Which of the following physiologic changes decreases pulmonary vascular resistance (PVR)?
AInhaling the inspiratory reserve volume (IRV)
BExhaling the entire vital capacity (VC)
CExhaling the expiratory reserve volume (ERV)
DBreath holding maneuver at functional residual capacity (FRC)
EInhaling the entire vital capacity (VC)
A 57-year-old man presents to the clinic for a chronic cough over the past 4 months. The patient reports a productive yellow/green cough that is worse at night. He denies any significant precipitating event prior to his symptoms. He denies fever, chest pain, palpitations, weight changes, or abdominal pain, but endorses some difficulty breathing that waxes and wanes. He denies alcohol usage but endorses a 35 pack-year smoking history. A physical examination demonstrates mild wheezes, bibasilar crackles, and mild clubbing of his fingertips. A pulmonary function test is subsequently ordered, and partial results are shown below: Tidal volume: 500 mL Residual volume: 1700 mL Expiratory reserve volume: 1500 mL Inspiratory reserve volume: 3000 mL What is the functional residual capacity of this patient?
A4500 mL
B2000 mL
C2200 mL
D3200 mL
E3500 mL
A 65-year-old woman presents to her physician with chronic breathlessness. Her condition has been progressively worsening over the last 20 years despite treatment with inhaled salbutamol, inhaled corticosteroids, and multiple courses of antibiotics. She has a 30-pack-year smoking history but quit 20 years ago. Her pulse is 104/min and respirations are 28/min. Physical examination shows generalized wasting. Chest auscultation reveals expiratory wheezes bilaterally and distant heart sounds. Pulmonary function testing shows a non-reversible obstructive pattern. Her carbon monoxide diffusion capacity of the lungs (DLCO) is markedly reduced. Which of the following explains the underlying mechanism of her condition?
ADecreased partial pressure of alveolar oxygen
BContraction of pulmonary smooth muscles
CInflammation of the pulmonary bronchi
DDiminished surface area for gas exchange
EAccumulation of fluid in the alveolar space
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