Cardiopulmonary Pathophysiology
Textbook Exam Questions
Course Introduction
Cardiopulmonary Pathophysiology explores the functional and structural abnormalities affecting the heart and lungs, with a focus on disease mechanisms, progression, and clinical manifestations. Students will examine key concepts such as gas exchange, hemodynamics, and regulatory control, as well as metabolic and compensatory responses to disease states. The course emphasizes the pathogenesis of common cardiopulmonary conditions, including heart failure, hypertension, chronic obstructive pulmonary disease (COPD), asthma, and pulmonary embolism, integrating foundational science with clinical case studies to foster a comprehensive understanding of diagnostics, treatment strategies, and patient management.
Recommended Textbook
Cardiopulmonary Anatomy Physiology Essentials of Respiratory Care 6th Edition by Terry Des Jardins
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Chapter 1: The Anatomy and Physiology of the Respiratory System
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Sample Questions
Q1) What type of epithelium extends from the trachea to the respiratory bronchioles?
A) pseudostratified ciliates columnar
B) cuboidal
C) pseudostratified squamous
D) stratified squamous
Answer: A
Q2) Which of the following is a subglottic airway obstruction usually caused by the parainfluenza virus?
A) laryngotracheobronchitis (LTB)
B) epiglottitis
C) tonsillitis
D) pharyngitis
Answer: A
Q3) What is one of the most common iatrogenic complications from a thoracentesis?
A) pneumothorax
B) hemorrhage
C) empyema
D) pleural effusion
Answer: A
Page 3
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Chapter 2: Ventilation
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Sample Questions
Q1) Which law best explains the basic operation of the negative pressure ventilator?
A) Boyle's
B) Dalton's
C) Charles'
D) Hooke's
Answer: A
Q2) Which gas law states that at constant temperature,a volume of gas varies inversely proportional to its pressure?
A) Boyle's
B) Charles
C) Gay-Lussac's
D) Henry's
Answer: A
Q3) In which breathing pattern is an individual only able to breathe comfortably in the upright position?
A) orthopnea
B) tachypnea
C) eupnea
D) hyperpnea
Answer: A
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Chapter 3: Pulmonary Function Measurements
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Sample Questions
Q1) What gas is used when the "single breath technique" is performed?
A) CO
B) room air
C) Nitrogen
D) 100% Oxygen
Answer: A
Q2) Which of the following can be used to predict readiness to wean from mechanical ventilation?
I.MIP
II.V<sub>D</sub>/V<sub>T</sub>
III.C<sub>L</sub>
IV.RSBI
A) I, II, III, IV
B) I and IV only
C) IV only
D) I, III, and IV only
Answer: A
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Chapter 4: The Diffusion of Pulmonary Gases
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Sample Questions
Q1) How do the rates of diffusion of CO and O compare?
A) CO diffuses 20 times faster than O
B) O diffuses 20 times faster than CO
C) CO diffuses 10 times faster than O
D) O diffuses 10 times faster than CO
Q2) How is oxygen diffusion affected when pulmonary edema is present?
A) Diffusion is indirectly related to thickness of the a-c membrane so diffusion will decrease
B) Diffusion is indirectly related to the thickness of the a-c membrane so diffusion will increase
C) Diffusion is directly related to thickness of the a-c membrane so diffusion will increase
D) Diffusion is directly related to the thickness of the a-c membrane so diffusion will decrease
Q3) Which law is represented by the equation below?
V gas = [AD (P1-P2)] / T
A) Fick's law
B) Dalton's law
C) Henry's law
D) Boyle's law
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Chapter 5: The Anatomy and Physiology of the Circulatory System
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Sample Questions
Q1) What are the smallest of the formed elements in the blood?
A) platelets or thrombocytes
B) basophils
C) eosinophils
D) lymphocytes
Q2) What is the term or acronym for the percentage of RBCs in the blood volume?
A) hematocrit
B) HBV ratio
C) hematocyte %
D) RBCV
Q3) What is the term for the stretching of vessels that were previously open but not to their full capacity?
A) distention
B) recruitment
C) overfill
D) engorgement
Q4) Which white blood cells normally composes 65% of the total WBC count?
A) Neutrophils
B) Basophils
C) Lymphocytes
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Chapter 6: Oxygen and Carbon DioxideTransport
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Sample Questions
Q1) How would a PO of 80 mm Hg affect the oxyhemoglobin dissociation curve and hemoglobin's ability to transport oxygen to peripheral tissues?
A) the curve would not be shifted and oxygen delivery would remain normal
B) the curve would left but oxygen delivery would remain normal
C) the curve would shift right and enhance oxygen delivery
D) the curve would shift left and reduce oxygen delivery
Q2) What is another term for absolute shunts?
A) true shunts
B) relative shunts
C) deadspace
D) shunt-like effects
Q3) In a normal lung,how large is the normal anatomic shunt?
