Deck 6: Oxygen and Carbon Dioxide Transport

Question 1

How much oxygen can dissolve in a plasma at body temperature?

A) 0.003 mL/dL/mmHg PO₂
B) 0.3 mL/dL/mmHg PO₂
C) 1.34 mL/dL/mmHg PO₂
D) 0.03 mL/dL/mmHg PO₂

Answer 1

A

Question 2

How many heme groups are in each Hb A molecule?

A) 280 million
B) 15
C) 4
D) 1.34

Answer 2

C

Question 3

What is the normal hemoglobin value for adult females?

A) 10-14 g%
B) 12-18 g%
C) 12-15 g%
D) 14-16g%

Answer 3

C

Question 4

If the hemoglobin level is 16 g%, what is the maximum quantity of oxygen that can be transported bound to the hemoglobin?

A) 21.44 vol %
B) 16 vol%
C) 20.93 vol %
D) 21.74 vol%

Question 5

Which type of hemoglobin contains 2 alpha and 2 gamma chains?

A) HbF
B) HbM
C) HbS
D) HbO

Question 6

How many alpha and beta chains are present in a HbA molecule?

A) 141 alpha and 146 beta chains
B) 2 alpha and 2 beta chains
C) 146 alpha and 141 beta chains
D) 1 alpha and 1 beta chain

Question 7

At body temperature and a PaO2 of 500 mmHg, how much oxygen can dissolve in the plasma?

A) 1.5 vol%
B) 0.015 vol%
C) 15 vol%
D) 0.15 vol%

Question 8

Which vessels contribute to normal physiologic shunts?
I. bronchial vein
II. thebesian veins
III. pulmonary capillaries that perfuse underventilated alveoli

A) III only
B) I and III only
C) I, II, III
D) I and II only

Question 9

What would the total oxygen content equal if the hemoglobin was 16g%, SaO2 was 90% and PaO2 was 63 mm Hg?

A) 21.6 vol%
B) 20.1 vol %
C) 19.8 vol%
D) 19.48 vol%

Question 10

What is the term for HbO2?

A) carboxyhemoglobin
B) oxyhemoglobin
C) reduced hemoglobin
D) carbaminohemoglobin

Question 11

A patient with a gunshot wound arrived via ambulance at the ER with Hb 4g%, SaO₂ 98% on F_IO₂ 1.0 and PaO₂ of 503 mm Hg. What would her oxygen content equal?

A) 20.1 vol %O₂
B) 12.6 vol% O₂
C) 9.8 vol% O₂
D) 6.76 vol% O₂

Question 12

Approximately how many hemoglobin molecules are contained in one RBC?

A) 280 million
B) 15
C) 1.34
D) 4

Question 13

What quantity of oxygen would be transported if Hb was 12g% and the SaO2 was 90%?

A) 14.47 vol% O2
B) 19.8 vol%
C) 16.98 vol%
D) 16.08 vol% O2

Question 14

What is the term for Hb?

A) methemoglobin
B) carboxyhemoglobin
C) oxyhemoglobin
D) deoxyhemoglobin

Question 15

What is the normal hemoglobin value for adult males?

A) 15-18 g%
B) 12-15 g%
C) 14-16 g%
D) 12-18 g%

Question 16

What does a hematocrit of 54% indicate for a 40-year-old male residing at sea level?

A) polycythemia
B) anemia
C) normal value
D) hemophilia

Question 17

What is the formula for calculating CcO2?

A) (Hb x 1.34) + (PAO2 x 0.003)
B) (Hb x 1.34) + (PvO2 x 0.003)
C) (Hb x 1.34) + (PAO2 x 0.03)
D) (Hb x 1.34) + (PAO2 x 0.03)

Question 18

In which type of hemoglobin is the iron in the ferric state?

A) HbF
B) methemoglobin
C) HbA
D) carboxyhemoglobin

Question 19

What is derived from the following formula? (Hb x 1.34 x SvO2) + (PvO2 x 0.003)

A) CvO2
B) CcO2
C) CaO2
D) DO2

Question 20

The quantity of oxygen that dissolves in the plasma is a function of what law?

