Respiration
Questions
DIRECTIONS (Questions 150-235): Each of the numbered items or incomplete statements in this section is followed by answers or by completions of the statement. Select the ONE lettered answer or completion that is BEST in each case.
150. At functional residual capacity (FRC)
(A) no further inspiration is possible
(B) chest wall elastic forces are greater than the lungs elastic recoil
(C) the pressure difference between the alveoli and the intrapleural space is zero
(D) the total pulmonary vascular resistance is very high
(E) the pressure difference between the alveoli and atmosphere is zero
151. All statements in regard to the sensation of dyspnea are correct EXCEPT dyspnea may be:
(A) influenced by chemoreceptors that are located in the medulla
(B) mediated by J-receptors during pulmonary edema
(C) due to hyperinflation of the lung
(D) mediated by metaboreceptors located in muscle
(E) due to low cardiac output in individuals with obesity
152. During mechanical ventilation proximal airway pressure will increase with
(A) decreases in tidal volume
(B) increases in lower respiratory system compliance
(C) increases in respiratory flow
(D) decreases in PEEP
(E) decreases in airway resistance
153. A 60-year-old man with COPD and an 80-pack-year smoking history is scheduled to undergo pulmonary function testing. Measurements that can be obtained by spirometry include all of the following EXCEPT
(A) tidal volume
(B) residual volume
(C) expiratory reserve volume
(D) inspiratory reserve volume
(E) vital capacity
154. A double-lumen tube is used for anesthesia in patients with severe
(A) asthma
(B) hemoptysis
(C) emphysema
(D) heart failure
(E) tracheal stenosis
155. Carbon dioxide transport involves all of the following EXCEPT
(A) water
(B) bicarbonate ion
(C) carbonic anhydrase
(D) hemoglobin
(E) carboxyhemoglobin
156. In the normal upright lung
(A) the blood flow is greatest at the apex
(B) the ventilation is greatest at the apex
(C) the ventilation/perfusion (V/Q) ratio is higher at the apex
(D) ventilation is uniform
(E) the PO2 is lower at the apex compared to the base
157. A 57-year-old woman is undergoing thoracotomy for resection of her left lower lobe because of a small-cell tumor. She has a right-sided double-lumen endotracheal tube in place. All of the following are effective ways to improve oxygenation during one-lung ventilation EXCEPT
(A) lung recruitment maneuver in the dependent lung
(B) decrease blood flow in the dependent lung, i.e., placement of a ligature on the pulmonary artery
(C) increase blood flow and perfusion to the dependent lung
(D) increase PaO2 in the nondependent lung
(E) PEEP to the dependent lung
158. If one measured pleural pressure in a standing human, one would find that the pressure was
(A) highest at the apex of the lung
(B) highest at the base of the lung
(C) equal at all levels
(D) unrelated to body position
(E) completely unpredictable from one level to another
159. The LaPlace law is important in pulmonary physiology because it describes
(A) the properties of gas mixtures
(B) the angles of the bronchi
(C) the bucket handle movement of the ribs during ventilation
(D) the pressure relationships within the alveoli
(E) resistance in large airways
160. Surfactant is a substance that
(A) is produced in the liver of the newborn
(B) is important in newborns but has little importance in the adult
(C) is produced by the basement membrane of the lung
(D) lowers surface tension in the alveoli
(E) is a long-chained carbohydrate molecule
161. The functional residual capacity (FRC) is defined as the combination of
(A) tidal volume and residual volume
(B) tidal volume and expiratory reserve volume
(C) tidal volume and inspiratory reserve volume
(D) residual volume and expiratory reserve volume
(E) vital capacity less the closing volume
162. A 16-year-old girl with asthma is to undergo routine pulmonary function testing. In order to measure the FEV1 during spirometry, she
(A) is asked to inhale forcefully
(B) exhales forcefully from total lung capacity to residual volume
(C) is asked to breathe slowly at normal tidal volumes
(D) forcefully exhales from total lung capacity to respiratory reserve volume
(E) is asked to forcefully exhale for 1 second
163. A previously healthy 46-year-old man developed gallstone pancreatitis and then required mechanical ventilation to maintain adequate oxygenation. The ICU team decided that his case of adult respiratory distress syndrome was best managed with high-frequency jet ventilation. This ventilatory mode
