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Chapter 7: Gas Diffusion
Test Bank
MULTIPLE CHOICE
1. For a person breathing 21% oxygen, what is the inspired oxygen partial pressure?
a. Approximately 80 mm Hg
b. Approximately 100 mm Hg
c. Approximately 140 mm Hg
d. Approximately 160 mm Hg
ANS: D
Inspired air contains about 21% oxygen and essentially no carbon dioxide. Thus, inspired
oxygen partial pressure (PIO2) is about 160 mm Hg, as the following calculation shows:
PIO2 = 0.2095 760 mm Hg = 159 mm Hg
3. What is the PAO2 of a person breathing room air at sea level, with a PaCO2 equal to 40 mm Hg
and an R equal to 0.8?
a. Approximately 80 mm Hg
b. Approximately 90 mm Hg
c. Approximately 100 mm Hg
d. Approximately 110 mm Hg
ANS: C
A normal PAO2 for a person breathing room air at sea level, with a PaCO2 equal to 40 mm Hg
and an R equal to 0.8, is approximately 100 mm Hg. This is shown as follows:
PAO2 = 0.2093 (760 − 47) − (40 1.2)
PAO2 = 149.2 − 48
PAO2 = 101.2
DIF: Recall REF: 132
5. The rate of gas diffusion in the lung is inversely proportional to its molecular weight and
directly proportional to which of the following physical properties?
a. Density
b. Solubility
c. Specific gravity
d. Proton concentration
ANS: B
The rate of gas diffusion in the lung is inversely proportional to its molecular weight and
directly proportional to its solubility.
6. How many times faster does oxygen diffuse through a gas medium than CO2?
a. 0.9
b. 1.0
c. 1.1
d. 1.2
ANS: D
Because oxygen is a lighter molecule, it diffuses through a gas medium 1.17 times faster than
CO2.
7. Which of the following laws states that the amount of gas dissolving in a liquid is directly
proportional to the gas partial pressure?
a. Boyle’s law
b. Charles’ law
c. Henry’s law
d. Reynold’s law
ANS: C
Carbon dioxide is much more soluble in water than oxygen. Henry’s law states that the
amount of gas dissolving in a liquid is directly proportional to the gas partial pressure.
9. Combining Graham’s law and Henry’s law, how many times faster does carbon dioxide
diffuse across the alveolar capillary membrane than oxygen?
a. 10
b. 20
c. 30
d. 40
ANS: B
Combining Graham’s law and Henry’s law, carbon dioxide diffuses across the alveolar
capillary membrane approximately 20 times faster than oxygen.
10. Diffusion of which of the following gases will be limited by a defective alveolar capillary
membrane?
a. O2
b. CO2
c. NO2
d. N2O
ANS: A
Alveolar capillary membrane defects limit oxygen diffusion long before they limit CO2
diffusion.
11. When are patients with thickened alveolar capillary membranes most likely to show evidence
of oxygen diffusion impairment?
a. In supine position
b. In prone position
c. During exercise
d. In any position at rest
ANS: C
If a healthy person exercises vigorously at a high altitude, where atmospheric PO2 is very low,
the oxygen diffusion gradient may be so low that oxygen cannot cross the alveolar capillary
membrane quickly enough to establish equilibrium during the shortened transit time. Or if
disease thickens the alveolar capillary membrane, the diffusion rate across the membrane may
be slowed enough to prevent complete oxygen equilibrium by the time blood leaves the
capillary. In the clinical setting, this rarely occurs at rest, even in severe lung disease.
However, exercise immediately exposes the diffusion abnormality problem because it
shortens the blood’s transit time through the capillary, preventing oxygen equilibrium (Figure
7-5). Thus, patients with thickened alveolar capillary membranes are most likely to show
evidence of oxygen diffusion impairment during exercise.
