining the functional residual capacity in human infants
   5. May be easily demonstrated after bilateral vagus nerve transection

1. The Hering-Breuer reflexes
   1. Are the main factor that determines the tidal volume in adult humans
   2. Have their afferent fibers in the phrenic nerves
   3. Cannot be demonstrated in humans
   4. May play an important role in maintaining the functional residual capacity in human infants
   5. May be easily demonstrated after bilateral vagus nerve transection

1. During a normal eupneic inspiration
   1. Alveolar pressure is greater than atmospheric pressure
   2. Alveolar pressure is greater than intrapleural pressure
   3. Intrapleural pressure is greater than atmospheric pressure
   4. Alveolar elastic recoil pressure is decreasing
   5. All of the above are correct

1. During a normal eupneic inspiration
   1. Alveolar pressure is greater than atmospheric pressure
   2. Alveolar pressure is greater than intrapleural pressure
   3. Intrapleural pressure is greater than atmospheric pressure
   4. Alveolar elastic recoil pressure is decreasing
   5. All of the above are correct

1. Compared to the systemic circulation, the pulmonary circulation
   1. Has greater resistance to blood flow
   2. Has a larger proportion of the total resistance to blood flow in the arterioles
   3. Has greater arterial pressure
   4. Has similar ventricular outputs
   5. All of the above are correct

1. Compared to the systemic circulation, the pulmonary circulation
   1. Has greater resistance to blood flow
   2. Has a larger proportion of the total resistance to blood flow in the arterioles
   3. Has greater arterial pressure
   4. Has similar ventricular outputs
   5. All of the above are correct

1. A woman’s hemoglobin concentration is 12 grams/100 ml blood and her arterial oxygen content is 12 ml O₂/100 ml blood. What is her % oxyhemoglobin saturation (ignore physically dissolved oxygen)?
   1. 75%
   2. 80%
   3. 85%
   4. 97%
   5. 100%

1. A woman’s hemoglobin concentration is 12 grams/100 ml blood and her arterial oxygen content is 12 ml O₂/100 ml blood. What is her % oxyhemoglobin saturation (ignore physically dissolved oxygen)?
   1. 75%
   2. 80%
   3. 85%
   4. 97%
   5. 100%

1. A rapid intravenous injection of a dilute nonlethal concentration of sodium cyanide would likely
   1. Stimulate only the central chemoreceptors
   2. Stimulate only the arterial chemoreceptors
   3. Stimulate both the arterial and central chemoreceptors
   4. Stimulate neither the arterial nor the central chemoreceptors
   5. Cause an immediate increase in arterial PCO₂

1. A rapid intravenous injection of a dilute nonlethal concentration of sodium cyanide would likely
   1. Stimulate only the central chemoreceptors
   2. Stimulate only the arterial chemoreceptors
   3. Stimulate both the arterial and central chemoreceptors
   4. Stimulate neither the arterial nor the central chemoreceptors
   5. Cause an immediate increase in arterial PCO₂

1. Which of the following conditions would likely shift the pressure-volume curve of the lungs to the left, that is, make them more compliant?
   1. Decreased production of pulmonary surfactant
   2. Diffuse interstitial alveolar fibrosis
   3. Emphysema
   4. Pulmonary vascular congestion
   5. Atelectasis

1. Which of the following conditions would likely shift the pressure-volume curve of the lungs to the left, that is, make them more compliant?
   1. Decreased production of pulmonary surfactant
   2. Diffuse interstitial alveolar fibrosis
   3. Emphysema
   4. Pulmonary vascular congestion
   5. Atelectasis

1. Which of the following would likely increase pulmonary vascular resistance?
   1. Inhaling from FRC to the TLC
   2. Exhaling from the FRC to the RV
   3. Breathing 10% O₂-90% N₂ for 10 minutes
   4. Decreasing the cardiac output from 5 L/min to 2.5 L/min
   5. All of the above are correct

1. Which of the following would likely increase pulmonary vascular resistance?
   1. Inhaling from FRC to the TLC
   2. Exhaling from the FRC to the RV
   3. Breathing 10% O₂-90% N₂ for 10 minutes
   4. Decreasing the cardiac output from 5 L/min to 2.5 L/min
   5. All of the above are correct

1. Which of the following would be expected to increase the ventilatory response to carbon dioxide; that is shift the CO₂ response curve to the left?
   1. Metabolic acidosis
   2. Barbiturates, such as sodium pentobarbital
   3. Opiate alkaloids, such as morphine
   4. Slow wave sleep
   5. All of the above are correct

1. Which of the following would be expected to increase the ventilatory response to carbon dioxide; that is shift the CO₂ response curve to the left?
   1. Metabolic acidosis
   2. Barbiturates, such as sodium pentobarbital
   3. Opiate alkaloids, such as morphine
   4. Slow wave sleep
   5. All of the above are correct

1. Changing from the supine to the upright position would likely
   1. Decrease the functional residual capacity
   2. Decrease the outward recoil of the chest wall
   3. Increase the inward recoil of the lungs
   4. Increase the pulmonary capillary blood volume
   5. Increase the pulmonary diffusing capacity

1. Changing from the supine to the upright position would likely
   1. Decrease the functional residual capacity
   2. Decrease the outward recoil of the chest wall
   3. Increase the inward recoil of the lungs
   4. Increase the pulmonary capillary blood volume
   5. Increase the pulmonary diffusing capacity

1. Which of the following statements concerning the transport of carbon dioxide by the blood is correct?
   1. Most of the CO₂ transported by the blood is physically dissolved
   2. Most of the CO₂ transported by the blood is in carbamino compounds
   3. Most of the CO₂ transported by the blood is in bicarbonate
   4. Most of the CO₂ transported by the blood is in bubbles about 10 microns in diameter
   5. The presence of greater concentrations of oxyhemoglobin shifts the whole blood CO₂ dissociation curve to the left

1. Which of the following statements concerning the transport of carbon dioxide by the blood is correct?
   1. Most of the CO₂ transported by the blood is physically dissolved
   2. Most of the CO₂ transported by the blood is in carbamino compounds
   3. Most of the CO₂ transported by the blood is in bicarbonate
   4. Most of the CO₂ transported by the blood is in bubbles about 10 microns in diameter
   5. The presence of greater concentrations of oxyhemoglobin shifts the whole blood CO₂ dissociation curve to the left

1. Nonrespiratory functions of the airways and lungs include
   1. Heating and humidifying inspired air
   2. Filtration and removal of particles from the inspired air
   3. Activation or inactivation of various vasoactive substances in the blood
   4. Filtration of small clots and other matter from the venous blood
   5. All of the above are correct

1. Nonrespiratory functions of the airways and lungs include
   1. Heating and humidifying inspired air
   2. Filtration and removal of particles from the inspired air
   3. Activation or inactivation of various vasoactive substances in the blood
   4. Filtration of small clots and other matter from the venous blood
   5. All of the above are correct

For the next 2 questions: A 15-year-old patient has frequent episodes of dyspnea and wheezing, especially in the spring. Inhaling a bronchodilator partly alleviates the symptoms.

1. Which of the following statements about his pulmonary function tests is correct?
   1. His FEV₁/FVC during these episodes is less than 80%.
   2. His FEV₁/FEC is improved after the administration of a bronchodilator
   3. His peak expiratory flow during these episodes is les than predicted
   4. His arterial PO₂ during these episodes is likely less than normal.
   5. All of the above are correct
2. Which of the following statements about his respiratory mechanics and standard lung volumes and capacities is correct?
   1. His work of breathing during these episodes is normal
   2. His resistance to air flow during these episodes is greater than normal
   3. His residual volume is likely less than predicted during these episodes
   4. His functional residual capacity is likely less than predicted during these episodes
   5. All of the above are correct

For the next 2 questions: A 15-year-old patient has frequent episodes of dyspnea and wheezing, especially in the spring. Inhaling a bronchodilator partly alleviates the symptoms.

1. Which of the following statements about his pulmonary function tests is correct?
   1. His FEV₁/FVC during these episodes is less than 80%.
   2. His FEV₁/FEC is improved after the administration of a bronchodilator
   3. His peak expiratory flow during these episodes is les than predicted
   4. His arterial PO₂ during these episodes is likely less than normal.
   5. All of the above are correct
2. Which of the following statements about his respiratory mechanics and standard lung volumes and capacities is correct?
   1. His work of breathing during these episodes is normal
   2. His resistance to air flow during these episodes is greater than normal
   3. His residual volume is likely less than predicted during these episodes
   4. His functional residual capacity is likely less than predicted during these episodes
   5. All of the above are correct

For the next 2 questions: A woman’s cardiac output is determined by the thermodilution method to be 4.5 L/min. On 100% O₂ her arterial oxygen content is 17 ml O₂/100 ml blood and her mixed venous oxygen content is 14 ml O₂/100 ml of blood. Her arterial hemoglobin concentration is 14.2 grams/100 ml blood, so her end-capillary oxygen content is 19 ml O₂/100 ml blood.

1. Assuming she has only normal alveolar-capillary units and absolute shunts, how much of her cardiac output is perfusing shunts?
   1. 0.45 L/min
   2. 0.90 L/min
   3. 1.35 L/min
   4. 1.80 L/min
   5. 2.25 L/min
2. What is her % shunt?
   1. 10%
   2. 20%
   3. 30%
   4. 40%
   5. 50%

For the next 2 questions: A woman’s cardiac output is determined by the thermodilution method to be 4.5 L/min. On 100% O₂ her arterial oxygen content is 17 ml O₂/100 ml blood and her mixed venous oxygen content is 14 ml O₂/100 ml of blood. Her arterial hemoglobin concentration is 14.2 grams/100 ml blood, so her end-capillary oxygen content is 19 ml O₂/100 ml blood.

1. Assuming she has only normal alveolar-capillary units and absolute shunts, how much of her cardiac output is perfusing shunts?
   1. 0.45 L/min
   2. 0.90 L/min
   3. 1.35 L/min
   4. 1.80 L/min
   5. 2.25 L/min
2. What is her % shunt?
   1. 10%
   2. 20%
   3. 30%
   4. 40%
   5. 50%

Match following sets of blood gas data to one of the underlying problems listed below. Assume the body temperature to be 37°C and the hemoglobin concentration to be 15 g Hb/100 ml blood. F_iO₂ is 0.21 (room air).

