Respiratory 1

1. Which of the following factors affect the flow of air into and out of the lungs and alveoli?

1. loss of surfactant
2. accumulation of mucous in airways
3. bronchoconstriction
4. loss of elastic recoil of lungs

a) 3 only
b) 1 and 3 only
c) 1, 2 and 3 only
d) 1, 2, 3 and 4

2. Jason is suffering from asthma and he develops hypercapnia and respiratory acidosis.
Which statement is correct?

a) Central chemoreceptors will detect the lowered pH

b) Central chemoreceptors will detect the raised PO2
c) The respiratory acidosis is due to a low level of H+ ions in his blood
d) The respiratory acidosis is due to the high pH of his blood

3. Ed is 45 years old and has had recurring episodes of asthma attacks since his childhood.
They are becoming more frequent and severe. Which of the following features lead to
obstruction of airflow during his asthma attacks?

1. mucus plugs in bronchioles

2. bronchospasm
3. destruction of alveoli walls
4. mucus gland hypertrophy

a) 1 and 2 only
b) 2 and 3 only
c) 1, 2 and 4 only
d) 1, 2, 3 and 4

4. Which of the following statements is INCORRECT? Emphysema and chronic bronchitis

are:
a) usually reversible
b) characterised by difficulty in exhalation of air
c) usually caused by smoking
d) characterised by progressive damage to lung tissue

5. Compare and contrast the general mechanism of action of 2-agonists and anti-
cholinergics in treating respiratory disease (3 marks).
 Answers

1 d. A loss of surfactant causes a reduction in surface tension and the alveoli collapse making
it harder to inhale. The accumulation of mucus in the airways blocks airways and increases
airway resistance and decreases ventilation, in particular exhalation. Constriction of the
bronchi (bronchospasm) increases airway resistance and decreases ventilation, in particular
exhalation. If the elastic recoil is lost the lungs tend not to return to their resting state, airways
collapse and it is more difficult to exhale, causing air to be trapped in the lungs.

2a. It is the central chemoreceptors that respond to the lowered pH, which occurs due to the
accumulation of CO2. They they do not detect changes in Po2. The respiratory acidosis is
due to a high level of H+ ions in his blood i.e. it is due to the low pH of his blood.

3c is correct. Mucus plugs develop during asthma, and over time this is accompanied by
mucus gland hypertrophy. Also, bronchospasm leads to constriction of the airways, which is
also accompanied by bronchial smooth muscle hypertrophy. The alveolar walls are not
destroyed in asthma; this is characteristic of emphysema.

4a is incorrect, as emphysema and chronic bronchitis are not reversible (there is permanent
damage which cannot be cured). All of the other statements are correct.

5. 2-agonists work by enhancing the effects of adrenaline/noradrenaline at the adrenergic

receptors on the bronchi, which has a similar result to increasing the effects of the
sympathetic nervous system. They cause bronchodilation. Anti-cholinergic drugs work by
blocking the cholinergic receptors on the bronchi, as it blocks the effects of the
parasympathetic nervous system. They cause bronchodilation. These two groups of drugs are
similar, in that they both result in relaxation of the smooth muscle and result in
bronchodilation, but they do this by different mechanisms. (1 mark for each drug
mechanism, and 1 mark for the comparison).