12. Which of the following is the main limiting factor for the oxygen transfer rate?
a. Perfusion
b. Diffusion
c. Solubility
d. Molecular weight of the gas
ANS: A
The diffusion rate of oxygen through the alveolar capillary membrane is normally perfusion
limited (see Figure 7-4); that is, a change in blood flow rate alters the amount of oxygen that
crosses the alveolar capillary membrane each minute.
13. If oxygen equilibrium between the alveolus and capillary never occurs because of thickened
membranes, oxygen transfer is truly:
a. Perfusion limited
b. Diffusion limited
c. Concentration limited
d. Perfusion and diffusion limited
ANS: B
If oxygen equilibrium between the alveolus and capillary never occurs because of thickened
membranes, oxygen transfer is truly diffusion limited. In such an instance it is the alveolar
capillary membrane, not the blood flow rate, that influences the oxygen transfer rate (see
Figure 7-5).
14. Why is CO the ideal gas for measuring the extent to which the alveolar capillary membrane
itself impedes the diffusion rate?
a. Blood can absorb CO at a greater rate than CO can diffuse across the alveolar
capillary membrane.
b. CO is lighter than O2.
c. CO can diffuse across the alveolar capillary membrane faster than blood can
absorb it.
d. CO is heavier than O2.
ANS: A
Carbon monoxide (CO) is the ideal gas for this kind of measurement because blood can
absorb it at a greater rate than carbon monoxide can diffuse across the alveolar capillary
membrane, even under resting conditions.
15. Why is N2O the ideal gas for measuring the extent to which pulmonary blood contributes to
the diffusion rate?
a. Blood can absorb N2O at a greater rate than N2O can diffuse across the alveolar
capillary membrane.
b. If N2O is inhaled, the pulmonary capillary blood reaches its maximum capacity for
N2O almost instantly.
c. If N2O is inhaled, the pulmonary capillary blood reaches its maximum capacity for
N2O slowly.
d. Blood can absorb N2O at a slower rate than N2O can diffuse across the alveolar
capillary membrane.
ANS: B
If N2O is inhaled, the pulmonary capillary blood reaches its maximum capacity for N2O
almost instantly (Figure 7-7). N2O partial pressures across the alveolar capillary membrane
reach equilibrium in the first one-twentieth of the distance along the capillary.
Increased blood flow causes N2O-saturated blood to exit the capillary sooner, allowing more
mixed venous blood to enter and take up alveolar N2O. Thus, diffusion of N2O in the lung is
perfusion limited. This makes N2O an ideal test gas to measure pulmonary blood flow.
17. Which of the following conditions can increase the length of the diffusion path?
I. Fibrotic thickening of alveolar and capillary walls
II. Fluid in the alveoli
III. Interstitial edema fluid
IV. Capillary vasoconstriction
a. I, II, III
b. II, III
c. I, II, III, IV
d. II, III, IV
ANS: A
Various abnormal conditions can increase the diffusion path length, including the following:
(1) fibrotic thickening of alveolar and capillary walls; (2) interstitial edema fluid, separating
alveolar and capillary membranes; (3) fluid in the alveoli; (4) interstitial fibrotic processes that
thicken the interstitial space; and (5) dilated, engorged capillaries, which allow red blood cells
to flow side by side.
21. What is the best explanation for the DLO2 being greater than the DLCOsb?
a. O2 is less soluble than CO in the alveolar capillary membrane but more soluble in
the plasma and therefore diffuses more rapidly.
b. O2 is more soluble than CO in the alveolar capillary membrane and less soluble in
the plasma and therefore diffuses more rapidly.
c. O2 is less soluble than CO in the alveolar capillary membrane and the plasma and
therefore diffuses more rapidly.
d. O2 is more soluble than CO in the alveolar capillary membrane and the plasma and
therefore diffuses more rapidly.