A) 3% of cardiac output
B) 6% of cardiac output
C) 9% of cardiac output
D) less than 1% of cardiac output
Q4) What is the formula for calculating CCO ?
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)
Page 8
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Chapter 7: Acid Base Balance
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Sample Questions
Q1) What is the term for substance that dissociates completely in water to liberate all of the H+?
A) strong acid
B) weak acid
C) strong base
D) weak base
Q2) Which acid-base abnormality would be present if the ABG revealed a pH of 7.52,PaCO 42,and HCO - of 30 mEq/L?
A) metabolic alkalosis
B) metabolic acidosis
C) respiratory alkalosis
D) combined respiratory and metabolic alkalosis
Q3) Which of the following are examples of weak acids?
I.Acetic acid
II.Hydrochloric acid
III.Carbonic acid
A) I and III only
B) II only
C) I, II, and III
D) II and III only
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Chapter 8: Ventilation Perfusion Relationships
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Sample Questions
Q1) Which of the following conditions would result in an increased ETCO ?
I.Seizures
II.Hyperthermia
III.Hemorrhage
IV.Pulmonary emboli
A) I and II only
B) I, II, and III only
C) I and III only
D) II, III, and IV only
Q2) Which waveform on a capnogram is characteristic of bronchospasm that occurs during a severe asthmatic episode?
A) shark-fin
B) sine wave
C) sawtooth
D) square wave
Q3) What is the normal value for ETCO in a healthy young adult?
A) 5%
B) 8%
C) 15%
D) 18%
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Chapter 9: Control of Ventilation
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Sample Questions
Q1) What separates the blood from the CSF in the medulla?
A) a semipermeable membrane called the blood-brain barrier
B) a membrane that is permeable to H+ and bicarbonate ions
C) a thick gelatinous membrane that is impermeable to CO molecules
D) nothing-they are in direct contact
Q2) If a low-land resident ascends to a high mountain altitude,which of the following would be stimulated first?
A) peripheral chemoreceptors due to drop in PaO
B) peripheral chemoreceptors due to drop in PaCO
C) central chemoreceptors due to drop in PaO
D) central chemoreceptors due to increase in H+ in CSF
Q3) What is the term for an involuntary diaphragmatic spasm followed by sudden glottic closure?
A) hiccup
B) burp
C) cough
D) sneeze
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Chapter 10: Fetal Development and the Cardiopulmonary System
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Sample Questions
Q1) Which of the following factors contribute to stimulate the first breath?
I.Tactile stimulation
II.Stimulation of central chemoreceptors
III.Stimulation of peripheral chemoreceptors
IV.Thermal stimuli
A) I, II, III, IV
B) I, II, and III only
C) II and III only
D) I and IV only
Q2) What is the normal PO in the umbilical arteries?
A) 20 mm Hg
B) 40 mm Hg
C) 55 mm Hg
D) 80 mm Hg
Q3) What is the average value for airway resistance in a newborn?
A) 30 cm H20/L/sec
B) 3 cm H20/L/sec
C) 0.005 /L/ sec/cm H20
D) 0.50 L/sec/cm H20
12
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Chapter 11: Aging and the Cardiopulmonary System
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Sample Questions
Q1) How are stroke volume and stroke volume index affected by aging?
A) Both are diminished
B) Both are increased
C) The stroke volume decreases and the stroke index increases
D) The stroke index decreases and the stroke volume increases
Q2) How is the ventilatory response to hypercapnia affected in healthy men over age 65?
A) It is decreased >40%
B) It is decreased 30%
C) It is decreased 20%
D) It is decreased 10%
Q3) What effect does aging have on PaCO in the healthy adult?
A) PaCO remains constant throughout adult life
B) It decreases 2 mmHg per year after age 45
C) It increases 2 mmHg per year after age 45
D) It decreases until age 75 then levels off.
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Chapter 12: Electrophysiology of the Heart
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Q1) What effect will stimulation of sympathetic neural fibers have on heart rate and excitability?
A) both will be increased
B) both will be decreased
C) heart rate will increase and excitability will decrease
D) heart rate will increase and excitability will be unaffected
Q2) Which portion of the conductive system is considered to be the pacemaker of the heart?
A) sinoatrial node
B) sinoarterial node
C) atrioventricular node
D) arteriovalvular node
Q3) Approximately what percentage of the heart is composed of autorhythmic cells?
A) 1%
B) 12%
C) 18%
D) 24%
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Chapter 13: The Standard 12 ECG System
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Q1) Which portion of the ECG tracing represents ventricular repolarization?
A) T wave
B) U wave
C) QRS complex
D) ST interval
Q2) What is the term for two or more waveforms together on an ECG?
A) complex
B) interval
C) segment
D) deflection
Q3) On ECG paper operating at standard speed,what is the duration of the large squares?