(A) can provide ventilatory support only when a tightly sealed airway is established
(B) cannot be applied for surgical procedures
(C) can be used to provide emergency ventilation after cricothyroid cannulation
(D) creates a jet drag effect, preventing secondary gases from entering the airway
(E) is only necessary during rigid bronchoscopy
164. Factors contributing to increased airway pressure under anesthesia include all of the following EXCEPT
(A) muscle paralysis of the chest wall
(B) a decrease in functional residual capacity
(C) the supine position
(D) the presence of an endotracheal tube
(E) controlled ventilation
165. Distribution of ventilation in the lung is such that
(A) the apical portions are better ventilated
(B) the dependent areas are better ventilated
(C) the central or hilar areas are better ventilated
(D) all areas are ventilated equally
(E) ventilation is not affected by position
166. The level of arterial PCO2 (PaCO2)
(A) depends on minute ventilation only
(B) is independent of CO2 production
(C) is not dependent on dead space ventilation
(D) varies directly with CO2 production and inversely with alveolar ventilation
(E) decreases when dead space ventilation increases
167. A healthy 26-year-old man underwent open herniorrhaphy. He had a Class I preoperative airway examination and the medical student intubated him on her first attempt. When deciding when to extubate him, you should consider that
(A) laryngospasm is of no concern, as it only occurs during induction
(B) laryngospasm should be managed with positive pressure ventilation, oxygen, suctioning of oropharyngeal secretions, and, in severe cases, a small dose of IV succinylcholine
(C) airway obstruction only occurs in the first 4 to 6 min after extubation
(D) extubation during deep anesthesia carries the risk of a profound cardiovascular response
(E) in patients who were difficult to intubate, extubation should be carried out during deep anesthesia
168. A 70-year-old man underwent left carotid endarterectomy two years ago and is about to have the same operation on his right side. Following this right-sided surgery, he will
(A) have no respiratory changes
(B) show no change in arterial carbon dioxide
(C) respond to hypoxia with hyperventilation
(D) be more susceptible to hypoxemia
(E) always develop hypertension
169. Mechanisms that may cause hypoxemia under anesthesia include all of the following EXCEPT
(A) hypoventilation
(B) hyperventilation
(C) increase in functional residual capacity (FRC)
(D) supine position
(E) increased airway pressure
170. A healthy 44-year-old woman underwent ablation of a dysrhythmia focus. The procedure required two hours, and the cardiologist requested apnea during periods of image acquisition. You hyperventilated her throughout the procedure. Now that she is extubated and breathing room air, she will
(A) return to normal parameters within 30 min
(B) remain hypocarbic for 2 h
(C) possibly become hypoxemic if not treated with oxygen
(D) become hypoxemic and hypercarbic
(E) be well oxygenated if the air exchange is unimpaired by drugs
171. All of the following lead to decreases in lung compliance, EXCEPT
(A) pneumothorax
(B) emphysema
(C) pulmonary fibrosis
(D) pneumonectomy
(E) hyperinflation
172. The ventilatory response to PaCO2
(A) is independent of hypoxemia
(B) has a major peripheral component
(C) is depressed by metabolic acidemia
(D) is unaffected by opioid antagonists
(E) is augmented by norepinephrine
173. When considering oxygen transport in the lung, the LEAST important cause of hypoxemia is
(A) ventilation/perfusion mismatch
(B) diffusion barrier
(C) venous admixture
(D) bronchial artery blood flow
(E) altitude
174. In pulmonary function testing, carbon monoxide diffusing capacity (DLCO)
(A) is greater than functional residual capacity (FRC)
(B) is unchanged in anemia
(C) is increased in pulmonary fibrosis
(D) estimates the gas transfer ability of the lung
(E) estimates the dead space ratio (VD/VT) of the lung
175. All of the following lead to decreases in chest wall compliance, EXCEPT
(A) chest wall edema
(B) thoracic deformities
(C) flail chest
(D) ventilator dyssynchrony
(E) abdominal distension
176. The oxyhemoglobin dissociation curve describes the relationship of oxygen saturation to oxygen tension. All of the following are true EXCEPT that
(A) at an oxygen tension of 60 mm Hg, the saturation is approximately 90%
(B) the curve is shifted to the left with a more acidic pH
(C) the curve is shifted to the right with an increase in carbon dioxide tension