ANS: D
A mean DLCOsb of 26 mL/min/mm Hg yields a normal DLO2 of approximately 32
mL/min/mm Hg. It might seem odd that DLO2 is greater than DLCOsb, considering
hemoglobin’s much greater affinity for CO than O2. This peculiarity is explained by the fact
that O2 is more soluble than CO in the alveolar capillary membrane and the plasma, and
therefore diffuses more rapidly.
22. Which of the following conditions has an inverse relationship with DLCOsb?
a. Age
b. Exercise
c. Lung volumes
d. PAO2
ANS: D
High PAO2 is associated with lower DLCOsb because in the blood, oxygen competes with CO
for binding sites on the hemoglobin molecule.
23. The DLCOsb is useful in differentiating emphysema from what other obstructive disease?
a. Asthma
b. Pneumonia
c. ARDS
d. Bronchiectasis
ANS: A
The DLCOsb is useful in differentiating emphysema from other obstructive diseases not
associated with destroyed alveolar architecture, such as chronic bronchitis and asthma.
Asthma is often associated with an increased DLCOsb.
FOOTNOTES:
[1] Phillips, American Negro Slavery, p. 361.
[2] Statutes of S. C., Vols. 2 & 7, pp. 153, 367, 370.
[3] S. C. Gazette, Feb. 26, 1732, McCrady, S. C. under the
Royal Government, p. 378.
[4] Compendium of the Ninth Census of the United States, p.
13.
[5] Farrand. Records of the Federal Convention, Vol. 2, p. 183.
[6] Farrand. Records of the Federal Convention, Vol. 2, p. 364.
[7] Farrand. Records of the Federal Convention, Vol. 2, pp. 369,
374.
[8] Ibid. p. 374.
[9] Ibid. p. 400.
Prof. Farrand renders “abst” absent, which the context
contradicts. King of Massachusetts, was put on the committee.
[10] Farrand. Records of the Federal Convention, Vol. 2, p. 415.
[11] S. C. Gazette, Feb. 19, 1732, Stat. S. C. Vol. 7, pp. 367-
370. McCrady, S. C. Under the Royal Government, p. 378.
[12] Stat. S. C. Vol. 7, p. 430.
[13] State Gazette, Jan. 28, 1788.
[14] Jervey, Robert Y. Hayne and His Times, p. 130.
[15] Calhoun’s Correspondence, p. 369.
CHAPTER II
FOOTNOTES:
[16] Stat. S. C. Vol. 7 pp. 431-448.
[17] Charleston Courier, December 5, 1803.
[18] Ibid. December 6, 1803.
[19] Ibid. December 13, 1803.
[20] S. C. Hist. & Genealog. Mag. Vol. 2, p. 72.
[21] Annual Report American Hist. Ass. 1896, Vol. 1, p. 870.
[22] Charleston Courier, December 26, 1803.
[23] Jervey, Robert Y. Hayne & His Times, p. 148.
[24] Charleston Courier, December 26, 1803.
[25] Ibid. January 2, 1804.
[26] City Gazette and Daily Advertiser, December 21, 1803.
[27] Memoirs of Aaron Burr, Vol. 2, p. 270.
[28] Charleston Courier, December 12, 1804.
[29] Ibid. December 24, 1804.
[30] Charleston Courier, December 2, 1805.
[31] Jervey, Robert Y. Hayne & His Times, p. 534.
[32] Annual Report American Hist. Assn. 1896, Vol. 1, p. 868.
[33] Charleston Courier, December 13, 1805.
[34] Annual Report American Hist. Assn. Vol. 1, p. 878, 1896.
[35] Charleston Courier, December 9, 1805.
[36] Charleston Year Book, 1880, p. 263.
[37] Thomas’s Reminiscences, Case Tiffany & Burnham, Vol. 2,
p. 35.
[38] C. L. Martzolff, Ohio University, Nov. 30, 1909.
[39] S. C. Reports, Brevard, Vol. 2, p. 145. State vs. McDowell.
[40] Charleston Courier, February 27, 1811.
CHAPTER III