A) 0.2 seconds
B) 2 seconds
C) 0.04 sec
D) 0.4 sec
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Chapter 14: ECG Interpretation
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Sample Questions
Q1) What is another term for "flat-line"?
A) asystole
B) complete AV block
C) ventricular flutter
D) ventricular fibrillation
Q2) How is the rate determined on an ECG when the ventricular heart rate is irregular?
A) Count the number of QRS complexes in a 2 vertical marks then multiply by 10
B) Count the number of QRS complexes in 3 vertical marks then multiply by 10
C) Count the number of QRS complexes in a 2 vertical marks then multiply by 6
D) Count the number of QRS complexes in a 3 vertical marks then multiply by 6
Q3) In the adult at rest,what is the term for a heart rate less than 60 beats/min?
A) bradycardia
B) tachycardia
C) normal heart rate
D) third degree heart block
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Chapter 15: Hemodynamic Measurements
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Sample Questions
Q1) What effect would myocardial infarction and pulmonary emboli have on SVI?
A) They would decrease SVI
B) They would increase SVI
C) MI would decrease SVI and pulmonary emboli would have no effect on SVI
D) Pulmonary emboli would decrease SVI and myocardial infarction would increase SVI
Q2) Which hemodynamic meausrement would be most increased when a pulmonary embolism is present?
A) mean pulmonary pressure
B) SVR
C) PCWP
D) LVSWI
Q3) What effects would late stage septic shock and CHF have on SV and CO?
A) The SV and CO would both decrease
B) The SV and CO would both increase
C) SV would decrease but CO would increase
D) SV would increase but CO would decrease
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Chapter 16: Renal Failure and Its Effects on the
Cardiopulmonary System
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Sample Questions
Q1) What percent of patients with chronic renal failure experience platelet abnormalities and bleeding disorders?
A) 20%
B) 40%
C) 10%
D) 5%
Q2) Which ions account for over 90% of the positively charged ions in extracellular fluid?
A) Na+
B) K+
C) Ca+
D) Mg+
Q3) Into which vessels do the efferent arterioles branch?
A) peritubular capillaries
B) interlobular arteries
C) arcurate arteries
D) interlobar arteries
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Chapter 17: Sleep Physiology and Its Relationship to the
Cardiopulmonary
System
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Sample Questions
Q1) What are the two major types of sleep?
A) NREM and REM
B) W and REM
C) W and NREM
D) Drowsy and REM
Q2) What is the average duration of short term insomnia?
A) 1-3 weeks
B) less than 1 week
C) 3-4 weeks
D) 1-3 months
Q3) Which is the average duration of Stage N1?
A) 10-12 minutes
B) 4-6 minutes
C) 14-16 minutes
D) 20-22 minutes
Q4) What does a sleep latency of less than 5 minutes indicate?
A) excessive sleepiness
B) emotional stress
C) illness or pain
D) medication overuse
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Chapter 18: Exercise and Its Effects on the Cardiopulmonary System
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Q1) What changes would be expected in the size of the heart chambers and heart mass of a marathon runner?
A) Both would increase
B) Both would decrease
C) No change would occur
D) The size of the heart chambers would remain normal but the heart mass would increase
Q2) Which of the following are benefits of moderate exercise?
I.Reduced stress,anxiety and depression
II.Reduced weight
III.Decreased bone density
IV.Improved sleep quality
A) I, III, and IV only
B) I, II, III, and IV
C) I and IV only
D) III and IV only
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Chapter 19: High Altitude and Its Effects on the
Cardiopulmonary System
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Q1) For what duration do adaptive changes occur in the blood after ascent to high altitudes?
A) 6 weeks
B) 1 week
C) 48-72 hours
D) 12-24 hours
Q2) What of the following primarily controls the phenomenon of hypoxic pulmonary vasoconstriction?
A) P<sub>A</sub>O<sub>2</sub>
B) P<sub>a</sub>O<sub>2</sub>
C) central chemoreceptors
D) baroreceptors
Q3) What is the most prevalent acid-base abnormality among natives at high altitudes?
A) mild respiratory alkalosis
B) mild respiratory acidosis
C) mild metabolic acidois
D) mild metabolic alkalosis
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Chapter 20: High Pressure Environments and Their Effects on
the Cardiopulmonary System
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Q1) What is the half life of CO b on FIO 0.21 at 1 atm?
A) 5 hours
B) 10 hours
C) 15 hours
D) 20 hours
Q2) Which of the following are clinical indications for hyperbaric oxygenation?
I.Acute traumatic ischemia
II.Thermal burns
III.Clostridial infections
IV.Carbon monoxide poisoning
A) I, II, III, and IV
B) IV only
C) I, II, and IV only
D) I, III, and IV only
Q3) What is the term for the drop in PaO that occurs when a breath hold diver ascends from a deep dive?
A) hypoxia of ascent
B) the bends
C) diving response
D) decompression sickness
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