A) Bryce's
B) Dalton's
C) Henry's
D) Torr's

Question 21

How would a PO2 of 80 mm Hg affect the oxyhemoglobin dissociation curve and hemoglobin's ability to transport oxygen to peripheral tissues?

A) the curve would left but oxygen delivery would remain normal
B) the curve would not be shifted and oxygen delivery would remain normal
C) the curve would shift left and reduce oxygen delivery
D) the curve would shift right and enhance oxygen delivery

Question 22

From 97% and 90% saturation on the oxyhemoglobin dissociation curve, what change occurs in the PO2?

A) It falls from 100mm Hg to 60 mm Hg.
B) It falls from 75mm hg to 60 mm Hg.
C) It rises from 27mm Hg to 40 mm Hg.
D) It rises from 60 mm Hg to 100 mm Hg.

Question 23

Which of the following increase the 2, 3 BPG levels?
I. hypoxia
II. anemia
III. blood stored for more than 1 week
IV. decreased pH

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

Question 24

What is derived when (content of oxygen in arterial blood x 10) is multiplied by cardiac output?

A) oxygen extraction ratio
B) oxygen consumption
C) shunt
D) total oxygen delivery

Question 25

A patient has a reported SaO2 of 90%, hemoglobin 15 g%, PaO2 of 61 mmHg, cardiac output of 6 L/min, and CvO2 of 14.2 vol%. What would the C(a-v) O2 equal?

A) 5 vol%
B) 4.07 vol%
C) 6.07 vol%
D) insufficient info provided to calculate

Question 26

Which portion of the oxyhemoglobin dissociation curve illustrates that hemoglobin has a safety zone for the loading of oxygen in the lungs?

A) flat portion between 90-100% saturation
B) steep portion between 0-25% saturation
C) steep portion between 50-90% saturation
D) flat portion between 50-75% saturation

Question 27

What is the normal P₅₀?

A) 27 mm Hg
B) 30 mm Hg
C) 50 mm Hg
D) 20 mm Hg

Question 28

From 97% and 90% saturation on the oxyhemoglobin dissociation curve, what change occurs in the PO2?

A) It falls from 75mm hg to 60 mm Hg.
B) It rises from 60 mm Hg to 100 mm Hg.
C) It rises from 27mm Hg to 40 mm Hg.
D) It falls from 100mm Hg to 60 mm Hg.

Question 29

Which variable appears on the left side (y axis) of the oxyhemoglobin dissociation curve nomogram?

A) barometric pressure
B) oxygen pressure
C) total oxygen content
D) percentage of hemoglobin chemically bound to oxygen

Question 30

Which of the following shift the oxyhemoglobin dissociation curve to the left?
I. Fetal Hb (HbF)
II. carboxyhemoglobin
III. increased H+ concentration

A) I, II, and III
B) I and III only
C) II and III only
D) I and II only

Question 31

During an acute asthma episode, a female patient arrived in ER and on room air was found to have a pH 7.25, PaCO2 71 mm Hg, PaO2 27 mmHg. What effect would these blood gases have on the oxyhemoglobin dissociation curve?

A) pH and PCO2 would shift the curve to the left
B) pH would cause left shift but PCO2 would cause right shift
C) pH and PCO2 would shift the curve to the right
D) PCO2 would cause left shift but pH would cause right shift

Question 32

What does a hematocrit of 51% indicate for a 50-year-old male residing at sea level?

A) carboxyhemoglobinemia
B) anemia
C) polycythemia
D) normal value

Question 33

What does a P₅₀ of 30 indicate?

A) a leftward shift of the curve meaning a decreased affinity of hemoglobin for O2
B) a rightward shift of the curve meaning a decreased affinity of hemoglobin for O2
C) a leftward shift of the curve meaning an increased affinity of hemoglobin for O2
D) a rightward shift of the curve meaning an increased affinity of hemoglobin for O2

Question 34

Using the 40-50-60/70-80-90 Rule, what PaO2 would be predicted if the SpO2 were 80%?