A.    Acute vomiting (10 minutes after vomiting)

B.     Acute methanol ingestion

C.     Diarrhea

D.    Accidental hypoventilation of a patient on a mechanical ventilator for 10 minutes

E.     Accidental hyperventilation of a patient on a mechanical ventilator for 10 minutes

1. pHa = 7.60      PaCO₂ = 20 mmHg     [HCO3-] = 20 mEq/L            
   PaO₂ = 110 mmHg      Anion gap = 12 mEq/L
2. pHa = 7.25      PaCO₂ = 30 mmHg     [HCO3-] = 15 mEq/L            
   PaO₂= 95 mmHg         Anion gap = 25 mEq/L
3. pHa = 7.25      PaCO₂ = 50 mmHg     [HCO3-] = 26 mEq/L            
   PaO₂ = 70 mmHg        Anion gap = -11 mEq/L
4. pHa = 7.47      PaCO₂ = 46 mmHg     [HCO3-] = 33 mEq/L            
   PaO₂ = 85 mmHg        Anion gap = 9 mEq/L
5. pHa = 7.25      PaCO₂ = 30 mmHg     [HCO3-] = 15 mEq/L            
   PaO₂ = 95 mmHg        Anion gap = 10 mEq/L

Match following sets of blood gas data to one of the underlying problems listed below. Assume the body temperature to be 37°C and the hemoglobin concentration to be 15 g Hb/100 ml blood. F_iO₂ is 0.21 (room air).

A.    Acute vomiting (10 minutes after vomiting)

B.     Acute methanol ingestion

C.    Diarrhea

D.    Accidental hypoventilation of a patient on a mechanical ventilator for 10 minutes

E.     Accidental hyperventilation of a patient on a mechanical ventilator for 10 minutes

1. pHa = 7.60      PaCO₂ = 20 mmHg     [HCO3-] = 20 mEq/L             E
   PaO₂ = 110 mmHg      Anion gap = 12 mEq/L
2. pHa = 7.25      PaCO₂ = 30 mmHg     [HCO3-] = 15 mEq/L             B
   PaO₂= 95 mmHg         Anion gap = 25 mEq/L
3. pHa = 7.25      PaCO₂ = 50 mmHg     [HCO3-] = 26 mEq/L             D
   PaO₂ = 70 mmHg        Anion gap = -11 mEq/L
4. pHa = 7.47      PaCO₂ = 46 mmHg     [HCO3-] = 33 mEq/L             A
   PaO₂ = 85 mmHg        Anion gap = 9 mEq/L
5. pHa = 7.25      PaCO₂ = 30 mmHg     [HCO3-] = 15 mEq/L             C
   PaO₂ = 95 mmHg        Anion gap = 10 mEq/L

1. The ventilatory response to hypoxia
   1. Appears to arise solely from the arterial chemoreceptors, not the central chemoreceptors
   2. Appears to result from changes in arterial PO₂, not arterial oxygen content
   3. Is small until arterial PO₂ falls below 40-60 mmHg
   4. Is increased if arterial PCO₂ is increased
   5. All of the above are correct

1. The ventilatory response to hypoxia
   1. Appears to arise solely from the arterial chemoreceptors, not the central chemoreceptors
   2. Appears to result from changes in arterial PO₂, not arterial oxygen content
   3. Is small until arterial PO₂ falls below 40-60 mmHg
   4. Is increased if arterial PCO₂ is increased
   5. All of the above are correct

1. Which of the following statements concerning the medullary respiratory center is correct?
   1. The ventral respiratory groups are located in the nuclei of the tractus solitarius
   2. The dorsal respiratory groups are located in the nucleus ambiguus
   3. Cells in the Boetzinger complex may act as pacemakers for the respiratory rhythm
   4. The ventral respiratory groups are exclusively inspiratory neurons
   5. All of the above are correct

1. Which of the following statements concerning the medullary respiratory center is correct?
   1. The ventral respiratory groups are located in the nuclei of the tractus solitarius
   2. The dorsal respiratory groups are located in the nucleus ambiguus
   3. Cells in the Boetzinger complex may act as pacemakers for the respiratory rhythm
   4. The ventral respiratory groups are exclusively inspiratory neurons

All of the above are correct

1. A patient on a positive pressure ventilator with positive end-expiratory pressure (10 cm H₂0 PEEP) would be likely to have
   1. Positive intrapleural pressure
   2. Increased pulmonary vascular resistance
   3. Decreased pulmonary capillary blood volume
   4. Decreased pulmonary diffusing capacity
   5. All of the above are correct

1. A patient on a positive pressure ventilator with positive end-expiratory pressure (10 cm H₂0 PEEP) would be likely to have
   1. Positive intrapleural pressure
   2. Increased pulmonary vascular resistance
   3. Decreased pulmonary capillary blood volume
   4. Decreased pulmonary diffusing capacity
   5. All of the above are correct

For the next 2 questions: A 40-year-old patient is diagnosed with sarcoidosis, a multisystem granulomatous disease that ultimately affects the lungs by causing alveolar interstitial fibrosis.

1. Which of the following statements about her respiratory mechanics and standard lung volumes and capacities is correct?
   1. Her functional residual capacity is likely less than predicted
   2. Her total lung capacity is likely greater than predicted
   3. Her lung compliance is likely greater than normal
   4. Her lung elastic recoil is likely less than normal
   5. Her residual volume is likely greater than normal
2. Which of the following statements about her pulmonary function tests is correct?
   1. Her FEV₁/FVC is likely less than 80%
   2. Her diffusing capacity is likely less than predicted
   3. Her forced vital capacity is likely greater than predicted
   4. Her alveolar-arterial PO₂ gradient is likely less than 5 mmHg
   5. Her inspiratory flow-volume curve is normal, but her expiratory flow-volume curve is concave in the effort-independent segment

For the next 2 questions: A 40-year-old patient is diagnosed with sarcoidosis, a multisystem granulomatous disease that ultimately affects the lungs by causing alveolar interstitial fibrosis.

1. Which of the following statements about her respiratory mechanics and standard lung volumes and capacities is correct?
   1. Her functional residual capacity is likely less than predicted
   2. Her total lung capacity is likely greater than predicted
   3. Her lung compliance is likely greater than normal
   4. Her lung elastic recoil is likely less than normal
   5. Her residual volume is likely greater than normal
2. Which of the following statements about her pulmonary function tests is correct?
   1. Her FEV₁/FVC is likely less than 80%
   2. Her diffusing capacity is likely less than predicted
   3. Her forced vital capacity is likely greater than predicted
   4. Her alveolar-arterial PO₂ gradient is likely less than 5 mmHg
   5. Her inspiratory flow-volume curve is normal, but her expiratory flow-volume curve is concave in the effort-independent segment

For the next 2 questions: A 42-year-old woman complains of shortness of breath. She is 5 feet 4 inches tall and weighs 110 pounds. She does not complain of a chronic cough and says she has never smoked. Her pulmonary function tests gave the following results

1. The patient has
   1. Restrictive disease
   2. Obstructive disease
   3. Both obstructive and restrictive disease
   4. Neither obstructive nor restrictive disease
2. The disease is most likely
   1. Emphysema
   2. Alveolar fibrosis such as sarcoidosis
   3. Myasthenia gravis
   4. Asthma
   5. Chronic bronchitis

For the next 2 questions: A 42-year-old woman complains of shortness of breath. She is 5 feet 4 inches tall and weighs 110 pounds. She does not complain of a chronic cough and says she has never smoked. Her pulmonary function tests gave the following results

1. The patient has
   1. Restrictive disease
   2. Obstructive disease
   3. Both obstructive and restrictive disease
   4. Neither obstructive nor restrictive disease
2. The disease is most likely
   1. Emphysema
   2. Alveolar fibrosis such as sarcoidosis
   3. Myasthenia gravis
   4. Asthma
   5. Chronic bronchitis

For the next 3 questions: A 200 pound man (whose anatomic dead space is therefore estimated to be 200 ml) has a tidal volume of 600 ml and a breathing frequency of 20 breaths per minute. His arterial PCO₂ is 40 mmHg, his expired PCO₂ is 20 mmHg, and his end-tidal PCO₂ (“alveolar PCO₂”) is 30 mmHg.

1. What is his alveolar dead space?
   1. 4000 ml/min
   2. 8000 ml/min
   3. 12000 ml/min
   4. 100 ml
   5. 300 ml
2. What is his minute volume?
   1. 4000 mls/min
   2. 8000 mls/min
   3. 12000 mls/min
   4. 100 ml
   5. 300 ml
3. What is his alveolar ventilation?
   1. 4000 ml/min
   2. 8000 ml/min
   3. 12000 ml/min
   4. 100 ml
   5. 300 ml

For the next 3 questions: A 200 pound man (whose anatomic dead space is therefore estimated to be 200 ml) has a tidal volume of 600 ml and a breathing frequency of 20 breaths per minute. His arterial PCO₂ is 40 mmHg, his expired PCO₂ is 20 mmHg, and his end-tidal PCO₂ (“alveolar PCO₂”) is 30 mmHg.

1. What is his alveolar dead space?
   1. 4000 ml/min
   2. 8000 ml/min
   3. 12000 ml/min
   4. 100 ml
   5. 300 ml
2. What is his minute volume?
   1. 4000 mls/min
   2. 8000 mls/min
   3. 12000 mls/min
   4. 100 ml
   5. 300 ml
3. What is his alveolar ventilation?
   1. 4000 ml/min
   2. 8000 ml/min
   3. 12000 ml/min
   4. 100 ml
   5. 300 ml

1. Most of the carbon dioxide transported in venous blood is
   1. Physically dissolved in the plasma
   2. Carbamino compounds formed with plasma proteins
   3. Carbamino compounds formed with hemoglobin
   4. Bicarbonate ions
   5. Little bubbles

1. Most of the carbon dioxide transported in venous blood is
   1. Physically dissolved in the plasma
   2. Carbamino compounds formed with plasma proteins
   3. Carbamino compounds formed with hemoglobin
   4. Bicarbonate ions
   5. Little bubbles

1. Which of the following gases have “diffusion-limited” transfer across the alveolar-capillary barrier in normal people at resting cardiac output?
   1. Nitrous oxide
   2. Carbon monoxide
   3. Carbon dioxide
   4. Oxygen
   5. All of the above are correct

1. Which of the following gases have “diffusion-limited” transfer across the alveolar-capillary barrier in normal people at resting cardiac output?
   1. Nitrous oxide
   2. Carbon monoxide
   3. Carbon dioxide
   4. Oxygen
   5. All of the above are correct

1. Compared to alveoli in lower (more “gravity dependent”) regions of the lung, at the functional residual capacity, alveoli in upper regions of the lung
   1. Have smaller transmural pressures
   2. Are larger
   3. Are more compliant
   4. Are better ventilated
   5. All of the above are correct

1. Compared to alveoli in lower (more “gravity dependent”) regions of the lung, at the functional residual capacity, alveoli in upper regions of the lung
   1. Have smaller transmural pressures
   2. Are larger
   3. Are more compliant
   4. Are better ventilated
   5. All of the above are correct

