RESPIRATORY FAILURE MCQ and Questions

1. Which of the following will NOT increase the minute

ventilation?
A. An increase in arterial pH.
B. An increase in arterial partial pressure of carbon dioxide.
C. Increase in alveolar pressure of carbon dioxide.
D. Exercise.
E. Hypoxia.

2. If the blood moved slower than normal through the alveolar
capillaries, which of the following would have an increased
uptake?
A. Carbon dioxide.
B. Carbon monoxide.
C. Oxygen
D. None of the above.


3. If you blocked the blood supply to an alveolus, which of the
following would NOT occur as a result?
A. The ventilation perfusion ratio would be 0.
B. The PAO2 would be greater than normal.
C. The PACO2 would be 0.
D. All of the above are true.






4. Which of the following is NOT a form by which CO2 can be
transported in the blood?
A. As bicarbonate
B. Dissolved in the blood.
C. Bound to the amino end groups in proteins.
D. Bound to the imidazole ring of glutamate.

1. A 35 year old man is brought to the Emergency Room
unresponsive by ambulance. He is cyanotic with a BP of 100/80
and pulse of 75. His arterial blood gases on room air are: PaO2
= 45 mmHg; PaCO2 = 75 mmHg; pHa = 7.12. The most likely
diagnosis for the blood gases are:
A. Metabolic acidosis
B. Hypoxic respiratory failure
C. Hypercapnic respiratory failure
D. Combined respiratory and metabolic acidosis
2. In the case in Question 1, the most appropriate therapeutic
intervention is:
A. Administration of bicarbonate IV
B. Consider mechanical ventilation
C. Administer bronchodilators
D. Administer steroids IV

4. In hypoxic ventilatory failure the arterial PCO2 is usually
A. Normal
B. Reduced
C. Increased







. Oxygen therapy is ineffective to the respiratory failure caused by
A. Ventilation disorder B. Diffusion impairment
C. Anatomic shunt D. Dead space like ventilation
E. Functional shunt

1. The pathogenesis of respiratory failure includes
A. Ventilation disorder
B. Increased anatomic shunt
C. Ventilation and perfusion imbalance
D. Diffusion impairment
E. Decreased anatomic shunt

2. The common causes of type respiratory failure include
A. Inhibition of respiratory center B. Paralysis of respiratory
muscles
C. Obstruction of central airway D. COPD
E. Impairment of diffusion

3. The mechanisms by which COPD results in pulmonary
hypertension include
A. Hypoxia causes pulmonary arteriolar constriction
B. CO
2
retention results in pulmonary arteriolar constriction
C. CO
2
retention results in pulmonary arteriolar dilatation
D. Original lung diseases result in pulmonary arteriole fibrosis and
stenosis
E. Increased red blood cells resulted from chronic hypoxia leads to
an increase of blood viscosity









. Questions to be answered briefly
1. Please briefly outline the pathogenesis of respiratory failure.
What are the manifestations of respiratory failure?
. Definition of respiratory failure (RF)
Respiratory failure is a severe disorder of function of external
respiration. It is generally defined as in rest: PaO
2
8kPa(60mmHg),
with/without PaCO
2
6.67 kPa (50mmHg). Respiratory failure is
generally diagnosed from arterial blood gas disturbances, when the
subject is breathing room air.
In which the presence of hypoxia: PaO
2
8kPa (60mmHg)
with or without hypercapnial: with or without PaCO
2
6.67 kPa
(50mmHg)
. Classification of respiratory failure
1. According to pathogenesis and the alteration of blood gas
Group I Low PaO
2

Hypoxaemic RF
which could be seen in diffusional RF with reduction of the alveolar-
capillary membrane and the surface area for gas exchange
Group II Low Pa O
2
and high PaCO2
hypoxaemia with hypercapnial
ventilatory RF with alveolar hypoventilation
2. According to the duration
Acute respiratory failure: In terms of hours or days, develops too rapid to
allow complete compensation
Chronic respiratory failure: Over month to years; allow compensation