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Advanced Pathophysiology Exam 4 Questions & Answers Latest Solution
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Work of breathing - resistance - - pressure that is required to overcome the resistance to gas flow through the airway during prespiration Clinical conditions that increase airway resistance - - COPD Mechanical obstruction Infection Asthma, bronchospasm Work of breathing - compliance - ...

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  • October 16, 2024
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  • 2024/2025
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Advanced Pathophysiology Exam 4 Questions &
Answers Latest Solution


Normal Blood Gas Values - ✔✔✔ - pH: 7.35 - 7.45

PaO2: 80 - 100 mmHg

PaCO2: 35 - 45 mmHg



Causes for CO2 increase - ✔✔✔ - -CO2 is being produced but not being exhaled quickly enough

-increase in CO2 by increased metabolism like fever or exercise

-PaCO2 in ABG is increased therefore pH decreases

-as CO2 accumulates, peripheral and central chemoreceptors signal brain to increase RR

-PaCO2 is influenced by alveolar minute ventilation and CO2 production

-ventilation is influenced by alveolar minute ventilation and Co2 production

-O2 sat decreases because increased CO2 pressure keeps O2 away




Hypoxemia normal P (A-a) O2

(15-20) - ✔✔✔ - -lungs are working fine but there is problem above airways

-altitude

-nitrogen gas poisoning

-fire smoke (O2 displacement)



Alveolar hypoventilation increased P (A-a) O2

(>20) - ✔✔✔ - not getting enough ventilation into the alveoli, reducing oxygen

-ex. OD antidepressants slowing RR

Fixed with O2 and increased ventilation

,Causes of hypoxemia with increased P - ✔✔✔ - V/Q mismatch

Shunt

Diffusion Defect



V/Q mismatch - ✔✔✔ - areas of our lungs that are receiving ventilation are not matched with
perfused areas.

When there is high CO2, pulmonary vessels selectively vasoconstirct so blood goes where best work
is done

Low ventilation but normal perfusion because of airway secretions

Somewhat hypoxemic but not as severe as shunt



Shunt - ✔✔✔ - extreme VQ mismatch

Severe pneumonia

ARDS

When alveoli is filled with something that should not be there (fluid, blood, or infection) or alveoli is
collapsed (atelectasis) Very hypoxemic



Diffusion defect - ✔✔✔ - conditions where there is a problem in O2 diffusing into the bloodstream:
like with interstitial lung disease, some sort of irritation, body tries to restore damage, and fibroblasts
lines up on the alveolar walls. Other examples are pulmonary edema, hydrostatic pressure is too
great, leaking into interstitial space



Work of breathing - resistance - ✔✔✔ - pressure that is required to overcome the resistance to gas
flow through the airway during prespiration



Clinical conditions that increase airway resistance - ✔✔✔ - COPD

Mechanical obstruction

Infection

Asthma, bronchospasm

,Work of breathing - compliance - ✔✔✔ - the ability of the lungs to expand is measured as the lung
compliance. The volume change per unit of pressure



When more muscular effort for work of breathing is required? - ✔✔✔ - lung compliance is decreased
(ex. pulmonary edema)

Chest wall compliance is decreased (spinal cord deformity or obesity)

Airways are obstructed by bronchospasm of mucous plugging (asthma, bronchitis)



What 5 problems with oxygenation result in hypoxemia? - ✔✔✔ - -O2 concentration of FiO2

-ventilation of the alveoli (hypoventilation)

-V/Q mismatch

-Diffusion Defect

-Shunt



Examples of O2 content of FiO2 as a problem with O2 delivery to the alveoli - ✔✔✔ - high altitudes
or oxygen displacement scenarios



Examples of hypoventilation as a problem with O2 delivery to the alveoli - ✔✔✔ - unconsciousness
neurologic, muscular or bone diseases that restrict chest expansion

COPD



Examples of VQ mismatch as a problem with diffusion of O2 from the alveoli into the blood - ✔✔✔ -
atelectasis

asthma

chronic bronchitis

pneumonia

ARDS

PE

, Examples of diffusion defects as a problem with diffusion of O2 from the alveoli into the blood - ✔✔✔
- edema

fibrosis

emphysema



Examples of shunt as problem with perfusion of pulmonary capillaries - ✔✔✔ - blood flow bypassing
lungs

intracardiac defects

Intrapulmonary arteriovenous malformations



DLCO - ✔✔✔ - diffusion capacity of the lung for carbon monoxide



How is DLCO measured and preformed? - ✔✔✔ - inhale CO for 10 seconds and exhale

measure how deep of breath and how much CO is left over

diffusing capacity is a measure of the gas diffusion rate at the alveolocapillary membrane



Variables that affect DLCO - ✔✔✔ - Hb

CoHb

altitude

PAO2

body position

pulmonary capillary blood volume

asthma

obesity



When is DLCO reduced - ✔✔✔ - pulmonary fibrosis

pulmonary vascular disease

restrictive lung diseases (loss of lung volume, fibrotic lung diseases)

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