(D) the curve is shifted to the left with a decrease in temperature
(E) the curve is shifted to the right with increased levels of 2,3-DPG
177. The definitive test of adequacy of ventilation is
(A) listening to the esophageal stethoscope
(B) watching the rise and fall of the chest
(C) analyzing arterial blood gases
(D) measuring tidal volume with a spirometer
(E) using an apnea monitor
178. Pulmonary vascular resistance
(A) is entirely dependent on the cardiac output
(B) is entirely dependent on the pressure in the pulmonary artery
(C) is equal to pressure divided by radius of the artery
(D) depends on the state of vasomotor tone, flow, and pressure
(E) is not affected by cardiac output
179. The work of breathing
(A) can be excessively high during SIMV (spontaneous intermittent mandatory ventilation)
(B) is solely due to airway resistance
(C) is solely due to elastic forces
(D) is at its lowest at a respiratory rate of 25 breaths per minute
(E) is increased in the patient with restrictive disease if the respiratory rate is increased
180. Anatomic dead space
(A) is independent of lung size
(B) is about 1 mL/kg body weight
(C) is not affected by equipment
(D) combined with alveolar dead space constitutes physiologic dead space
(E) is of less importance in the newborn than the adult
181. The term P50 in reference to the oxyhemoglobin dissociation curve
(A) refers to the position on the curve at which the PO2 is 50 mm Hg
(B) normally has a value of 27 mm Hg
(C) describes an enzyme system in hemoglobin
(D) is constant
(E) is affected only by type of hemoglobin
182. All of the following are frequently found in carbon monoxide poisoning EXCEPT
(A) seizures and coma
(B) lactic acidosis
(C) desaturation by pulse oximetry
(D) carboxyhemoglobin
(E) normal PaO2
183. The carotid bodies primarily
(A) respond to elevated PCO2
(B) respond to Svo2
(C) respond to PaO2
(D) signal the medulla via the vagus nerve
(E) respond to hydrogen ions
184. Hypercapnia under anesthesia may be a result of
(A) hyperventilation
(B) decreased dead space ventilation
(C) decreased carbon dioxide production
(D) use of an Ayre T-piece at less than peak inspiratory flow rate
(E) increased pulmonary artery flow
185. All of the following statements about the diaphragm are true EXCEPT
(A) it is innervated via the vagus nerve
(B) it has no fixed insertion
(C) it is mainly active in inspiration
(D) it has an equal mix of slow twitch and fast twitch fibers
(E) it is deficient in stretch receptors
DIRECTIONS: Use the following figure to answer Questions 186-189:
186. In Zone 1 of the lung
(A) no air is moving
(B) circulation is highest
(C) venous pressure is high
(D) dead space is high
(E) shunting is high
187. In Zone 2 of the lung
(A) there is good blood flow regardless of ventilation
(B) venous pressure is high
(C) dead space is high
(D) the pulmonary vessels are collapsed
(E) the blood flow is determined primarily by pulmonary artery pressure and alveolar pressure
188. In Zone 3 of the lung
(A) blood flow is governed by the arteriovenous pressure difference
(B) dead space is high
(C) there is high alveolar pressure
(D) venous pressure is very low
(E) little blood flow occurs
189. All of the following are true EXCEPT
(A) Zone 2 is the “waterfall” region of the lung
(B) Zone 1 will increase in hypovolemic shock
(C) Zone 4 will increase with lymphatic blockage
(D) these zones would matter less if we could breathe in water
(E) these zones are independent of gravitational effects
190. Hypoventilation in the recovery room
(A) should always be treated with opioid reversal
(B) is common after inhalation anesthesia
(C) is uncommon after upper abdominal procedures
(D) is best detected by pulse oximetry
(E) is always accompanied by increases in blood pressure
191. All of the following statements about preoxygenation are true EXCEPT
(A) 80% of the nitrogen in the functional residual capacity (FRC) is being replaced with oxygen during preoxygenation
(B) during preoxygenation, nitrogen is eliminated rapidly, dependent on the volume of the breaths
(C) preoxygenation preceding induction of general anesthesia can sustain vital organs for up to 15 min even without active ventilation
(D) preoxygenation should always be considered before induction of general anesthesia
(E) preoxygenation should be carried out over 2-3 min, or as a series of four vital capacity breaths
192. Which one of the following statements is true about Type II alveolar cells?
(A) They produce surfactant.
(B) They are the major component of gas exchange.
(C) They line the capillary endothelium.