1. The outward recoil of the chest wall
   1. At the functional capacity is greater when a person is standing up then when she is in the supine position
   2. Is greater at the functional residual capacity in an obese person in the supine position than it is at the functional residual capacity in a slender person in the supine position
   3. Is greater at the functional residual capacity than it is at the residual volume
   4. Is greatest at about 70% of the total lung capacity
   5. All of the above are correct

1. The outward recoil of the chest wall
   1. At the functional capacity is greater when a person is standing up then when she is in the supine position
   2. Is greater at the functional residual capacity in an obese person in the supine position than it is at the functional residual capacity in a slender person in the supine position
   3. Is greater at the functional residual capacity than it is at the residual volume
   4. Is greatest at about 70% of the total lung capacity
   5. All of the above are correct

1. At the functional residual capacity
   1. Alveolar pressure is equal to atmospheric pressure
   2. The inward recoil of the lungs is equal and opposite to the outward recoil of the chest wall
   3. The respiratory muscles are not contracting (although they do have tone)
   4. Air is not flowing from the atmosphere into the alveoli
   5. All of the above are correct

1. At the functional residual capacity
   1. Alveolar pressure is equal to atmospheric pressure
   2. The inward recoil of the lungs is equal and opposite to the outward recoil of the chest wall
   3. The respiratory muscles are not contracting (although they do have tone)
   4. Air is not flowing from the atmosphere into the alveoli
   5. All of the above are correct

1. Which of the following is likely to occur when a woman is placed on positive pressure ventilation with 10 cm H₂0 PEEP?
   1. Increased cardiac output
   2. Recruitment of pulmonary capillaries
   3. Increased pulmonary vascular resistance
   4. Distension of pulmonary capillaries
   5. Increased surface area for diffusion

1. Which of the following is likely to occur when a woman is placed on positive pressure ventilation with 10 cm H₂0 PEEP?
   1. Increased cardiac output
   2. Recruitment of pulmonary capillaries
   3. Increased pulmonary vascular resistance
   4. Distension of pulmonary capillaries
   5. Increased surface area for diffusion

1. Which of the following would be expected to increase the compliance of the lungs (that is, shift the pulmonary pressure-volume curve to the left?)
   1. Abnormally low production of pulmonary surfactant?
   2. Emphysema
   3. Sarcoidosis
   4. Pulmonary vascular congestion
   5. Atelectasis of 30% of the alveoli

1. Which of the following would be expected to increase the compliance of the lungs (that is, shift the pulmonary pressure-volume curve to the left?)
   1. Abnormally low production of pulmonary surfactant?
   2. Emphysema
   3. Sarcoidosis
   4. Pulmonary vascular congestion
   5. Atelectasis of 30% of the alveoli

1. A person with a restrictive disease like sarcoidosis would be likely to have
   1. An abnormally low FEV₁/FEC
   2. Increased respiratory work of breathing
   3. Larger than normal tidal volumes
   4. A greater than predicted total lung capacity
   5. A greater than predicted functional residual capacity

1. A person with a restrictive disease like sarcoidosis would be likely to have
   1. An abnormally low FEV₁/FEC
   2. Increased respiratory work of breathing
   3. Larger than normal tidal volumes
   4. A greater than predicted total lung capacity
   5. A greater than predicted functional residual capacity

1. Alveolar-capillary units with very low ventilation-perfusion ratios
   1. Would be expected to have low PO₂’s
   2. Would be expected to have PCO₂’s close to that of mixed venous blood
   3. Are similar to intrapulmonary shunts
   4. Contribute little to alveolar-capillary gas exchange
   5. All of the above are correct

1. Alveolar-capillary units with very low ventilation-perfusion ratios
   1. Would be expected to have low PO₂’s
   2. Would be expected to have PCO₂’s close to that of mixed venous blood
   3. Are similar to intrapulmonary shunts
   4. Contribute little to alveolar-capillary gas exchange
   5. All of the above are correct

1. A woman has 13 grams of hemoglobin per 100 ml blood. At an arterial PO₂ of 85 mmHg her hemoglobin is 95% saturated with oxygen. Ignoring her physically dissolved oxygen, what is her arterial oxygen content?
   1. 11.05 ml O₂/100 ml blood
   2. 12.35 ml O₂/100 ml blood
   3. 15.26 ml O₂/100 ml blood
   4. 16.55 ml O₂/100 ml blood
   5. 21.44 ml O₂/100 ml blood

1. A woman has 13 grams of hemoglobin per 100 ml blood. At an arterial PO₂ of 85 mmHg her hemoglobin is 95% saturated with oxygen. Ignoring her physically dissolved oxygen, what is her arterial oxygen content?
   1. 11.05 ml O₂/100 ml blood
   2. 12.35 ml O₂/100 ml blood
   3. 15.26 ml O₂/100 ml blood
   4. 16.55 ml O₂/100 ml blood
   5. 21.44 ml O₂/100 ml blood

1. A person with an obstructive disease like emphysema would likely have
   1. No difficulty increasing airflow by blowing harder during a forced expiration
   2. A greater than predicted FEV₁/FVC
   3. A greater than predicted closing capacity (closing volume)
   4. A functional residual capacity less than predicted
   5. A residual volume less than predicted

1. A person with an obstructive disease like emphysema would likely have
   1. No difficulty increasing airflow by blowing harder during a forced expiration
   2. A greater than predicted FEV₁/FVC
   3. A greater than predicted closing capacity (closing volume)
   4. A functional residual capacity less than predicted
   5. A residual volume less than predicted

1. Which of the following will decrease the work of breathing?
   1. Breathing through the nose instead of the mouth
   2. Breathing a gas mixture with a greater viscosity than that of air
   3. Increased sympathetic stimulation of the airways
   4. Increased parasympathetic stimulation of the airways
   5. All of the above are correct

1. Which of the following will decrease the work of breathing?
   1. Breathing through the nose instead of the mouth
   2. Breathing a gas mixture with a greater viscosity than that of air
   3. Increased sympathetic stimulation of the airways
   4. Increased parasympathetic stimulation of the airways
   5. All of the above are correct

1. Compared to the systemic circulation, the pulmonary circulation normally
   1. Offers less resistance to blood flow
   2. Has a greater proportion of the total resistance to blood flow in its arterioles
   3. Has a greater arterial pressure
   4. Has more muscular arterioles
   5. All of the above are correct

1. Compared to the systemic circulation, the pulmonary circulation normally
   1. Offers less resistance to blood flow
   2. Has a greater proportion of the total resistance to blood flow in its arterioles
   3. Has a greater arterial pressure
   4. Has more muscular arterioles
   5. All of the above are correct

A man’s tidal volume is 500 ml and his anatomic dead space is determined to be 100 ml. His breathing frequency is 10 breaths/minute.

1. If his arterial PCO2₂ is 42 mmHG and his mixed expired PCO₂ is 21 mmHG, what is his alveolar dead space?
   1. 0 ml
   2. 50 ml
   3. 150 ml
   4. 250 ml
   5. 400 ml
2. What is his alveolar ventilation?
   1. 1000 ml/min
   2. 2000 ml/min
   3. 4000 ml/min
   4. 6000 ml/min
   5. 12,000 ml/min
3. What is his minute ventilation?
   1. 1000 ml/min
   2. 2000 ml/min
   3. 4000 ml/min
   4. 5000 ml/min
   5. 12,000 ml/min

A man’s tidal volume is 500 ml and his anatomic dead space is determined to be 100 ml. His breathing frequency is 10 breaths/minute.

1. If his arterial PCO2₂ is 42 mmHG and his mixed expired PCO₂ is 21 mmHG, what is his alveolar dead space?
   1. 0 ml
   2. 50 ml
   3. 150 ml
   4. 250 ml
   5. 400 ml
2. What is his alveolar ventilation?
   1. 1000 ml/min
   2. 2000 ml/min
   3. 4000 ml/min
   4. 6000 ml/min
   5. 12,000 ml/min
3. What is his minute ventilation?
   1. 1000 ml/min
   2. 2000 ml/min
   3. 4000 ml/min
   4. 5000 ml/min
   5. 12,000 ml/min

1. Alveoli that are ventilated but not perfused
   1. Have infinite V/Q ratios
   2. Constitute alveolar dead space
   3. Have PO₂’s of approximately 150 torr
   4. Have PCO₂’s of approximately 0 torr

All of the above are correct

1. Alveoli that are ventilated but not perfused
   1. Have infinite V/Q ratios
   2. Constitute alveolar dead space
   3. Have PO₂’s of approximately 150 torr
   4. Have PCO₂’s of approximately 0 torr
   5. All of the above are correct

1. Intrapleural pressure
   1. Is greater than atmospheric pressure during a forced expiration to the residual volume
   2. Is greater than atmospheric pressure during a eupneic expiration
   3. Exceeds alveolar pressure during a forced expiration
   4. Is always greater than alveolar pressure
   5. All of the above are correct

1. Intrapleural pressure
   1. Is greater than atmospheric pressure during a forced expiration to the residual volume
   2. Is greater than atmospheric pressure during a eupneic expiration
   3. Exceeds alveolar pressure during a forced expiration
   4. Is always greater than alveolar pressure
   5. All of the above are correct

1. In a normal person, sitting upright and breathing from the functional residual capacity, alveoli in upper regions of the lung
   1. Are larger than those in lower regions
   2. Are less compliant than those in lower regions
   3. Have more elastic recoil than those in lower regions
   4. Are less well ventilated than those in lower regions
   5. All of the above

1. In a normal person, sitting upright and breathing from the functional residual capacity, alveoli in upper regions of the lung
   1. Are larger than those in lower regions
   2. Are less compliant than those in lower regions
   3. Have more elastic recoil than those in lower regions
   4. Are less well ventilated than those in lower regions
   5. All of the above

1. A patient is maintained with positive pressure mechanical ventilation, including 10 cm H₂0 positive end-expiratory pressure. According to blood has analysis her arterial PCO₂ is 40 torr. However, her end-tidal PCO₂ is only 35 torr. Assuming the information is correct
   1. Her physiologic dead space exceeds her anatomic dead space
   2. Her pulmonary vascular resistance is likely increased
   3. She has alveoli that has ventilated but not perfused
   4. She has alveolar dead space
   5. All of the above are correct

1. A patient is maintained with positive pressure mechanical ventilation, including 10 cm H₂0 positive end-expiratory pressure. According to blood has analysis her arterial PCO₂ is 40 torr. However, her end-tidal PCO₂ is only 35 torr. Assuming the information is correct
   1. Her physiologic dead space exceeds her anatomic dead space
   2. Her pulmonary vascular resistance is likely increased
   3. She has alveoli that has ventilated but not perfused
   4. She has alveolar dead space
   5. All of the above are correct

