Deck 6: Pulmonary Blood Flow

Question 1

Which of the following are endogenous substances that produce pulmonary vasodilation?
I.Bradykinin
II.Histamine
III.Serotonin
IV.cAMP

A) I, III
B) II, IV
C) II, III, IV
D) I, II, III

Answer 1

I, II, III

Question 2

What is the normal value for systemic vascular resistance (SVR)?

A) 96 dynes·sec·cm^-5
B) 400 dynes·sec·cm^-5
C) 800 dynes·sec·cm^-5
D) 1456 dynes·sec·cm^-5

Answer 2

1456 dynes·sec·cm^-5

Question 3

During the insertion of a pulmonary artery catheter, it is observed that the waveform increases in height and that the pressure is about 25/0.Where is the catheter probably located?

A) RA
B) Superior vena cava
C) RV
D) Pulmonary artery

Answer 3

RV

Question 4

What is the normal value for the PCWP?

A) 2 mm Hg
B) 4 mm Hg
C) 25 mm Hg
D) 4 to 12 mm Hg

Question 5

What is the name of the pressure that is commonly used as a clinical indicator of left ventricular function?

A) Ejection pressure
B) Aortic pressure
C) Pulmonary pressure
D) Wedge pressure

Question 6

What is the normal value for PVR?

A) 96 dynes·sec·cm^-5
B) 400 dynes·sec·cm^-5
C) 800 dynes·sec·cm^-5
D) 1456 dynes·sec·cm^-5

Question 7

Which of the following statements are true of the pulmonary circulation?
I.It is a low-resistance system compared with the systemic circulation.
II.Its pressures are lower even though it receives the same cardiac output as the systemic circulation.
III.The resistance to blood flow in the pulmonary circulation is approximately one-fourth as great as it is in the systemic circulation.
IV.The resistance to blood flow in the pulmonary circulation is approximately one-tenth as great as it is in the systemic circulation.

A) I, II, IV
B) III, IV
C) I, II, III, IV
D) II, IV

Question 8

What would happen to PCWP in a patient with a stenotic mitral valve?

A) Increase
B) Decrease
C) Remain unchanged
D) Decrease only during cardiac systole

Question 9

In which of the following conditions is the PAP increased?
I.Hypervolemia
II.Left ventricular failure
III.High pulmonary vascular resistance
IV.Hypovolemia

A) I, II, III
B) III, IV
C) I, II, III, IV
D) II, IV

Question 10

Increased blood volume causes which of the following changes?

A) It lowers the PVR.
B) It increases the PVR.
C) It lowers cardiac output.
D) It increases PCWP.

Question 11

Which of the following is the most important chemical factor causing pulmonary vasoconstriction?

A) Alveolar hypoxia
B) Tissular hypoxia
C) Acidosis
D) Hypercapnia

Question 12

In which of the following groups of patients has NO? been especially beneficial in treating pulmonary hypertension?

A) Toddlers
B) Infants
C) Adults
D) Elderly

Question 13

In the presence of increased LAP due to inadequate left ventricular pumping action, what will be the effect on the PVR?

A) It will be unaffected.
B) It will be increased.
C) It will be decreased.
D) It will remain the same until cardiac output improves.

Question 14

What is the explanation for the dicrotic notch on the waveform of the PAC?

A) Closure of the pulmonic valve
B) Opening of the pulmonic valve
C) Atrial systole
D) Ventricular systole

Question 15

Which of the following statements are true of the bronchial vasculature?
I.Bronchial systemic venous blood drains directly into the pulmonary veins.
II.Oxygen-poor blood mixes with freshly oxygenated pulmonary venous blood on its way to the left ventricle.
III.Bronchial blood flow is only 1% to 2% of the cardiac output.
IV.The anatomical shunt from this source is usually approximately 10%.

A) I, II, III
B) III, IV
C) I, II, III, IV
D) II, IV

Question 16

Which channel of the PAC should be selected to draw blood from if a mixed venous sample is required?

A) Proximal
B) Venous
C) Distal
D) Arterial

Question 17

Which of the following techniques is useful in evaluating cardiac output?