(D) They can be replaced by Type I cells.
(E) They are migratory and phagocytic.
193. A 56-year-old female patient is scheduled for emergent exploratory laparotomy for acute bowel obstruction. After rapid sequence induction of general anesthesia, the patient is noted to have regurgitation of gastric contents during direct laryngoscopy. Regarding perioperative aspiration of gastric content, all of the following are true, EXCEPT
(A) the severity of symptoms depends on the type and volume of material aspirated
(B) initial management comprises suctioning, administration of bronchodilators, supplemental O2, and ICU transfer
(C) bronchoscopy may be of benefit to remove particulate material
(D) pulmonary lavage with large volumes of saline should be carried out repeatedly
(E) administration of empirical antibiotic is not recommended
194. Regarding hypoxemia during the postoperative period, which one of the following is true?
(A) Hypoxemia necessitates reintubation in most cases.
(B) Hypoxemia is rarely caused by decreased ventilatory drive.
(C) Opioid antagonists should be avoided, as they impede pain therapy.
(D) The incidence of postoperative hypoxemia is relatively independent of surgical site.
(E) Analgesics can enhance postoperative respiratory mechanics in some cases.
195. Comparing infant (<1 yr) and adult (>8 yr) airways,
(A) the angle between trachea and right bronchus is smaller in infants
(B) the narrowest position of the airway is glottis in infants and cricoid cartilage in adults
(C) only adults have a prominent protrusion of the corniculate and cuneiform tubercles into the laryngeal aditus
(D) the angle between trachea and left bronchus remains unchanged
(E) the epiglottic cross-section shape remains unchanged
196. If a patient is allowed to breathe 100% oxygen under anesthesia
(A) areas of atelectasis will disappear
(B) bowel distention will decrease
(C) the PO2 will rise due to increased dead space
(D) lung units with low ventilation/perfusion (V/Q) ratios may become shunt units
(E) the oxygen tension will rise due to an increase in functional residual capacity (FRC)
197. All of the following statements are true about the esophageal-tracheal airway, Combitube, EXCEPT
(A) the combitube enters the trachea in approximately one third of cases
(B) the device has two lumens, one opening at the distal end, one at fenestrations between the balloons
(C) ventilation takes place using the more proximal lumen in the majority of cases
(D) the combitube does not need to be replaced even if it enters the trachea
(E) it is intended to establish emergency airway access if the operator is not able to perform face mask ventilation or conventional intubation
198. Independent risk factors for difficult mask ventilation include all of the following, EXCEPT
(A) sleep apnea
(B) limited mandibular protrusion
(C) body mass index <21 kg/m2
(D) facial hair
(E) age >55 years
199. A 46-year-old woman with a history of scleroderma for more than twenty years is being evaluated in the preoperative clinic. She would be expected to have all of these pulmonary manifestations of scleroderma EXCEPT
(A) increased compliance
(B) diffuse fibrosis
(C) decreased vital capacity
(D) hypoxemia
(E) increased VD/VT ratio
200. All of the following statements are true about alveoli EXCEPT
(A) they are 100–300 microns in diameter
(B) they are mostly lined with Type I alveolar cells
(C) they are partially lined with Type II alveolar cells
(D) they are partially lined with Type III alveolar cells
(E) they are surrounded by capillaries
201. Auto-PEEP (positive end-expiratory pressure)
(A) decreases end-expiratory lung volume
(B) can be measured by applying an expiratory pause in mechanically ventilated patients
(C) promotes venous return
(D) decreases with increasing respiratory rate
(E) decreases with increasing minute ventilation
202. Chest wall compliance
(A) normally is 200 mL/cm H2O
(B) decreases in the setting of a flail chest
(C) is increased in patients with kyphoscoliosis
(D) is increased in patients with abdominal distension
(E) is increased in morbidly obese patients
203. The work of breathing
(A) involves both resistive and elastic work
(B) is expended mostly in expiration
(C) to overcome elastic forces is decreased when breathing is deep and slow
(D) to overcome resistive forces is decreased when breathing is fast and shallow
(E) is expended mostly in inspiration
DIRECTIONS: Use the following figure to answer Questions 204-205:
204. All of the following are TRUE of the flow-volume loop shown in the figure EXCEPT