1. Which of the following would be expected to increase V_E?
   1. Intravenous administration of 0.2 mg/kg KCN
   2. Doubling the “anatomic” dead space
   3. Intravenous administration of lactic acid
   4. Breathing a gas mixture consisting of 95% O₂ and 5% CO₂
   5. All of the above are correct

1. Which of the following would be expected to increase V_E?
   1. Intravenous administration of 0.2 mg/kg KCN
   2. Doubling the “anatomic” dead space
   3. Intravenous administration of lactic acid
   4. Breathing a gas mixture consisting of 95% O₂ and 5% CO₂
   5. All of the above are correct

1. When oxygen combines chemically with the hemoglobin, it
   1. Allows more carbon dioxide to be carried in the blood in the form of bicarbonate
   2. Makes hemoglobin a stronger acid
   3. Increases the amount of carbon dioxide carried in the blood in the form of carbamino compounds
   4. Shifts the whole blood carbon dioxide dissociation upward and to the left
   5. All of the above are correct

1. When oxygen combines chemically with the hemoglobin, it
   1. Allows more carbon dioxide to be carried in the blood in the form of bicarbonate
   2. Makes hemoglobin a stronger acid
   3. Increases the amount of carbon dioxide carried in the blood in the form of carbamino compounds
   4. Shifts the whole blood carbon dioxide dissociation upward and to the left
   5. All of the above are correct

1. Which of the following would likely increase the pulmonary diffusing capacity in a patient?
   1. Interstitial pulmonary edema
   2. Alveolar edema
   3. Hemorrhagic blood loss
   4. Increasing the hematocrit from 25 to 40%
   5. All of the above are correct

1. Which of the following would likely increase the pulmonary diffusing capacity in a patient?
   1. Interstitial pulmonary edema
   2. Alveolar edema
   3. Hemorrhagic blood loss
   4. Increasing the hematocrit from 25 to 40%
   5. All of the above are correct

1. Laminar air flow
   1. Usually occurs in small airways
   2. Usually occurs only when the linear velocity of airflow is high
   3. Requires a greater driving pressure to generate the same airflow than during turbulent airflow
   4. Rarely occurs in normal adults
   5. All of the above are correct

1. Laminar air flow
   1. Usually occurs in small airways
   2. Usually occurs only when the linear velocity of airflow is high
   3. Requires a greater driving pressure to generate the same airflow than during turbulent airflow
   4. Rarely occurs in normal adults
   5. All of the above are correct

1. At the residual volume
   1. Alveolar elastic recoil is greater than it is at the total lung capacity
   2. Most of the alveolar air is in gravity-dependent regions (lower regions) of the lung
   3. Airways resistance is less than it is at the total lung capacity
   4. Chest wall recoil is more outward than it is at the total lung capacity
   5. All of the above are correct

1. At the residual volume
   1. Alveolar elastic recoil is greater than it is at the total lung capacity
   2. Most of the alveolar air is in gravity-dependent regions (lower regions) of the lung
   3. Airways resistance is less than it is at the total lung capacity
   4. Chest wall recoil is more outward than it is at the total lung capacity
   5. All of the above are correct

1. A patient’s cardiac output is determined to be 6000 ml/min by the thermodilution technique. Her pulmonary end-capillary oxygen content is calculated to be 20 ml O₂/100 ml blood and her arterial and mixed venous oxygen contents are 19 ml O₂/100 ml blood and 17 ml O₂ per 100 ml respectively. How much blood flow per minute is entering the systemic arterial blood without undergoing gas exchange with alveoli? (Assume that the V/Q for all ventilated alveoli = 1.0)
   1. 333 ml/min
   2. 1000 ml/min
   3. 1600 ml/min
   4. 2000 ml/min
   5. 4000 ml/min

1. A patient’s cardiac output is determined to be 6000 ml/min by the thermodilution technique. Her pulmonary end-capillary oxygen content is calculated to be 20 ml O₂/100 ml blood and her arterial and mixed venous oxygen contents are 19 ml O₂/100 ml blood and 17 ml O₂ per 100 ml respectively. How much blood flow per minute is entering the systemic arterial blood without undergoing gas exchange with alveoli? (Assume that the V/Q for all ventilated alveoli = 1.0)
   1. 333 ml/min
   2. 1000 ml/min
   3. 1600 ml/min
   4. 2000 ml/min
   5. 4000 ml/min

1. Inspired particles trapped in the mucus sheets lining airways may be removed by
   1. Coughing
   2. Expectoration
   3. Sneezing
   4. Swallowing
   5. All of the above are correct

1. Inspired particles trapped in the mucus sheets lining airways may be removed by
   1. Coughing
   2. Expectoration
   3. Sneezing
   4. Swallowing
   5. All of the above are correct

1. Compared to the alveoli in upper regions of the lung, the alveoli in lower regions (more gravity dependent)
   1. Are better perfused
   2. Are better ventilated
   3. Have lower PO₂’s
   4. Have more gas exchange
   5. All of the above are correct

1. Compared to the alveoli in upper regions of the lung, the alveoli in lower regions (more gravity dependent)
   1. Are better perfused
   2. Are better ventilated
   3. Have lower PO₂’s
   4. Have more gas exchange
   5. All of the above are correct

For the next 4 questions, match each set of blood gases below with the condition most likely associated with it.

A.     Partly uncompensated respiratory acidosis

B.     Uncompensated respiratory alkalosis

C.     Uncompensated respiratory acidosis

D.    Partly uncompensated respiratory alkalosis

1. pH = 7.55; PCO₂ = 25; PO₂ = 124 torr          
2. pH = 7.34; PCO₂ = 65; PO₂ = 65 torr            
3. pH = 7.20; PCO₂ = 65; PO₂ = 65 torr            

pH = 7.48; PCO₂ = 65; PO₂ = 75 torr            

For the next 4 questions, match each set of blood gases below with the condition most likely associated with it.

A.     Partly uncompensated respiratory acidosis

B.     Uncompensated respiratory alkalosis

C.     Uncompensated respiratory acidosis

D.    Partly uncompensated respiratory alkalosis

1. pH = 7.55; PCO₂ = 25; PO₂ = 124 torr           B
2. pH = 7.34; PCO₂ = 65; PO₂ = 65 torr             A
3. pH = 7.20; PCO₂ = 65; PO₂ = 65 torr             C
4. pH = 7.48; PCO₂ = 65; PO₂ = 75 torr             D

For the next 5 questions, match the blood gas set with the condition most likely associated with it

A.     Chronic bronchitis

B.     Chronic hyperventilation syndrome

C.     Acute severe vomiting (10 minutes post-vomiting)

D.    Hyperventilation for 5 minutes

E.     Exercise severe enough to produce lactic acid

1. pH = 7.34; PCO₂ = 65; [HCO₃^-] = 33.6; PO₂ = 68                
2. pH = 7.46; PCO₂ = 25; [HCO₃^-] = 17.0; PO₂ = 119              
3. pH = 7.30; PCO₂ = 40; [HCO₃^-] = 19.0; PO₂ = 95                
4. pH = 7.46; PCO₂ = 46; [HCO₃^-] = 31.0; PO₂ = 90                

pH = 7.57; PCO₂ = 25; [HCO₃^-] = 22.0; PO₂ = 119  

For the next 5 questions, match the blood gas set with the condition most likely associated with it

A.     Chronic bronchitis

B.     Chronic hyperventilation syndrome

C.     Acute severe vomiting (10 minutes post-vomiting)

D.    Hyperventilation for 5 minutes

E.     Exercise severe enough to produce lactic acid

1. pH = 7.34; PCO₂ = 65; [HCO₃^-] = 33.6; PO₂ = 68                 A
2. pH = 7.46; PCO₂ = 25; [HCO₃^-] = 17.0; PO₂ = 119               B
3. pH = 7.30; PCO₂ = 40; [HCO₃^-] = 19.0; PO₂ = 95                 E
4. pH = 7.46; PCO₂ = 46; [HCO₃^-] = 31.0; PO₂ = 90                 C
5. pH = 7.57; PCO₂ = 25; [HCO₃^-] = 22.0; PO₂ = 119               D

1. An absolute intrapulmonary shunt that constitutes 35% of the right ventricular output would decrease the
   1. Arterial PO₂
   2. Arterial oxygen content
   3. Mixed venous PO₂
   4. Mixed venous oxygen content
   5. All of the above are correct

1. An absolute intrapulmonary shunt that constitutes 35% of the right ventricular output would decrease the
   1. Arterial PO₂
   2. Arterial oxygen content
   3. Mixed venous PO₂
   4. Mixed venous oxygen content
   5. All of the above are correct

1. Which of the following would be expected to stimulate breathing? (Assume normal function of the vagus nerves).
   1. PaO₂ = 35 torr
   2. PaCO₂ = 45 torr
   3. pH = 7.20
   4. Low pH in the cerebrospinal fluid
   5. All of the above are correct

1. Which of the following would be expected to stimulate breathing? (Assume normal function of the vagus nerves).
   1. PaO₂ = 35 torr
   2. PaCO₂ = 45 torr
   3. pH = 7.20
   4. Low pH in the cerebrospinal fluid
   5. All of the above are correct

1. In Zone 3 of the lung
   1. Alveolar pressure is less than pulmonary venous pressure
   2. The effective driving pressure for blood flow is pulmonary arterial pressure minus alveolar pressure
   3. Alveolar pressure exceeds pulmonary arterial pressure
   4. There is no blood flow
   5. Pulmonary venous pressure exceeds pulmonary arterial pressure

1. In Zone 3 of the lung
   1. Alveolar pressure is less than pulmonary venous pressure
   2. The effective driving pressure for blood flow is pulmonary arterial pressure minus alveolar pressure
   3. Alveolar pressure exceeds pulmonary arterial pressure
   4. There is no blood flow
   5. Pulmonary venous pressure exceeds pulmonary arterial pressure

1. During positive pressure mechanical ventilation with positive end-expiratory pressure (PEEP)
   1. Intrapleural pressure is negative during inspiration
   2. Alveolar pressure is positive throughout the respiratory cycle
   3. Airway pressure is negative during expiration
   4. Alveolar pressure is equal to atmospheric pressure at end inspiration
   5. All of the above are correct

1. During positive pressure mechanical ventilation with positive end-expiratory pressure (PEEP)
   1. Intrapleural pressure is negative during inspiration
   2. Alveolar pressure is positive throughout the respiratory cycle
   3. Airway pressure is negative during expiration
   4. Alveolar pressure is equal to atmospheric pressure at end inspiration
   5. All of the above are correct

1. During a forced expiration to the residual volume
   1. Airways closure normally first occurs in the lower (more gravity dependent) regions of the lung
   2. Dynamic compression of airways occurs
   3. The driving pressure for airflow is effectively equal to alveolar pressure minus intrapleural pressure
   4. Airflow becomes effort-independent
   5. All of the above are correct.

