Physiology
10 questionsIsocapnic buffering is?
Vital capacity is measured by:
In patients with emphysematous bullae, total lung volume is best determined by?
Which of the following statements about lung compliance is false?
What is the normal value of respiratory compliance in ml/cm H2O?
In the relaxation pressure curve, at zero relaxation pressure in chronic smokers:
Which of the following parameters indicates the elimination of CO2 from the lungs?
In zero gravity, the V/Q ratio is?
What is the normal O2 extraction ratio of tissues?
Aortic valve closure occurs in which part of cardiac cycle?
NEET-PG 2015 - Physiology NEET-PG Practice Questions and MCQs
Question 561: Isocapnic buffering is?
- A. None of the options
- B. Increased pCO2 with increased CO2
- C. Increased pCO2 with decreased CO2
- D. Normal pCO2 with increased CO2 (Correct Answer)
Explanation: ***Normal pCO2 with increased CO2*** - Isocapnic buffering refers to the process where the body buffers an **increase in lactic acid** or other metabolic acids without a significant change (maintaining it within a normal range) in **arterial partial pressure of carbon dioxide (pCO2)**. - This is achieved by an increase in **ventilation** stimulated by the acid, which expels more CO2 to compensate for the additional CO2 produced from the buffering reaction, thereby keeping pCO2 stable. *Increased pCO2 with increased CO2* - This scenario would indicate **hypoventilation** or a failure of the respiratory compensation mechanism to maintain pCO2 within normal limits during an increased metabolic CO2 load. - **Increased pCO2** would signify a state of **respiratory acidosis** or inadequate respiratory compensation, not isocapnic buffering. *Increased pCO2 with decreased CO2* - This statement is inherently contradictory; it is not possible to have an **increased pCO2** simultaneously with **decreased CO2** in the context of buffering. - **pCO2** is a measure of the partial pressure of carbon dioxide, directly related to the amount of CO2 present and dissolved in the blood. *None of the options* - This option is incorrect because "Normal pCO2 with increased CO2" accurately describes the physiological phenomenon of **isocapnic buffering**.
Question 562: Vital capacity is measured by:
- A. Plethysmography
- B. Nitrogen washout technique
- C. Spirometer (Correct Answer)
- D. Gas-dilution method
Explanation: ***Spirometer*** - A **spirometer** is a device used to measure lung volumes and capacities, including **vital capacity**. - It measures the volume of air inspired and expired by evaluating mechanical changes in the volume of air in the lungs. *Plethysmography* - **Plethysmography** is primarily used to measure **residual volume** and **total lung capacity**, not vital capacity directly. - This method measures changes in body volume to infer changes in lung volume. *Gas-dilution method* - The **gas-dilution method**, typically using helium, is used to measure the **functional residual capacity (FRC)** and subsequently calculate residual volume and total lung capacity. - It involves rebreathing a known concentration of gas to determine the volume of gas already in the lungs. *Nitrogen washout technique* - The **nitrogen washout technique** is also used to measure **functional residual capacity (FRC)** and detect uneven ventilation. - It involves breathing 100% oxygen to wash out all nitrogen from the lungs, allowing for calculation of lung volumes.
Question 563: In patients with emphysematous bullae, total lung volume is best determined by?
- A. Spirometry
- B. Any of the above
- C. Helium dilution method
- D. Plethysmography (Correct Answer)
Explanation: ***Plethysmography*** - This method accurately measures **total lung capacity (TLC)**, functional residual capacity (FRC), and residual volume (RV) by determining the **volume of gas in the thorax**. - It is particularly useful in conditions like **emphysema** with air trapping and bullae, as it accounts for **non-communicating air spaces** that other methods miss. *Spirometry* - Spirometry measures volumes of air that can be **exhaled or inhaled forcibly**, such as FVC and FEV1. - It cannot measure residual volume (RV) or total lung capacity (TLC) directly, especially in cases of **air trapping** where trapped air cannot be exhaled. *Helium dilution method* - The helium dilution method measures **communicating lung volumes**, like functional residual capacity (FRC), by assessing the dilution of a known concentration of helium after rebreathing. - In conditions with **emphysematous bullae** and air trapping, it **underestimates total lung volume** because it cannot measure air in non-communicating or poorly communicating spaces. *Any of the above* - Only plethysmography can accurately measure total lung volume in the presence of **emphysematous bullae** due to its ability to measure both communicating and non-communicating air spaces. - Spirometry and helium dilution methods would provide **inaccurate or incomplete measurements** in this clinical scenario.
Question 564: Which of the following statements about lung compliance is false?