(A) the X axis is volume
(B) the Y axis is pressure
(C) vital capacity is the distance from point 1 to point 3
(D) a breath proceeds through points 1, 2, 3, and 4, in that order
(E) there is no air leak
205. In this flow-volume loop
(A) there is evidence of tracheal stenosis
(B) point 2 is at maximum expiratory volume
(C) point 3 is at maximum inspiratory volume
(D) one can determine inspiratory reserve volume
(E) one can determine functional residual capacity (FRC)
206. Functional residual capacity (FRC) can be measured by
(A) use of an esophageal balloon
(B) computed tomography
(C) spirometry
(D) inert gas dilution technique
(E) bioimpedance
207. End-tidal CO2 is increased by
(A) bicarbonate administration
(B) a circuit leak around the endotracheal tube cuff
(C) hypotension
(D) cardiac arrest
(E) intracardiac air embolism
208. Hypoxic pulmonary vasoconstriction
(A) leads to an increase in the shunt fraction
(B) is increased with increases in pulmonary artery pressure
(C) is increased with increases in central blood volume
(D) is decreased with the use of sodium nitroprusside
(E) is increased with the use of inhaled nitric oxide
209. Conditions aggravated by hypercapnia include all of the following EXCEPT
(A) elevated intracranial pressure
(B) right-to-left cardiac shunts
(C) pulmonary hypertension
(D) cardiac dysrhythmia
(E) ARDS
210. The patient who is hyperventilated to a PCO2 of 20 mm Hg under anesthesia will have
(A) increased cerebral blood flow
(B) increased ionized calcium
(C) increased oxygen delivery to the tissues
(D) increased ventilation/perfusion (V/Q) mismatch due to inhibition of hypoxic pulmonary vasoconstriction
(E) increased respiratory drive
211. Specific effects of anesthesia on control of breathing include a decreased response to all of the following, EXCEPT
(A) carbon dioxide
(B) hypoxemia
(C) metabolic acidemia
(D) added airway resistance
(E) external stimuli
212. Factors leading to pulmonary edema include all of the following, EXCEPT
(A) increased capillary pressure
(B) decreased oncotic pressure
(C) lymphatic insufficiency
(D) increased capillary permeability
(E) hyperinflation during ventilation
213. The respiratory quotient
(A) depends on the CO2 output and O2 uptake
(B) is independent of the metabolic substrate
(C) depends on the O2 uptake and cardiac output
(D) depends on the CO2 output and metabolic equivalent
(E) is always 0.8
214. Positive end-expiratory pressure (PEEP) usually
(A) decreases functional residual capacity (FRC)
(B) decreases compliance
(C) decreases work of breathing
(D) increases work of breathing
(E) decreases lung volume
215. In comparing closing capacity (CC) and functional residual capacity (FRC),
(A) obesity increases both CC and FRC
(B) increasing FRC relative to CC results in areas of low ventilation/perfusion (V/Q)
(C) anything that decreases CC below FRC results in areas of atelectasis
(D) increasing CC above the tidal volume plus FRC results in areas of atelectasis
(E) compared to adults, young children are less likely to suffer atelectasis from tidal breathing occurring from end-expiratory lung volumes close to closing capacity
216. During anesthesia, the diaphragm assumes a more cephalad position because of all of the following, EXCEPT
(A) paralysis from muscle relaxants
(B) increased end-expiratory tone of the abdominal wall
(C) surgical retraction
(D) second gas effect
(E) pneumoperitoneum
217. Forced exhaled vital capacity (FVC)
(A) may vary with patient cooperation
(B) is measured in the first second
(C) is a measure of inspiratory reserve volume
(D) is affected by restrictive disease in the first second
(E) can only be measured using body-plethysmography or the inert gas dilution technique
218. The medullary chemoreceptors are maximally stimulated by
(A) low oxygen tension
(B) reflex activity from the diaphragm
(C) carbon dioxide
(D) ondansetron
(E) hydrogen ion
219. The composition of alveolar gases differs from that of inhaled gas. Concerning this, all of the following are true, EXCEPT
(A) oxygen is being absorbed from the alveoli
(B) carbon dioxide is being added to the alveoli
(C) water vapor is being added
(D) nitrogen is taken up by the alveolar capillaries
(E) inhalational anesthetic agents are absorbed from or eliminated into the alveoli
220. The endotracheal tube position in a female adult patient is evaluated by the following: examining the patient, the numerical markings on the tube, and the chest x-ray. Which one of the following is consistent with the proper position?
