[MCQ] Disorders of Ventilation- Part 1

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Disorders of Ventilation- Part 1

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Question 1

In health and at sea level, arterial level of carbon dioxide (PaCO2) is maintained between ?

A	35 & 41 mmHg
B	36 & 42 mmHg
C	37 & 43 mmHg
D	38 & 44 mmHg

Question 1 Explanation:

In health the arterial level of carbon dioxide (PaCO2) is maintained between 37 and 43 mmHg at sea level

Question 2

In the equation PaCO2 = (k)(V.CO2)/V. A, V. CO2 represents ?

A	Carbon dioxide excretion
B	Carbon dioxide production
C	Carbon dioxide excess
D	Carbon dioxide retention

Question 2 Explanation:

V.CO2 represents the carbon dioxide production, k is a constant and V. A is fresh gas alveolar ventilation

Question 3

V. A is calculated by which of the following formula ?

A	Minute ventilation x (1-Vd/Vt)
B	Minute ventilation / (1-Vd/Vt)
C	Minute ventilation + (1-Vd/Vt)
D	Minute ventilation - (1-Vd/Vt)

Question 3 Explanation:

V. A can be calculated as minute ventilation x(1-Vd/Vt) where Vd/Vt represents dead space fraction.

Question 4

Disturbances of PaCO2 reflect which of the following ?

A	Altered CO2 production
B	Minute ventilation
C	Minute ventilation
D	All of the above

Question 4 Explanation:

All disorders of ventilation result in abnormal measurements of Pa CO2. All disturbances of PaCO2 must reflect altered CO 2 production, minute ventilation, or dead space fraction

Question 5

Dorsal respiratory group (DRG) & ventral respiratory column (VRC) are located in ?

A	Pleura
B	Lung parenchyma
C	Bronchial airways
D	Bronchial airways

Question 5 Explanation:

The spontaneous cycle of inspiration & expiration is automatically generated in medulla through dorsal respiratory group (DRG) and ventral respiratory column (VRC)

Question 6

DRG acts as the initial integration site for which of the following ?

A	PaO2
B	PaCO2
C	pH
D	All of the above

Question 6 Explanation:

DRG acts as the initial integration site for afferent nerves bringing in information about partial pressure of arterial oxygen (PaO2), Pa CO2, pH, and blood pressure from carotid and aortic chemoreceptors and baroreceptors to the central nervous system (CNS)

Question 7

Which of the following nerves relay information from stretch receptors & juxtapulmonary-capillary receptors in lung parenchyma & chest wall to DRG ?

A	Vagus nerve
B	Phrenic nerve
C	Phrenic nerve
D	All of the above

Question 7 Explanation:

Vagus nerve relays information from stretch receptors and juxtapulmonary-capillary receptors in the lung parenchyma and chest wall to the DRG

Question 8

Pre-Bötzinger complex is a part of ?

A	DRG
B	VRC
C	Parafacial respiratory group (pFRG)
D	All of the above

Question 9

Which of the following is responsible for the generation of inspiratory activity ?

A	DRG
B	Parafacial respiratory group (pFRG)
C	Pre-Bötzinger complex
D	All of the above

Question 10

Which of the following is responsible for the generation of expiratory activity ?

A	DRG
B	Parafacial respiratory group (pFRG)
C	Pre-Bötzinger complex
D	All of the above

Question 10 Explanation:

The respiratory rhythm is generated within the VRC, as well as the more rostrally located parafacial respiratory group (pFRG), which is particularly important for the generation of active expiration. One particularly important area within the VRC is the so-called pre-Bötzinger complex. This area is responsible for the generation of various forms of inspiratory activity, and lesioning of the preBötzinger complex leads to the complete cessation of breathing. The neural output of these medullary respiratory networks can be voluntarily suppressed or augmented by input from higher brain centers and the autonomic nervous system. During normal sleep there is an attenuated response to hypercapnia and hypoxemia resulting in mild nocturnal hypoventilation that corrects upon awakening

Question 11

Which of the following confirms chronic alveolar hypoventilation ?

A	Elevated plasma bicarbonate
B	Elevated PaCO2
C	Normal pH
D	All of the above

Question 11 Explanation:

Elevated plasma bicarbonate in the absence of volume depletion is suggestive of hypoventilation. An arterial blood gas demonstrating elevated PaCO2 with a normal pH confirms chronic alveolar hypoventilation

Question 12

Which of the following is used to identify patients of alveolar hypoventilation ?

A	Berlin Questionnaire
B	Epworth Sleepiness Scale (ESS)
C	STOP-Bang questionnaire
D	All of the above

Question 13

Which out of the following measures daytime sleepiness ?

A	Berlin Questionnaire
B	Epworth Sleepiness Scale (ESS)
C	STOP-Bang questionnaire
D	All of the above

Question 13 Explanation:

Berlin Questionnaire has been validated in a primary care setting and identifies patients likely to have OSA. ESS measures daytime sleepiness. STOP-Bang survey is used in preoperative clinics to identify patients at risk of having OSA.

Question 14

Which of the following parameter in PFT is used to monitor for respiratory muscle involvement in diseases with progressive muscle weakness ?

A	Maximum inspiratory pressure
B	Maximum expiratory pressure
C	Forced vital capacity (FVC)
D	All of the above

Question 14 Explanation:

Respiratory muscle weakness has to be profound before lung volumes are compromised and hypercapnia develops. Measurement of maximum inspiratory and expiratory pressures or forced vital capacity (FVC) can be used to monitor for respiratory muscle involvement in diseases with progressive muscle weakness

Question 15

Which of the following stimulates respiration ?