- A. Decreased in emphysema (Correct Answer)
- B. Total compliance is 0.2 L/cm H2O
- C. A measure of lung distensibility
- D. Change in volume per unit change in pressure
Explanation: ***Decreased in emphysema*** - This statement is **false** because **emphysema** is characterized by the destruction of elastic fibers in the lung parenchyma, which paradoxically leads to an **increase** in lung compliance. - The loss of elastic recoil makes the lungs more distensible and easier to inflate, but also impairs their ability to passively exhale. *Total compliance is 0.2 L/cm H2O* - This value represents the **normal total lung compliance** in a healthy adult (0.17 to 0.25 L/cm H2O), including both lung and chest wall compliance. - Lung compliance alone is typically around 0.2 L/cm H2O for healthy lungs. *A measure of lung distensibility* - **Compliance** is intrinsically defined as a measure of how easily the lungs or chest wall can be stretched or distended. - High compliance means the lungs are easy to inflate, while low compliance means they are stiff and difficult to inflate. *Change in volume per unit change in pressure* - This is the explicit **formula and definition of compliance** (C = ΔV/ΔP). - It quantifies the change in lung volume in response to a given change in transpulmonary pressure.
Question 565: What is the normal value of respiratory compliance in ml/cm H2O?
- A. 200 ml/cm H2O (Correct Answer)
- B. 100 ml/cm H2O
- C. 150 ml/cm H2O
- D. 50 ml/cm H2O
Explanation: ***200 ml/cm H2O*** - Normal respiratory system compliance is approximately **200 ml/cm H2O**, indicating a relatively compliant lung and chest wall system. - This value reflects the **change in lung volume per unit change in pressure**, with higher values indicating greater elasticity and ease of inflation (distensibility). *50 ml/cm H2O* - A compliance of **50 ml/cm H2O** is significantly lower than normal, suggesting a **stiff respiratory system**. - This could be indicative of conditions like **pulmonary fibrosis**, **acute respiratory distress syndrome (ARDS)**, or severe asthma, where the lungs are harder to inflate. *100 ml/cm H2O* - A compliance of **100 ml/cm H2O** is typically considered **reduced compliance**, although not as severely as 50 ml/cm H2O. - This value might be seen in moderate lung diseases or conditions causing **reduced chest wall expansion**. *150 ml/cm H2O* - While closer to the normal range, **150 ml/cm H2O** is generally still considered to be on the **lower side of normal or mildly reduced compliance**. - This could indicate early or mild conditions affecting **lung or chest wall mechanics**.
Question 566: In the relaxation pressure curve, at zero relaxation pressure in chronic smokers:
- A. Lung volume decreases significantly
- B. Lung volume remains elevated (Correct Answer)
- C. No significant change in lung volume
- D. Lung compliance decreases
Explanation: ***Lung volume remains elevated*** - In chronic smokers, conditions like **emphysema** lead to loss of elastic recoil and **air trapping**. - At zero relaxation pressure (the point where the respiratory system is at its resting equilibrium), the **functional residual capacity (FRC)** is higher due to less elastic recoil, which maintains the lungs at a more inflated state. - The balance between inward lung recoil and outward chest wall recoil shifts, resulting in a new equilibrium at a higher lung volume. *Lung volume decreases significantly* - This would imply increased elastic recoil or significant **airway obstruction** preventing air from entering, which is contrary to the typical pathophysiological changes in chronic smokers (e.g., emphysema). - In emphysema, the **loss of elastic recoil** actually prevents the lungs from deflating efficiently, leading to increased rather than decreased lung volume at rest. *No significant change in lung volume* - Chronic smoking often results in **structural changes** to the lungs, particularly **emphysema**, which significantly alters lung mechanics. - These changes directly impact the **resting lung volume (FRC)** as the balance between elastic recoil and chest wall compliance is disturbed, leading to a noticeable increase. *Lung compliance decreases* - This is incorrect; in emphysema, lung **compliance actually increases** due to destruction of alveolar walls and loss of elastic tissue. - Increased compliance means the lungs are more easily distensible but have reduced elastic recoil, contributing to air trapping and elevated FRC.
Question 567: Which of the following parameters indicates the elimination of CO2 from the lungs?
- A. pH
- B. PaCO2 (Correct Answer)
- C. PaO2
- D. HCO3 level
Explanation: ***PaCO2*** - **Partial pressure of carbon dioxide in arterial blood (PaCO2)** directly reflects the efficiency of **alveolar ventilation**, which is the process of eliminating CO2 from the lungs. - When CO2 elimination is adequate, PaCO2 remains within the normal range (35-45 mmHg); higher or lower values indicate ventilatory impairment or hyperventilation, respectively. *PaO2* - **PaO2** measures the partial pressure of **oxygen in arterial blood** and indicates oxygenation, not the efficiency of carbon dioxide elimination. - While CO2 elimination and oxygenation are interdependent, **PaO2** primarily reflects how well oxygen is being transported from the lungs to the blood. *pH* - **pH** indicates the **acidity or alkalinity of the blood**, which is influenced by both respiratory (CO2) and metabolic (bicarbonate) components. - Although CO2 elimination affects pH through the carbonic acid-bicarbonate buffer system, pH itself is an overall measure of acid-base balance, not a direct indicator of CO2 elimination. *HCO3 level* - **Bicarbonate (HCO3-)** is a **metabolic component** of the acid-base balance, primarily regulated by the kidneys. - While it helps buffer CO2-induced acid changes, HCO3 level alone does not directly reflect the efficiency of CO2 elimination from the lungs.