(A) The left side is ventilated better than the right side.
(B) The tip of the tube is 30 cm from the upper front teeth.
(C) The tip of the tube overlies the 6th thoracic vertebra.
(D) Both sides ventilate equally.
(E) The ideal tube position is approximately 2 mm above the carina.
221. During mechanical ventilation inspiratory airway resistance
(A) cannot be estimated
(B) is decreased with the use of longer tubes
(C) is independent of endotracheal tube diameter
(D) is typically lower compared with expiratory airway resistance
(E) is independent of endotracheal tube length
222. A right shift in the oxyhemoglobin dissociation curve is caused by
(A) decreased temperature
(B) hypercarbia
(C) alkalosis
(D) the presence of fetal hemoglobin
(E) hypocarbia
223. Factors that increase the incidence of postoperative pulmonary complications include all of the following, EXCEPT
(A) upper vs. lower abdominal surgery
(B) chronic obstructive pulmonary disease
(C) heart failure
(D) asthma
(E) longer surgical duration
224. All of the following statements are true of closing capacity EXCEPT it is
(A) the lung volume at which the onset of airway closure is detected
(B) increased in smoking
(C) greater than residual volume
(D) greater than closing volume
(E) a smaller fraction of the total lung capacity in infants, compared to adults
225. Transpulmonary pressure
(A) measures intralung pressure
(B) is equal to intrapleural pressure at FRC
(C) is a gradient between the airway opening and the alveolar pressure
(D) increases with increasing lung volume
(E) is independent of tidal volume
226. All of the following statements are true in interpreting pulmonary function tests EXCEPT
(A) vital capacity measurement is not a timed measurement
(B) spirometry fails to detect early disease in small airways
(C) maximal breathing capacity is dependent on cooperation
(D) the FEV1 will detect restrictive disease
(E) absolute lung volumes cannot be determined using standard spirometry
227. A patient who arrives in the recovery room after a general anesthetic should
(A) be sedated to prevent overt postoperative stress
(B) always be encouraged to lie on the back for easier access to the airway
(C) be closely observed for respiratory depression
(D) be given opioids at fixed intervals
(E) always be maintained on arterial blood pressure monitoring, using a radial artery catheter
228. A 14-gauge catheter is inserted through the cricothyroid membrane and attached to a wall oxygen source in such a way that oxygen can be delivered intermittently. With this technique
(A) pneumothorax is inevitable
(B) adequate oxygenation is possible
(C) gastric dilatation is a hazard
(D) larynx injury is impossible
(E) prevention of hypercapnia is possible
229. Patients with pneumoconiosis, e.g., asbestosis or silicosis, often require surgery on other organs. In the preoperative assessment, one must recognize that
(A) the lung volumes will be increased
(B) the x-ray abnormality fully reflect the functional changes
(C) early airway closure is the hallmark
(D) fibrosis usually is present
(E) FEV1/FVC is regularly decreased in these patients
230. Vital capacity includes all of the following, EXCEPT
(A) tidal volume
(B) inspiratory reserve volume
(C) expiratory reserve volume
(D) functional residual capacity (FRC)
(E) closing volume
231. Hypoxemia may occur under anesthesia because of all of the following, EXCEPT
(A) blood loss
(B) increased release of oxygen from hemoglobin to the tissues
(C) depressed myocardial function
(D) shunting
(E) airway obstruction
232. Diffusion hypoxia
(A) is due to a large volume of nitrous oxide in the lungs
(B) is due to a large volume of carbon monoxide in the bloodstream
(C) is due to the second gas effect
(D) can occur up to 48 h after surgery
(E) does not respond to oxygen supplementation
233. Pneumothorax may be due to all of the following EXCEPT
(A) alveolar rupture
(B) chest wall trauma
(C) connection between the distal airway and the pleural space
(D) extrathoracic tracheal puncture
(E) a break in the parietal pleura
234. When assessing the acutely hypoxemic patient, causes that may be important are all of the following EXCEPT
(A) hypoventilation
(B) hypoperfusion
(C) ventilation/perfusion (V/Q) mismatch
(D) intracardiac shunts
(E) abnormal diffusion
235. Total pulmonary compliance
(A) is measured by dividing pressure by volume
(B) is usually decreased in elderly patients
(C) involves the lung only
(D) is independent of previous breaths
(E) is increased by surfactant
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