1. During a forced expiration to the residual volume
   1. Airways closure normally first occurs in the lower (more gravity dependent) regions of the lung
   2. Dynamic compression of airways occurs
   3. The driving pressure for airflow is effectively equal to alveolar pressure minus intrapleural pressure
   4. Airflow becomes effort-independent
   5. All of the above are correct

1. At the end of a normal tidal expiration the
   1. Transmural pressure gradient across the alveolar wall is equal and opposite to the intrapleural pressure
   2. Intrapleural pressure is positive
   3. Lungs are less compliant than they are after a maximal inspiratory effort
   4. Chest wall recoil is inward

1. At the end of a normal tidal expiration the
   1. Transmural pressure gradient across the alveolar wall is equal and opposite to the intrapleural pressure
   2. Intrapleural pressure is positive
   3. Lungs are less compliant than they are after a maximal inspiratory effort
   4. Chest wall recoil is inward

1. Which of the following would be expected to shift the CO₂ response curve to the left (this is, increase the respiratory response to increasing artificial PCO₂)?
   1. Chronic bronchitis
   2. Metabolic acidosis
   3. Morphine overdose
   4. Barbiturate overdose
   5. Slow-wave sleep

1. Which of the following would be expected to shift the CO₂ response curve to the left (this is, increase the respiratory response to increasing artificial PCO₂)?
   1. Chronic bronchitis
   2. Metabolic acidosis
   3. Morphine overdose
   4. Barbiturate overdose
   5. Slow-wave sleep

1. The dorsal respiratory groups
   1. Receive information from the arterial chemoreceptors and baroreceptors and from stretch receptors in the lungs
   2. Appear to be located in the nucleus of the tractus solitarius
   3. Are mainly composed of inspiratory neurons
   4. Are primarily responsible for the activity of the diaphragm
   5. All of the above are correct

1. The dorsal respiratory groups
   1. Receive information from the arterial chemoreceptors and baroreceptors and from stretch receptors in the lungs
   2. Appear to be located in the nucleus of the tractus solitarius
   3. Are mainly composed of inspiratory neurons
   4. Are primarily responsible for the activity of the diaphragm
   5. All of the above are correct

1. Which of the following will increase pulmonary vascular resistance?
   1. Breathing 10% O₂-90% N₂ for three minutes
   2. Inhaling from the FRC to the TLC
   3. Exhaling from the FRC to the RV
   4. Administration of positive pressure ventilation with 10 cm H₂0 positive end-expiratory pressure
   5. All of the above are correct

1. Which of the following will increase pulmonary vascular resistance?
   1. Breathing 10% O₂-90% N₂ for three minutes
   2. Inhaling from the FRC to the TLC
   3. Exhaling from the FRC to the RV
   4. Administration of positive pressure ventilation with 10 cm H₂0 positive end-expiratory pressure
   5. All of the above are correct

1. Which of the following would be expected to  cause increased static lung compliance (that is, shift the pulmonary pressure-volume curve upward and to the left)?
   1. A relative lack of functional pulmonary surfactant
   2. Diffuse interstitial alveolar fibrosis
   3. Pulmonary vascular congestion
   4. Emphysema
   5. Diffuse alveolar collapse

1. Which of the following would be expected to  cause increased static lung compliance (that is, shift the pulmonary pressure-volume curve upward and to the left)?
   1. A relative lack of functional pulmonary surfactant
   2. Diffuse interstitial alveolar fibrosis
   3. Pulmonary vascular congestion
   4. Emphysema
   5. Diffuse alveolar collapse

1. Emphysema is a disease that destroys alveolar septa and thus it decreases alveolar elastic recoil. Which of the following would be likely consequences of emphysema?
   1. Functional residual capacity and residual volume less than normal
   2. Diffusing capacity greater than normal
   3. FEV₁/FRC greater than normal
   4. Gas trapping behind closed airways during forced expirations
   5. All of the above are correct

1. Emphysema is a disease that destroys alveolar septa and thus it decreases alveolar elastic recoil. Which of the following would be likely consequences of emphysema?
   1. Functional residual capacity and residual volume less than normal
   2. Diffusing capacity greater than normal
   3. FEV₁/FRC greater than normal
   4. Gas trapping behind closed airways during forced expirations
   5. All of the above are correct

1. In changing from the supine to the standing position
   1. The functional residual capacity increases
   2. The outward recoil of the chest wall increases (at the functional residual capacity)
   3. The inward recoil of the lungs increases (at the functional residual capacity)
   4. The pulmonary blood volume decreases
   5. All of the above are correct

1. In changing from the supine to the standing position
   1. The functional residual capacity increases
   2. The outward recoil of the chest wall increases (at the functional residual capacity)
   3. The inward recoil of the lungs increases (at the functional residual capacity)
   4. The pulmonary blood volume decreases
   5. All of the above are correct

1. Which of the following would be expected to decrease the pulmonary diffusing capacity?
   1. Decreasing the cardiac output from 6 to 4  L/min
   2. Emphysema
   3. Severe diffuse interstitial fibrosis
   4. Decreased pulmonary capillary blood volume
   5. All of the above are correct

1. Which of the following would be expected to decrease the pulmonary diffusing capacity?
   1. Decreasing the cardiac output from 6 to 4  L/min
   2. Emphysema
   3. Severe diffuse interstitial fibrosis
   4. Decreased pulmonary capillary blood volume
   5. All of the above are correct

For the next 2 questions: a woman has 10 grams of hemoglobin per 100 ml of blood. At an arterial PO₂ of 70 mmHg (PCO₂ = 40 mmHG; pH = 7.40) her hemoglobin is 90% saturated with oxygen.

1. What is her arterial oxygen carrying capacity?
   1. 12.1 ml O₂/100 ml blood
   2. 13.4 ml O₂/100 ml blood
   3. 17.1 ml O₂/100 ml blood
   4. 19.6 ml O₂/100 ml blood
   5. 20.1 ml O₂/100 ml blood
2. How much oxygen is chemically combined with the hemoglobin in her arterial blood?
   1. 12.1 ml O₂/100 ml blood
   2. 13.4 ml O₂/100 ml blood
   3. 17.1 ml O₂/100 ml blood
   4. 19.6 ml O₂/100 ml blood
   5. 20.1 ml O₂/100 ml blood

For the next 2 questions: a woman has 10 grams of hemoglobin per 100 ml of blood. At an arterial PO₂ of 70 mmHg (PCO₂ = 40 mmHG; pH = 7.40) her hemoglobin is 90% saturated with oxygen.

1. What is her arterial oxygen carrying capacity?
   1. 12.1 ml O₂/100 ml blood
   2. 13.4 ml O₂/100 ml blood
   3. 17.1 ml O₂/100 ml blood
   4. 19.6 ml O₂/100 ml blood
   5. 20.1 ml O₂/100 ml blood
2. How much oxygen is chemically combined with the hemoglobin in her arterial blood?
   1. 12.1 ml O₂/100 ml blood
   2. 13.4 ml O₂/100 ml blood
   3. 17.1 ml O₂/100 ml blood
   4. 19.6 ml O₂/100 ml blood
   5. 20.1 ml O₂/100 ml blood

1. Which of the following shift the oxyhemoglobin dissociation curve to the left?
   1. Heating the blood from 37°C to 40°C
   2. Increasing the PCO₂ of the blood from 40 torr to 45 torr
   3. Increasing the concentration of 2,3-BPG in the blood
   4. Increasing the pH of the blood
   5. All of the above are correct

1. Which of the following shift the oxyhemoglobin dissociation curve to the left?
   1. Heating the blood from 37°C to 40°C
   2. Increasing the PCO₂ of the blood from 40 torr to 45 torr
   3. Increasing the concentration of 2,3-BPG in the blood
   4. Increasing the pH of the blood
   5. All of the above are correct

For the next 2 questions:

1. The patient has
   1. Restrictive disease
   2. Obstructive disease
   3. Mixed restrictive and obstructive disease
   4. Neither restrictive nor obstructive disease
2. The disease is most likely
   1. Emphysema
   2. Diffuse interstitial alveolar fibrosis
   3. Chronic bronchitis
   4. The patient is normal

For the next 2 questions:

1. The patient has
   1. Restrictive disease
   2. Obstructive disease
   3. Mixed restrictive and obstructive disease
   4. Neither restrictive nor obstructive disease
2. The disease is most likely
   1. Emphysema
   2. Diffuse interstitial alveolar fibrosis
   3. Chronic bronchitis
   4. The patient is normal

1. Which of the following shift the carbon dioxide response curve to the right (that is, cause decreased alveolar ventilation at the same arterial PO₂)?
   1. Slow-wave sleep
   2. Barbiturate overdose
   3. Morphine overdose
   4. Chronic obstructive pulmonary disease
   5. All of the above are correct

1. Which of the following shift the carbon dioxide response curve to the right (that is, cause decreased alveolar ventilation at the same arterial PO₂)?
   1. Slow-wave sleep
   2. Barbiturate overdose
   3. Morphine overdose
   4. Chronic obstructive pulmonary disease
   5. All of the above are correct

1. Which of the following would likely increase a person’s diffusing capacity?
   1. Emphysema
   2. Interstitial pulmonary edema
   3. Alveolar pulmonary edema
   4. Ventilation-perfusion mismatch
   5. Increased cardiac output

1. Which of the following would likely increase a person’s diffusing capacity?
   1. Emphysema
   2. Interstitial pulmonary edema
   3. Alveolar pulmonary edema
   4. Ventilation-perfusion mismatch
   5. Increased cardiac output

1. The rate of erythropoietin secretion
   1. Is directly proportional to the oxygen carrying capacity of the blood
   2. Is inversely proportional to the circulating red cell mass
   3. Regulates renal oxygen consumption
   4. Modulates thrombopoietin production by the liver
   5. All of the above are correct

1. The rate of erythropoietin secretion
   1. Is directly proportional to the oxygen carrying capacity of the blood
   2. Is inversely proportional to the circulating red cell mass
   3. Regulates renal oxygen consumption
   4. Modulates thrombopoietin production by the liver
   5. All of the above are correct

1. The dorsal respiratory groups in the medullary respiratory center
   1. Are primarily expiratory neurons
   2. Receive afferent information concerning arterial PO₂, PCO₂, pH and blood pressure, as well as lung and blood (can’t read)?
   3. Are located in the nucleus ambiguus
   4. Send efferent fibers to the abdominal muscles
   5. All of the above are correct

1. The dorsal respiratory groups in the medullary respiratory center
   1. Are primarily expiratory neurons
   2. Receive afferent information concerning arterial PO₂, PCO₂, pH and blood pressure, as well as lung and blood (can’t read)?
   3. Are located in the nucleus ambiguus
   4. Send efferent fibers to the abdominal muscles
   5. All of the above are correct