Question 568: In zero gravity, the V/Q ratio is?
- A. 0.8
- B. 1 (Correct Answer)
- C. 2
- D. 3
Explanation: ***Correct: 1*** - In **zero gravity**, the normal physiological effects of gravity on both ventilation and perfusion are eliminated, leading to a more uniform distribution. - Without gravity, blood flow and gas distribution become more even throughout the lungs, resulting in a V/Q ratio that approaches **unity (1)** across all lung regions. - This represents the ideal physiological state where ventilation perfectly matches perfusion. *Incorrect: 0.8* - A V/Q ratio of **0.8** represents the **average normal V/Q ratio** in an upright individual on Earth, where gravity creates disparities in ventilation and perfusion. - This value is an average, with regional variations (apex ~3.3, base ~0.6) in the lungs; it does not reflect the uniform conditions of zero gravity. *Incorrect: 2* - A V/Q ratio of **2** would indicate a significant **ventilation-perfusion mismatch** where ventilation greatly exceeds perfusion. - This scenario suggests substantial **dead space ventilation**, which is not the expected outcome in a zero-gravity environment where distribution is balanced. *Incorrect: 3* - A V/Q ratio of **3** represents an even more extreme case of **ventilation exceeding perfusion**, indicating severe physiologic dead space. - Such a high V/Q ratio would signify a major functional impairment, which is contrary to the more ideal and uniform distribution expected in zero gravity.
Question 569: What is the normal O2 extraction ratio of tissues?
- A. 5 percent
- B. 15 percent
- C. 25 percent (Correct Answer)
- D. 40 percent
Explanation: ***25 percent*** - The normal **O2 extraction ratio** (or **oxygen utilization coefficient**) is approximately 25%, meaning tissues extract about one-fourth of the oxygen delivered by arterial blood. - This ratio is crucial for understanding **tissue oxygenation** and can increase significantly during times of high metabolic demand, such as exercise. *5 percent* - An O2 extraction ratio of 5% is **too low** for normal physiological function, indicating that tissues are receiving much more oxygen than they are utilizing. - Such a low ratio would be seen only in situations of **excessive oxygen delivery** or **severely reduced metabolic demand**. *15 percent* - While 15% represents some oxygen extraction, it is **below the normal physiological range** for resting tissues. - An extraction ratio of 15% would mean the tissues are not extracting sufficient oxygen to meet their typical metabolic needs efficiently. *40 percent* - An O2 extraction ratio of 40% is **higher than the normal resting value** and suggests increased oxygen demand by the tissues. - This level of extraction is typically seen during **strenuous exercise** or in conditions of **reduced oxygen delivery** where tissues compensate by extracting more oxygen from available blood.
Question 570: Aortic valve closure occurs in which part of cardiac cycle?
- A. Beginning of isovolumetric contraction
- B. During rapid ventricular filling
- C. Beginning of ventricular ejection
- D. Beginning of isovolumetric relaxation (Correct Answer)
Explanation: ***Beginning of isovolumetric relaxation*** - Aortic valve closure marks the end of **ventricular systole** and the start of **isovolumetric relaxation**, as blood ceases to be ejected and the ventricle begins to relax while remaining closed. - This event corresponds to the **second heart sound (S2)** and signifies the beginning of a period where ventricular volume remains constant, but pressure drops. *Beginning of isovolumetric contraction* - This phase begins with the closure of the **mitral and tricuspid valves** (first heart sound, S1), as ventricular pressure rises but volume remains constant before ejection. - The aortic valve is still closed at this point, as ventricular pressure is not yet high enough to open it. *Beginning of ventricular ejection* - This phase begins when the **aortic valve opens** as ventricular pressure exceeds aortic pressure, allowing blood to be ejected from the left ventricle. - Aortic valve closure occurs *after* ejection, not at its beginning. *During rapid ventricular filling* - Rapid ventricular filling occurs when the **mitral valve opens** (following isovolumetric relaxation), allowing blood to flow from the atria into the ventricles. - During this phase, the aortic valve is closed, but its closure happened earlier, at the beginning of isovolumetric relaxation.