A	Acetazolamide
B	Oestrogen
C	Testosterone
D	Testosterone

Question 15 Explanation:

Pharmacologic agents that stimulate respiration are medroxyprogesterone and acetazolamide

Question 16

Which of the following is false about diagnosis of Obesity Hypoventilation Syndrome ?

A	Body mass index (BMI) >=30 kg/m2
B	PaCO2 >=45 mmHg
C	PaO2 < 80 mmHg
D	Chronic daytime alveolar hypoventilation

Question 16 Explanation:

Diagnosis of obesity hypoventilation syndrome (OHS) requires body mass index (BMI) >=30 kg/m2, sleep-disordered breathing and chronic daytime alveolar hypoventilation, defined as PaCO2 >=45 mmHg, and PaO2 < 70 mmHg in the absence of other known causes of hypercapnia.

Question 17

Ondine’s curse is best related to ?

A	Hyperventilation
B	Obstructive sleep apnea syndrome
C	Central hypoventilation syndrome (CCHS)
D	Obesity Hypoventilation Syndrome

Question 17 Explanation:

Central Hypoventilation Syndrome can present later in life or in the neonatal period where it is often called Ondine’s curse or congenital central hypoventilation syndrome (CCHS).

Question 18

Which of the following gene has been implicated in the pathogenesis of congenital central hypoventilation syndrome ?

A	PHOX1b
B	PHOX2b
C	PHOX3b
D	PHOX4b

Question 18 Explanation:

Abnormalities in the gene encoding PHOX2b, a transcription factor with a role in neuronal development, have been implicated in the pathogenesis of congenital central hypoventilation syndrome

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See all quizzes of Disorders of Ventilation at here:

1. In health and at sea level, arterial level of carbon dioxide (PaCO2)
is maintained between ?
A. 35 & 41 mmHg
B. 36 & 42 mmHg
C. 37 & 43 mmHg
D. 38 & 44 mmHg

2. In the equation PaCO2 = (k)(V.CO2)/V. A, V. CO2 represents ?
A. Carbon dioxide excretion
B. Carbon dioxide production
C. Carbon dioxide excess

D. Carbon dioxide retention

3. V. A is calculated by which of the following formula ?
A. Minute ventilation x (1-Vd/Vt)
B. Minute ventilation / (1-Vd/Vt)
C. Minute ventilation + (1-Vd/Vt)
D. Minute ventilation – (1-Vd/Vt)

4. Disturbances of PaCO2 reflect which of the following ?
A. Altered CO2 production
B. Minute ventilation
C. Dead space fraction
D. All of the above

5. Dorsal respiratory group (DRG) & ventral respiratory column(VRC) are located in ?
A. Pleura
B. Lung parenchyma
C. Bronchial airways
D. Medulla oblongata

6. DRG acts as the initial integration site for which of the following ?
A. PaO2
B. Pa
CO2
C. pH
D. All of the above

7 .Which of the following nerves relay information from stretch receptors & juxtapulmonary-capillary receptors in lung parenchyma & chest wall to DRG ?
A. Vagus nerve
B. Phrenic nerve
C. Intercostal nerves
D. All of the above

8. Pre-Bötzinger complex is a part of ?
A. DRG
B. VRC

C. Parafacial respiratory group (pFRG)
D. All of the above
9. Which of the following is responsible for the generation of inspiratory activity ?
A. DRG
B. Parafacial respiratory group (pFRG)
C. Pre-Bötzinger complex
D. All of the above
10. Which of the following is responsible for the generation ofexpiratory activity ?
A. DRG
B. Parafacial respiratory group (pFRG)
C. Pre-Bötzinger complex
D. All of the above

11. Which of the following confirms chronic alveolar hypoventilation ?
A. Elevated plasma bicarbonate
B. Elevated PaCO2
C. Normal pH
D. All of the above

12. Which of the following is used to identify patients of alveolar hypoventilation ?
A. Berlin Questionnaire
B. Epworth Sleepiness Scale (ESS)
C. STOP-Bang questionnaire
D. All of the above
13. Which out of the following measures daytime sleepiness ?
A. Berlin Questionnaire
B. Epworth Sleepiness Scale (ESS)
C. STOP-Bang questionnaire
D. All of the above

14. Which of the following parameter in PFT is used to monitor for respiratory muscle involvement in diseases with progressive muscle weakness ?

A. Maximum inspiratory pressure
B. Maximum expiratory pressure
C. Forced vital capacity (FVC)
D. All of the above

15. Which of the following stimulates respiration ?
A. Acetazolamide
B. Oestrogen
C. Testosterone
D. Norepinephrine

16. Which of the following is false about diagnosis of Obesity Hypoventilation Syndrome ?
A. Body mass index (BMI) >=30 kg/m2
B. PaCO2 >=45 mmHg
C. PaO2 < 80 mmHg
D. Chronic daytime alveolar hypoventilation

17. Ondine’s curse is best related to ?
A. Hyperventilation
B. Obstructive sleep apnea syndrome
C. Central hypoventilation syndrome (CCHS)
D. Obesity Hypoventilation Syndrome

18. Which of the following gene has been implicated in the pathogenesis of congenital central hypoventilation syndrome ?
A. PHOX1b
B. PHOX2b
C. PHOX3b
D. PHOX4b

Disorders of Ventilation

[MCQ] Disorders of Ventilation- Part 1

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Disorders of Ventilation- Part 1

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