1. Increasing the “anatomic” dead space by breathing through a long tube would likely
   1. Increase alveolar PCO₂
   2. Increase arterial PCO₂
   3. Cause a respiratory acidosis
   4. Stimulate the chemoreceptors to increase alveolar ventilation, mainly by increasing tidal volume
   5. All of the above are correct

1. Increasing the “anatomic” dead space by breathing through a long tube would likely
   1. Increase alveolar PCO₂
   2. Increase arterial PCO₂
   3. Cause a respiratory acidosis
   4. Stimulate the chemoreceptors to increase alveolar ventilation, mainly by increasing tidal volume
   5. All of the above are correct

1. Physiologic reserve is manifested in most organ systems of the body. Reserve mechanisms in the respiratory system is/are:
   1. The relationship between PO₂ and hemoglobin saturation
   2. The relationship between cardiac output and pulmonary vascular resistance
   3. The concentration gradient for diffusion
   4. That essentially the entire cardiac output traverses the pulmonary capillaries
   5. All of the above are correct

1. Physiologic reserve is manifested in most organ systems of the body. Reserve mechanisms in the respiratory system is/are:
   1. The relationship between PO₂ and hemoglobin saturation
   2. The relationship between cardiac output and pulmonary vascular resistance
   3. The concentration gradient for diffusion
   4. That essentially the entire cardiac output traverses the pulmonary capillaries
   5. All of the above are correct

1. Which of the following may lead to pulmonary edema?
   1. Low pulmonary capillary hydrostatic pressure
   2. Increased capillary oncotic pressure
   3. Very negative intrapleural pressure caused by attempts to reinflate a collapsed lung
   4. Placing a patient on positive pressure ventilation with positive end-expiratory pressure
   5. All of the above are correct

1. Which of the following may lead to pulmonary edema?
   1. Low pulmonary capillary hydrostatic pressure
   2. Increased capillary oncotic pressure
   3. Very negative intrapleural pressure caused by attempts to reinflate a collapsed lung
   4. Placing a patient on positive pressure ventilation with positive end-expiratory pressure
   5. All of the above are correct

1. The arterial chemoreceptors
   1. Stop firing when the arterial PO₂ is less than 50 mmHg
   2. Are responsible for 80% of the steady-state response to carbon dioxide
   3. Respond to changes in arterial PO₂, PCO₂ and/or pH within a few seconds
   4. Do not respond to changes in arterial PCO₂ until the arterial PCO₂ is greater than 50 mmHg
   5. All of the above are correct

1. The arterial chemoreceptors
   1. Stop firing when the arterial PO₂ is less than 50 mmHg
   2. Are responsible for 80% of the steady-state response to carbon dioxide
   3. Respond to changes in arterial PO₂, PCO₂ and/or pH within a few seconds
   4. Do not respond to changes in arterial PCO₂ until the arterial PCO₂ is greater than 50 mmHg
   5. All of the above are correct

1. In zone 3 of the lung
   1. Pulmonary artery and pulmonary vein pressure are both greater than alveolar pressure
   2. Alveolar pressure is greater than pulmonary artery pressure
   3. The pressure gradient for blood flow is pulmonary artery pressure minus alveolar pressure
   4. Alveolar pressure is greater than pulmonary vein pressure
   5. There is no blood flow

1. In zone 3 of the lung
   1. Pulmonary artery and pulmonary vein pressure are both greater than alveolar pressure
   2. Alveolar pressure is greater than pulmonary artery pressure
   3. The pressure gradient for blood flow is pulmonary artery pressure minus alveolar pressure
   4. Alveolar pressure is greater than pulmonary vein pressure
   5. There is no blood flow

1. At his functional residual capacity, a man’s intrapleural pressure is –5 cm H₂O. His alveolar transmural pressure gradient is
   1. –5 cm H₂O and his alveolar elastic recoil pressure is 5 cm H₂O
   2. 5 cm H₂O and his alveolar elastic recoil pressure is -5 cm H₂O
   3. 0 cm H₂O and his alveolar elastic recoil pressure is 4 cm H₂O
   4. 5 cm H₂O and his alveolar elastic recoil pressure is 0 cm H₂O
   5. 5 cm H₂O and his alveolar elastic recoil pressure is 5 cm H₂O

1. At his functional residual capacity, a man’s intrapleural pressure is –5 cm H₂O. His alveolar transmural pressure gradient is
   1. –5 cm H₂O and his alveolar elastic recoil pressure is 5 cm H₂O
   2. 5 cm H₂O and his alveolar elastic recoil pressure is -5 cm H₂O
   3. 0 cm H₂O and his alveolar elastic recoil pressure is 4 cm H₂O
   4. 5 cm H₂O and his alveolar elastic recoil pressure is 0 cm H₂O
   5. 5 cm H₂O and his alveolar elastic recoil pressure is 5 cm H₂O

1. Which of the following cause hemoglobin to release more oxygen at the same PO₂ (that is, shift the oxyhemoglobin dissociation curve to the right and increase the P₅₀)?
   1. Decreased temperature
   2. Increased pH
   3. Increased PCO₂
   4. Decreased 2,3-BPG
   5. All of the above are correct

1. Which of the following cause hemoglobin to release more oxygen at the same PO₂ (that is, shift the oxyhemoglobin dissociation curve to the right and increase the P₅₀)?
   1. Decreased temperature
   2. Increased pH
   3. Increased PCO₂
   4. Decreased 2,3-BPG
   5. All of the above are correct

1. Compared to alveolar-capillary units in lower (“gravity-dependent”) parts of the lung, alveolar-capillary units in upper parts of the lung
   1. Have more ventilation
   2. Have more perfusion
   3. Have greater ventilation-perfusion ratios
   4. Have more gas exchange
   5. All of the above are correct

1. Compared to alveolar-capillary units in lower (“gravity-dependent”) parts of the lung, alveolar-capillary units in upper parts of the lung
   1. Have more ventilation
   2. Have more perfusion
   3. Have greater ventilation-perfusion ratios
   4. Have more gas exchange
   5. All of the above are correct

1. Material removed by the respiratory system from the inspired air can be eliminated by
   1. Sneezing
   2. Coughing
   3. Blowing one’s nose
   4. The mucociliary escalator carrying it to the nasopharynx and oropharynx for removal
   5. All of the above are correct

1. Material removed by the respiratory system from the inspired air can be eliminated by
   1. Sneezing
   2. Coughing
   3. Blowing one’s nose
   4. The mucociliary escalator carrying it to the nasopharynx and oropharynx for removal
   5. All of the above are correct

1. During a normal eupneic inspiration
   1. Alveolar pressure is greater than atmospheric pressure
   2. Intrapleural pressure is greater than alveolar pressure
   3. Alveolar elastic recoil pressure is increasing
   4. Alveolar compliance is increasing
   5. Intrapleural pressure is greater than atmospheric pressure

1. During a normal eupneic inspiration
   1. Alveolar pressure is greater than atmospheric pressure
   2. Intrapleural pressure is greater than alveolar pressure
   3. Alveolar elastic recoil pressure is increasing
   4. Alveolar compliance is increasing
   5. Intrapleural pressure is greater than atmospheric pressure

For the next 5 questions, match each of the following patient data sets with the condition most likely associated with it.

A.     Metabolic alkalosis caused by acute vomiting (10 minutes after vomiting)

B.     Metabolic acidosis caused by acute methanol ingestion

C.     Metabolic acidosis caused by diarrhea

D.    Accidental hypoventilation of a patient on a mechanical ventilator for 10 minutes

E.     Chronic obstructive pulmonary disease

1. pH = 7.25, PCO₂ = 30, PO₂ = 95, [HCO₃-] = 15, anion gap = 25     
2. pH = 7.25, PCO₂ = 30, PO₂ = 95, [HCO₃-] = 15, anion gap = 10     
3. pH = 7.47, PCO₂ = 46, PO₂ = 85, [HCO₃-] = 33, anion gap = 9       
4. pH = 7.34, PCO₂ = 65, PO₂ = 65, [HCO₃-] = 40, anion gap = 11     
5. pH = 7.25, PCO₂ = 50, PO₂ = 70, [HCO₃-] = 26, anion gap = 10     

For the next 5 questions, match each of the following patient data sets with the condition most likely associated with it.

A.     Metabolic alkalosis caused by acute vomiting (10 minutes after vomiting)

B.     Metabolic acidosis caused by acute methanol ingestion

C.     Metabolic acidosis caused by diarrhea

D.    Accidental hypoventilation of a patient on a mechanical ventilator for 10 minutes

E.     Chronic obstructive pulmonary disease

1. pH = 7.25, PCO₂ = 30, PO₂ = 95, [HCO₃-] = 15, anion gap = 25      B
2. pH = 7.25, PCO₂ = 30, PO₂ = 95, [HCO₃-] = 15, anion gap = 10      C
3. pH = 7.47, PCO₂ = 46, PO₂ = 85, [HCO₃-] = 33, anion gap = 9        A
4. pH = 7.34, PCO₂ = 65, PO₂ = 65, [HCO₃-] = 40, anion gap = 11      E
5. pH = 7.25, PCO₂ = 50, PO₂ = 70, [HCO₃-] = 26, anion gap = 10      D

1. During a forced expiration to the residual volume
   1. Airways resistance is decreasing
   2. Intrapleural pressure is greater than alveolar pressure
   3. Atmospheric pressure is greater than alveolar pressure
   4. Intrapleural pressure is greater than atmospheric pressure
   5. The outward recoil of the chest wall is decreasing

1. During a forced expiration to the residual volume
   1. Airways resistance is decreasing
   2. Intrapleural pressure is greater than alveolar pressure
   3. Atmospheric pressure is greater than alveolar pressure
   4. Intrapleural pressure is greater than atmospheric pressure
   5. The outward recoil of the chest wall is decreasing

For the next 3 questions: a 69-year-old patient is diagnosed with chronic obstructive pulmonary disease that is primarily emphysema, a disease that destroys alveoli.

1. Which of the following statements about his lungs and chest wall are correct?
   1. His chest radiograph likely shows hyperinflated lungs and a flattened diaphragm
   2. His diaphragm likely must develop more tension than a normal person’s to generate the same transdiaphragmatic pressure gradient
   3. His pulmonary vascular resistance is likely greater than normal
   4. His work of breathing is likely greater than normal
   5. All of the above
2. Which of the following statements about his respiratory mechanics and standard lung volumes is correct?
   1. His functional residual capacity is likely less than predicted
   2. His total lung capacity is likely less than predicted
   3. His lung compliance is likely greater than normal
   4. His lung elastic recoil is likely greater than normal
   5. His closing capacity is likely less than predicted
3. Which of the following statements about his pulmonary function tests is correct?
   1. His FEV₁/FVC is likely less than 80%
   2. His diffusing capacity is likely less than predicted
   3. His functional residual capacity as determined using a body plethysmograph is likely greater than his functional residual capacity determined by the helium dilution method
   4. His FEV₁ is likely less than predicted
   5. All of the above are correct

For the next 3 questions: a 69-year-old patient is diagnosed with chronic obstructive pulmonary disease that is primarily emphysema, a disease that destroys alveoli.