A) Thermodilution
B) Transcutaneous blood gas monitoring
C) Plethysmography
D) Doppler

Question 18

Why should the balloon of the PAC be left inflated when inserted in the right atrium?
I.To decrease the risks of cardiac arrythmias
II.To allow blood flow to catch the balloon and carry the catheter forward
III.To decrease blood flow in the right atrium and facilitate introduction of the catheter
IV.To wedge the catheter

A) I, II
B) III, IV
C) I, II, III, IV
D) II, IV

Question 19

In drawing blood from the proximal channel of a pulmonary artery catheter the attempt is to measure which of the following pressures?

A) CVP
B) PAP
C) PCWP
D) BP

Question 20

What is the name of the pressure that is essentially equal to the left ventricular end-diastolic pressure?

A) Ejection pressure
B) Filling pressure
C) Pulmonary pressure
D) CVP

Question 21

Which of the following is an alternative to inhaled NO₂ for lowering PVR?

A) Prostaglandins
B) Sildenafil (Viagra)
C) Beta blockers
D) Captopril

Question 22

Which of the following are causes of pulmonary edema?
I.Increased hydrostatic pressure
II.Increased capillary permeability
III.Decreased plasma oncotic pressure
IV.Insufficient lymphatic drainage

A) I, II, IV
B) II, III
C) I, II, III, IV
D) II, IV

Question 23

In the presence of a normal PaO₂, how low does the pH need to get before a significant increase in PVR is present?

A) Below 7.40
B) Below 7.30
C) Below 7.25
D) Below 7.20

Question 24

Which of the following is a good example of edema associated with a high PCWP?

A) Cardiogenic pulmonary edema
B) ARDS
C) Noncardiogenic pulmonary edema
D) Hypovolemia

Question 25

Monitoring of a patient with a PAC reveals an elevated PAP due to left heart failure.Which of the following therapies will be specifically directed at decreasing the PAP?
I.Oxygen therapy
II.Diuretics
III.Vasodilators
IV.Inotropes

A) I, II, III
B) I, II, IV
C) II, III, IV
D) I, II, III, IV

Question 26

Which of the following conditions are associated with pulmonary edema due to increased hydrostatic pressure?
I.Left ventricular failure
II.Mitral valve insufficiency
III.Hypervolemia
IV.ARDS

A) I, II, IV
B) II, III
C) I, II, III
D) I, III

Question 27

Which of the following maneuvers can momentarily raise alveolar pressures, creating zone I conditions?
I.Coughing
II.Blowing a trumpet
III.Positive pressure mechanical ventilation
IV.Exercise

A) I, II, IV
B) II, III
C) I, II, III
D) II, IV

Question 28

Which of the following concepts apply to zone I under positive pressure ventilation?
I.It constitutes shunt.
II.In healthy individuals zone I does not exist.
III.It constitutes alveolar dead space ventilation.
IV.Arterial pressures exceed alveolar pressures.

A) I, II, IV
B) II, III
C) I, II, III, IV
D) II, IV

Question 29

Which of the following will inhibit HPV?
I.Alkalemia
II.Endogenous nitric oxide and prostacyclin
III.Alpha-adrenergic blockers
IV.Beta-adrenergic stimulants

A) I, II, IV
B) II, III, IV
C) I, II, III, IV
D) II, IV

Question 30

Which of the following conditions is associated with cardiac pulmonary edema?

A) Pneumonia
B) Sepsis
C) Oxygen toxicity
D) Mitral stenosis

Question 31

In which of the following conditions is the HPV response often diminished?
I.Smoke inhalation
II.ARDS
III.Emphysema
IV.Sepsis

A) I, III, IV
B) II, III, IV
C) I, II, IV
D) I, II, III, IV

Question 32

What is the PaO₂ at which the maximal vasoconstrictive response occurs when the pH is 7.40?

A) 40-50 mm Hg
B) 50-60 mm Hg
C) 60-70 mm Hg
D) 70-80 mm Hg

Question 33

In the presence of exercise, the increased cardiac output and PAPs will recruit which of the following zones?
I.I
II.II
III.III
IV.It will not recruit any zone.

A) I, II, IV
B) II, III
C) I, II, III
D) II, IV

Question 34

What is the name of the force tending to move fluid into the capillary?

A) Oncotic pressure
B) Hydrostatic pressure
C) Interstitial pressure
D) Filtration pressure