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

Question 35

What impact does the steep portion of the oxyhemoglobin dissociation curve have on oxygen delivery?

A) No oxygen can be released to tissues until PO2s are above 60 mm Hg
B) PO2s below 60 prevents the release of oxygen from hemoglobin to tissues
C) Oxygen binds irreversibly with hemoglobin until the P50 is reached
D) PO2s below 60 enhance the release of oxygen from hemoglobin to the tissues

Question 36

Oxygen delivery decreases when which of the following occur?
I. decline in cardiac output
II. decline in blood oxygenation
III. decline in carboxyhemoglobin
IV. decline in hemoglobin concentration

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

Question 37

Pulse oximeter measurements below what percent are considered inaccurate and unreliable?

A) 50
B) 65
C) 48
D) 70

Question 38

What is it called when CO bonds with hemoglobin?

A) carboxyhemoglobin
B) oxyhemoglobin
C) reduced hemoglobin
D) carbaminohemoglobin

Question 39

Which variable appears on the horizontal portion (x axis) of the oxyhemoglobin dissociation nomogram?

A) total oxygen content
B) barometric pressure
C) percentage of hemoglobin chemically bound to oxygen
D) oxygen partial pressure

Question 40

The effect of PaO2 and pH on the oxyhemoglobin curve is known as what?

A) Halston effect
B) Haldane effect
C) Bohr effect
D) Severinghaus effect

Question 41

What effect would cyanide poisoning and hypothermia have on VO2 and the O2ER?

A) Both would decrease
B) Both would increase
C) VO2 would increase and O2ER would decrease
D) VO2 would decrease and O2ER would increase

Question 42

What term is described as "pulmonary perfusion in excess of alveolar ventilation"?

A) wasted ventilation
B) anatomic shunt
C) relative shunt
D) dead space

Question 43

Which of the following shunts compose true shunts?

A) anatomic and relative
B) anatomic and dead space
C) capillary and relative
D) anatomic and capillary

Question 44

What value is derived when (CcO2-CaO2) is divided by (CcO2-CvO2)?

A) intrapulmonary shunt (Q_S/Q_T)
B) A-a gradient
C) O2ER
D) VO2

Question 45

What is the general definition of hypoxemia?

A) low oxygen tension at the tissue level
B) low oxygen tension in the hemoglobin
C) low oxygen tension in arterial blood
D) low oxygen tension in venous blood

Question 46

Which term refers to "low or inadequate oxygen for aerobic cellular metabolism"?

A) hypoxia
B) hypoxemia
C) lactic acid
D) anoxia

Question 47

In a healthy lung, how large is the normal anatomic shunt?

A) 6% of cardiac output
B) less than 1% of cardiac output
C) 3% of cardiac output
D) 9% of cardiac output

Question 48

What is the end result of venous admixture?

A) reduced PaO₂ and reduced CaO₂ returning to left side of the heart .
B) increased PaO₂ and increased CaO₂ returning to left side of the heart
C) Increased PaO₂ and increased CaO₂ returning to left side of the heart
D) reduced PaO₂ and reduced CaO₂ returning to left side of the heart.

Question 49

Which type of hypoxia is caused by hypoventilation, high altitudes, diffusion defects, and V/Q mismatch?

A) anemic
B) hypoxemic
C) circulatory
D) anemic

Question 50

Using the normal values for DO2 and VO2 for a healthy adult, how long would it take to deplete the oxygen stores in the body if an adult experienced a complete respiratory arrest?

A) about 10 minutes
B) about 2 minutes
C) about 8 minutes
D) about 4 minutes

Question 51

Which type of hypoxia is characterized by a normal PaO2 with either a low hemoglobin or a reduced oxygen carrying capacity of the hemoglobin?

A) circulatory
B) anemic
C) hypoxemic
D) histotoxic

Question 52

Which type of hypoxia results from an inability of tissue cells to utilize the oxygen delivered to them?

A) hypoxemic
B) histotoxic
C) anemic
D) circulatory

Question 53

What is another term for absolute shunts?