1. Which of the following statements about his lungs and chest wall are correct?
   1. His chest radiograph likely shows hyperinflated lungs and a flattened diaphragm
   2. His diaphragm likely must develop more tension than a normal person’s to generate the same transdiaphragmatic pressure gradient
   3. His pulmonary vascular resistance is likely greater than normal
   4. His work of breathing is likely greater than normal
   5. All of the above
2. Which of the following statements about his respiratory mechanics and standard lung volumes is correct?
   1. His functional residual capacity is likely less than predicted
   2. His total lung capacity is likely less than predicted
   3. His lung compliance is likely greater than normal
   4. His lung elastic recoil is likely greater than normal
   5. His closing capacity is likely less than predicted
3. Which of the following statements about his pulmonary function tests is correct?
   1. His FEV₁/FVC is likely less than 80%
   2. His diffusing capacity is likely less than predicted
   3. His functional residual capacity as determined using a body plethysmograph is likely greater than his functional residual capacity determined by the helium dilution method
   4. His FEV₁ is likely less than predicted
   5. All of the above are correct

For the next 4 questions: An unconscious patient’s ventilation is maintained with positive pressure ventilation with a tidal volume of 450 ml and a rate of 10 breaths per minute. She weighs 100 pounds. Her arterial PCO₂ is 42 mmHg, her end-tidal PCO₂ is 35 mmHg, and her mixed expired PCO₂ is 28 mmHg.

1. What is her minute volume?
   1. 350 ml/min
   2. 1000 ml/min
   3. 3500 ml/min
   4. 4500 ml/min
   5. 5500 ml/min
2. What is her alveolar dead space?
   1. 50 ml
   2. 100 ml
   3. 150 ml
   4. 200 ml
   5. 300 ml
3. What is her alveolar ventilation?
   1. 350 ml/min
   2. 1000 ml/min
   3. 3500 ml/min
   4. 4500 ml/min
   5. 5500 ml/min
4. What is her physiologic dead space?
   1. 50 ml
   2. 100 ml
   3. 150 ml
   4. 200 ml
   5. 300 ml

For the next 4 questions: An unconscious patient’s ventilation is maintained with positive pressure ventilation with a tidal volume of 450 ml and a rate of 10 breaths per minute. She weighs 100 pounds. Her arterial PCO₂ is 42 mmHg, her end-tidal PCO₂ is 35 mmHg, and her mixed expired PCO₂ is 28 mmHg.

1. What is her minute volume?
   1. 350 ml/min
   2. 1000 ml/min
   3. 3500 ml/min
   4. 4500 ml/min
   5. 5500 ml/min
2. What is her alveolar dead space?
   1. 50 ml
   2. 100 ml
   3. 150 ml
   4. 200 ml
   5. 300 ml
3. What is her alveolar ventilation?
   1. 350 ml/min
   2. 1000 ml/min
   3. 3500 ml/min
   4. 4500 ml/min
   5. 5500 ml/min
4. What is her physiologic dead space?
   1. 50 ml
   2. 100 ml
   3. 150 ml
   4. 200 ml
   5. 300 ml

1. A slightly inebriated fraternity brother accidentally aspirates a crawfish head into his right main stem bronchus, partly occluding it. While his fellow crawfish boil attendees debate who should attempt a Heimlich hug, compared to normal his
   1. Ventilation-perfusion ratio is increased
   2. Physiologic shunt is decreased
   3. Arterial PO₂ is decreased
   4. Alveolar-arterial PO₂ gradient is decreased
   5. All of the above are correct

1. A slightly inebriated fraternity brother accidentally aspirates a crawfish head into his right main stem bronchus, partly occluding it. While his fellow crawfish boil attendees debate who should attempt a Heimlich hug, compared to normal his
   1. Ventilation-perfusion ratio is increased
   2. Physiologic shunt is decreased
   3. Arterial PO₂ is decreased
   4. Alveolar-arterial PO₂ gradient is decreased
   5. All of the above are correct

1. Which of the following shifts the oxyhemoglobin dissociation curve to the right, that is, decreasing the affinity of hemoglobin for oxygen?
   1. Decreased blood temperature
   2. Decreased blood pH
   3. Decreased blood PCO₂
   4. Decreased blood 2,3-BPG
   5. All of the above are correct

1. Which of the following shifts the oxyhemoglobin dissociation curve to the right, that is, decreasing the affinity of hemoglobin for oxygen?
   1. Decreased blood temperature
   2. Decreased blood pH
   3. Decreased blood PCO₂
   4. Decreased blood 2,3-BPG
   5. All of the above are correct

1. The nearly immediate increase in breathing that occurs at the onset of exercise
   1. May be partly a learned response
   2. May partly result from collateral fibers from motor neurons to the muscles
   3. May partly arise from a coordinating center in the hypothalamus
   4. May partly result from stimulation of proprioreceptors or mechanoreceptors in the exercising limbs
   5. All of the above

1. The nearly immediate increase in breathing that occurs at the onset of exercise
   1. May be partly a learned response
   2. May partly result from collateral fibers from motor neurons to the muscles
   3. May partly arise from a coordinating center in the hypothalamus
   4. May partly result from stimulation of proprioreceptors or mechanoreceptors in the exercising limbs
   5. All of the above

1. Which of the following will likely stimulate increased alveolar ventilation?
   1. An abrupt increase in systemic arterial blood pressure
   2. A decrease in arterial PCO₂ from 40 to 20 mmHg
   3. An abrupt inflation of the lungs
   4. An abrupt deflation of the lungs
   5. Abruptly immersing a person’s face in cold water

1. Which of the following will likely stimulate increased alveolar ventilation?
   1. An abrupt increase in systemic arterial blood pressure
   2. A decrease in arterial PCO₂ from 40 to 20 mmHg
   3. An abrupt inflation of the lungs
   4. An abrupt deflation of the lungs
   5. Abruptly immersing a person’s face in cold water

1. During a forced expiration
   1. Intrapleural pressure is greater than atmospheric pressure
   2. Intrapleural pressure is greater than alveolar pressure
   3. Airways resistance is decreasing
   4. The outward recoil of the chest wall is decreasing
   5. All of the above are correct

1. During a forced expiration
   1. Intrapleural pressure is greater than atmospheric pressure
   2. Intrapleural pressure is greater than alveolar pressure
   3. Airways resistance is decreasing
   4. The outward recoil of the chest wall is decreasing
   5. All of the above are correct

1. Compared to the upper regions of an upright lung, the lower regions have
   1. Lower alveolar PCO₂s
   2. Greater alveolar PO₂s
   3. Greater ventilation-perfusion ratios
   4. More gas exchange
   5. All of the above are correct

1. Compared to the upper regions of an upright lung, the lower regions have
   1. Lower alveolar PCO₂s
   2. Greater alveolar PO₂s
   3. Greater ventilation-perfusion ratios
   4. More gas exchange
   5. All of the above are correct

1. Which of the following statements concerning diffusion through the alveolar-capillary barrier is correct?
   1. If the plasma partial pressure of a gas equals its alveolar partial pressure before the end of the capillary, its transfer is diffusion limited
   2. If the plasma partial pressure of a gas equals its alveolar partial pressure before the end of the capillary, its transfer is perfusion limited
   3. The transfer of oxygen from alveolus to pulmonary capillary at resting cardiac outputs is normally diffusion limited
   4. The transfer of carbon dioxide from alveolus to pulmonary capillary at resting cardiac outputs is normally diffusion limited
   5. All of the above are correct

1. Which of the following statements concerning diffusion through the alveolar-capillary barrier is correct?
   1. If the plasma partial pressure of a gas equals its alveolar partial pressure before the end of the capillary, its transfer is diffusion limited
   2. If the plasma partial pressure of a gas equals its alveolar partial pressure before the end of the capillary, its transfer is perfusion limited
   3. The transfer of oxygen from alveolus to pulmonary capillary at resting cardiac outputs is normally diffusion limited
   4. The transfer of carbon dioxide from alveolus to pulmonary capillary at resting cardiac outputs is normally diffusion limited
   5. All of the above are correct

1. In zone 2 of the lung
   1. Alveolar pressure > pulmonary arterial pressure > pulmonary venous pressure
   2. Pulmonary arterial pressure > alveolar pressure > pulmonary venous pressure
   3. Pulmonary arterial pressure > pulmonary venous pressure > alveolar pressure
   4. The effective pressure gradient for blood flow is pulmonary arterial pressure minus pulmonary venous pressure
   5. There is no blood flow

1. In zone 2 of the lung
   1. Alveolar pressure > pulmonary arterial pressure > pulmonary venous pressure
   2. Pulmonary arterial pressure > alveolar pressure > pulmonary venous pressure
   3. Pulmonary arterial pressure > pulmonary venous pressure > alveolar pressure
   4. The effective pressure gradient for blood flow is pulmonary arterial pressure minus pulmonary venous pressure

There is no blood flow

1. Artificially increasing the “anatomic” dead space by 100 ml by breathing through a wide-bore tube (assume negligible added resistance to air flow) for 5 minutes would likely
   1. Stimulate the arterial chemoreceptors
   2. Stimulate the central chemoreceptors
   3. Increase the tidal volume
   4. Increase the work of breathing
   5. All of the above are correct

1. Artificially increasing the “anatomic” dead space by 100 ml by breathing through a wide-bore tube (assume negligible added resistance to air flow) for 5 minutes would likely
   1. Stimulate the arterial chemoreceptors
   2. Stimulate the central chemoreceptors
   3. Increase the tidal volume
   4. Increase the work of breathing
   5. All of the above are correct

1. A 50-year-old man who had been immobilized in a hospital bed for a week because of a back injury suddenly has difficulty breathing. He complains of chest pain and his breathing is shallow and rapid. The diagnosis is acute pulmonary embolus. Which of the following are likely consequences of pulmonary embolus?
   1. His physiologic dead space is equal to his anatomic dead space
   2. His arterial end-tidal PCO₂ difference is zero
   3. He has significant areas of alveolar dead space, even in the supine position
   4. The alveolar-capillary units distal to the embolus have ventilation-perfusion ratios of zero
   5. All of the above are correct

1. A 50-year-old man who had been immobilized in a hospital bed for a week because of a back injury suddenly has difficulty breathing. He complains of chest pain and his breathing is shallow and rapid. The diagnosis is acute pulmonary embolus. Which of the following are likely consequences of pulmonary embolus?
   1. His physiologic dead space is equal to his anatomic dead space
   2. His arterial end-tidal PCO₂ difference is zero
   3. He has significant areas of alveolar dead space, even in the supine position
   4. The alveolar-capillary units distal to the embolus have ventilation-perfusion ratios of zero
   5. All of the above are correct

1. The compliance of the lungs is
   1. Greater at high lung volumes than it is at low lung volumes
   2. In parallel with the compliance of the chest wall
   3. Lower in a person with emphysema than it is at the same lung volume in a person with normal lungs
   4. Lower in a person with sarcoidosis than it is at the same lung volume in a person with normal lungs
   5. Greater in a prematurely born infant than in a normal adult

1. The compliance of the lungs is
   1. Greater at high lung volumes than it is at low lung volumes
   2. In parallel with the compliance of the chest wall
   3. Lower in a person with emphysema than it is at the same lung volume in a person with normal lungs
   4. Lower in a person with sarcoidosis than it is at the same lung volume in a person with normal lungs
   5. Greater in a prematurely born infant than in a normal adult

1. Which of the following statements about a person with diffusion limitation of oxygen transfer from alveoli to pulmonary capillary blood is correct?
   1. Increasing the cardiac output will not increase the diffusion of oxygen from alveoli to pulmonary capillaries
   2. Increasing the hematocrit will not increase the diffusion of oxygen from alveoli to pulmonary capillaries
   3. Pulmonary end-capillary PO₂ is equal to alveolar PO₂
   4. The person’s alveolar-arterial PO₂ difference will be abnormally high
   5. All of the above are correct

1. Which of the following statements about a person with diffusion limitation of oxygen transfer from alveoli to pulmonary capillary blood is correct?
   1. Increasing the cardiac output will not increase the diffusion of oxygen from alveoli to pulmonary capillaries
   2. Increasing the hematocrit will not increase the diffusion of oxygen from alveoli to pulmonary capillaries
   3. Pulmonary end-capillary PO₂ is equal to alveolar PO₂
   4. The person’s alveolar-arterial PO₂ difference will be abnormally high
   5. All of the above are correct

1. A non-lethal intravenous injection of cyanide stimulates the arterial chemoreceptors for about 20 seconds. Following the initial response to the cyanide many laboratory animals stop breathing for as long as a minute. This period of apnea results from
   1. Cyanide poisoning the arterial chemoreceptors
   2. Cyanide poisoning the diaphragm and intercostal muscles
   3. Chemoreceptor stimulation induced hyperventilation drives arterial PCO₂ to such low levels that there is little respiratory drive
   4. Cyanide depression of the central chemoreceptors

1. A non-lethal intravenous injection of cyanide stimulates the arterial chemoreceptors for about 20 seconds. Following the initial response to the cyanide many laboratory animals stop breathing for as long as a minute. This period of apnea results from
   1. Cyanide poisoning the arterial chemoreceptors
   2. Cyanide poisoning the diaphragm and intercostal muscles
   3. Chemoreceptor stimulation induced hyperventilation drives arterial PCO₂ to such low levels that there is little respiratory drive
   4. Cyanide depression of the central chemoreceptors

1. The ventral respiratory groups
   1. Send fibers to the pharynx, larynx and tongue via the vagus
   2. Contain cells in the pre-Böetzinger complex that probably act as pacemakers and establish the respiratory rhythm
   3. Contain both inspiratory and expiratory neurons
   4. Are located bilaterally in the retrofacial nucleus, nucleus ambiguus and nucleus retroambigualis
   5. All of the above are correct

1. The ventral respiratory groups
   1. Send fibers to the pharynx, larynx and tongue via the vagus
   2. Contain cells in the pre-Boetzinger complex that probably act as pacemakers and establish the respiratory rhythm
   3. Contain both inspiratory and expiratory neurons
   4. Are located bilaterally in the retrofacial nucleus, nucleus ambiguus and nucleus retroambigualis
   5. All of the above are correct

1. Artificially increasing the anatomic dead space by adding a long tube to an animal’s endotracheal tube for 5 minutes
   1. Initially causes an increase in alveolar PCO₂
   2. Stimulates the arterial chemoreceptors
   3. Stimulates the central chemoreceptors
   4. Increases alveolar ventilation, with an increase in tidal volume more effective than an increase in rate
   5. All of the above are correct

1. Artificially increasing the anatomic dead space by adding a long tube to an animal’s endotracheal tube for 5 minutes
   1. Initially causes an increase in alveolar PCO₂
   2. Stimulates the arterial chemoreceptors
   3. Stimulates the central chemoreceptors
   4. Increases alveolar ventilation, with an increase in tidal volume more effective than an increase in rate
   5. All of the above are correct

1. The “paradoxical” reflex of Head
   1. Sends afferent information via the vagus
   2. Is a deep inspiration in response to stretching the lungs
   3. May be important in generating the first breath of the neonate
   4. May help generate occasional “sighs”
   5. All of the above are correct

1. The “paradoxical” reflex of Head
   1. Sends afferent information via the vagus
   2. Is a deep inspiration in response to stretching the lungs
   3. May be important in generating the first breath of the neonate
   4. May help generate occasional “sighs”
   5. All of the above are correct

1. Intravenously administered lactic acid
   1. Depresses the ventilatory drive
   2. Stimulates the arterial chemoreceptors within seconds
   3. Stimulates the central chemoreceptors within seconds
   4. Crosses the blood-brain barrier immediately
   5. All of the above are correct

1. Intravenously administered lactic acid
   1. Depresses the ventilatory drive
   2. Stimulates the arterial chemoreceptors within seconds
   3. Stimulates the central chemoreceptors within seconds
   4. Crosses the blood-brain barrier immediately
   5. All of the above are correct

1. Which of the following would likely decrease diffusion of oxygen and carbon dioxide through the alveolar-capillary barrier?
   1. Increased cardiac output
   2. Increased pulmonary capillary blood volume
   3. Increased thickness of the alveolar-capillary barrier
   4. Improved matching of ventilation and perfusion
   5. Lower mixed venous PO₂, higher mixed venous PCO₂

1. Which of the following would likely decrease diffusion of oxygen and carbon dioxide through the alveolar-capillary barrier?
   1. Increased cardiac output
   2. Increased pulmonary capillary blood volume
   3. Increased thickness of the alveolar-capillary barrier
   4. Improved matching of ventilation and perfusion
   5. Lower mixed venous PO₂, higher mixed venous PCO₂

1. Which of the following increases the respiratory system’s response to carbon dioxide (that is, results in greater alveolar ventilation at the same arterial PCO₂)?
   1. Hypoxia
   2. Slow-wave sleep
   3. Barbiturates
   4. Morphine
   5. Chronic airway obstruction

1. Which of the following increases the respiratory system’s response to carbon dioxide (that is, results in greater alveolar ventilation at the same arterial PCO₂)?
   1. Hypoxia
   2. Slow-wave sleep
   3. Barbiturates
   4. Morphine
   5. Chronic airway obstruction

1. An effective drug to prevent exercise-induced asthma could work through which of the following mechanisms?
   1. Inhibition of troponin C-Ca⁺⁺ binding
   2. Phosphorylation of actin in thin filaments
   3. Inhibition of myosin light-chain phosphatase activity
   4. Inhibition of myosin light-chain kinase activity

1. An effective drug to prevent exercise-induced asthma could work through which of the following mechanisms?
   1. Inhibition of troponin C-Ca⁺⁺ binding
   2. Phosphorylation of actin in thin filaments
   3. Inhibition of myosin light-chain phosphatase activity
   4. Inhibition of myosin light-chain kinase activity

1. During very severe exercise
   1. Lactic acid is produced
   2. Plasma bicarbonate levels increase
   3. Arterial PCO₂ falls below normal
   4. The respiratory exchange ratio falls below 0.7
   5. All of the above are correct

1. During very severe exercise
   1. Lactic acid is produced
   2. Plasma bicarbonate levels increase
   3. Arterial PCO₂ falls below normal
   4. The respiratory exchange ratio falls below 0.7
   5. All of the above are correct

1. In zone 2 of the lungs
   1. Alveolar pressure is greater than pulmonary pressure
   2. The effective drive pressure for blood flow is pulmonary arterial pressure minus pulmonary venous pressure
   3. Alveolar pressure is greater than pulmonary venous pressure
   4. The driving pressure for blood flow remains constant as you move down the lung
   5. There is no blood flow

1. In zone 2 of the lungs
   1. Alveolar pressure is greater than pulmonary pressure
   2. The effective drive pressure for blood flow is pulmonary arterial pressure minus pulmonary venous pressure
   3. Alveolar pressure is greater than pulmonary venous pressure
   4. The driving pressure for blood flow remains constant as you move down the lung
   5. There is no blood flow

1. Particulate matter suspended in the inspired air
   1. May be filtered out by nasal hairs
   2. May impact mucus-covered airways and be removed by coughing, sneezing or the mucociliary escalator
   3. May settle on the alveolar surface and be phagocytized by alveolar macrophages
   4. May remain suspended in the inspired air and be exhaled
   5. All of the above are correct

1. Particulate matter suspended in the inspired air
   1. May be filtered out by nasal hairs
   2. May impact mucus-covered airways and be removed by coughing, sneezing or the mucociliary escalator
   3. May settle on the alveolar surface and be phagocytized by alveolar macrophages
   4. May remain suspended in the inspired air and be exhaled
   5. All of the above are correct

1. The best pulmonary function test indicator of pulmonary obstructive disease is
   1. A low FEV₁
   2. A low FVC
   3. A low FEV₁/FVC
   4. A low lung capacity
   5. An increased expiratory reserve volume

1. The best pulmonary function test indicator of pulmonary obstructive disease is
   1. A low FEV₁
   2. A low FVC
   3. A low FEV₁/FVC
   4. A low lung capacity
   5. An increased expiratory reserve volume

1. Which of the following would be likely to increase pulmonary vascular resistance?
   1. Increasing cardiac output from 3.5 L/min to 5.5 L/min
   2. Breathing 10% O₂-90% N₂ instead of air for 5 minutes
   3. Exhaling from the total lung capacity to the functional residual capacity
   4. Inhaling from the residual volume to the functional residual capacity
   5. All of the above are correct

1. Which of the following would be likely to increase pulmonary vascular resistance?
   1. Increasing cardiac output from 3.5 L/min to 5.5 L/min
   2. Breathing 10% O₂-90% N₂ instead of air for 5 minutes
   3. Exhaling from the total lung capacity to the functional residual capacity
   4. Inhaling from the residual volume to the functional residual capacity
   5. All of the above are correct