A) true shunts
B) shunt-like effects
C) relative shunts
D) dead space

Question 54

What is the general term for the situation when blood flows from the right side of the heart and returns to the left side without passing through the alveolar capillary system?

A) shunt-like effect
B) anatomic shunt
C) relative shunt
D) left-to-right shunt

Question 55

Which type of hypoxia is also called stagnant hypoxia?

A) histotoxic
B) circulatory
C) hypoxemic
D) anemic

Question 56

What is the minimum amount reduced hemoglobin that must be present for cyanosis to appear?

A) 5 g%
B) 1 %
C) 3 g%
D) 7 g%

Question 57

What effect would hyperthermia and shivering have on VO2 and the O2ER?

A) Both would increase
B) VO2 would decrease and O2ER would increase
C) Both would decrease
D) VO2 would increase and O2ER would decrease

Question 58

Which of the following pulmonary shunt values indicates normal lung status?

A) 45%
B) 23%
C) 10%
D) 17%

Question 59

Which type of hypoxia would be present in carbon monoxide poisoning?

A) hypoxemic
B) anemic
C) circulatory
D) histotoxic

Question 60

Which of the following would cause capillary shunts?
I. Atelectasis
II. Severe pulmonary edema
III. Pneumonia

A) I, II, and III
B) I only
C) II only
D) I and II only

Question 61

In the lungs, what substances does carbonic acid primarily dissociate into for removal?

A) CO2 and H20
B) lactic acid
C) carbamino Hb
D) HCO3- and H+

Question 62

What is the function of carbonic anhydrase in the RBC?

A) enhances the amount of CO2 that dissolves in the RBC
B) catalyzes the hydrolysis of dissolved CO2
C) prevents oxygen from binding with hemoglobin
D) binds to form carbamino compounds

Question 63

What substance is formed when CO2 is hydrolyzed?

A) lactic acid
B) carboxyhemoglobin
C) carbonic acid which dissociates into HCO3- and H+
D) carbamino compounds

Question 64

Which clinical anomaly is described as a bluish gray to purple discoloration resulting from increased levels of reduced hemoglobin?

A) cyanosis
B) mottling
C) jaundice
D) vitiligo

Question 65

Which of the following are ways carbon dioxide is transported in the RBC?
I. Dissolved
II. Bicarbonate
III. Carbamino-Hb

A) I only
B) I and II only
C) I, II, and III
D) II only

Question 66

How does the shape of the carbon dioxide dissociation curve compare to that of oxygen?

A) It is more linear than the oxygen dissociation curve.
B) They both are S shaped
C) They both are almost linear
D) It is shaped more like a sine wave

Question 67

What portion of the total CO2 transported by the body is carried as carbamino-Hb?

A) 11%
B) 21%
C) 41%
D) 1%

Question 68

Which of the following are ways carbon dioxide is transported in the plasma?
I. Dissolved
II. Bicarbonate
III. Carbamino-Hb

A) I, II, and III
B) I only
C) I and II only
D) II only

Question 69

Which hormone is used in blood boosting by athletes?

A) HCG
B) Glucagon
C) ACTH
D) EPO

Question 70

What volume of carbon dioxide is produced per minute by the average adult at rest?

A) 100 mL/min
B) 200 mL/min
C) 150 mL/min
D) 250 mL/min

Question 71

What is the normal ratio of HCO3- to H2CO3 in the plasma of arterial blood?

A) 20:1
B) 1:20
C) 10:1
D) 1:10

Question 72

How is the majority of CO2 transported from the tissues to the lungs?

A) bicarbonate
B) carbamino Hb
C) carbamino compounds
D) dissolved in the plasma

Question 73

What portion of the total amount of CO2 transported is carried as dissolved CO2 in the plasma?

A) 5%
B) 1%
C) 20%
D) 10%

Question 74

What is the name for the effect of the oxygenation levels of the blood on the uptake and release of CO2?

A) Halston effect
B) Haldane effect
C) Severinghaus effect
D) Bohr effect