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Kaplan Qbank USMLE



Author11 Posts
  #1

I'm confused - a kind soul plz help me out here with EXPLANATION
raised eyebrow

(graph)
x axis - pleural pressure (starting from about -5 cmH2O)
y axis - expiratory flow rate (starting from 0 to btw 4 - 5 l/sec and plateau continues on)


the graph shows an isovolumetric pressure-flow curve obtained at 25% of total lung capacity. an increase in which of the following is most likely to increase the plateau value of the expiratory flow rate?

a. airway resistance
b. amount of surfactant in the alveolar space
c. ciliary beating frequency
d. expiratory effort
e. lung volume
f. parasympathetic activity of fibers innervating the airways

  #2

i would answer expiratory effort. more force (increases pleural press) means faster air flow.

  #3

I had to research this but I think that maximum expiratory flow rates are effort independent. The explanation is as follows: normal people can exhale only 80% of their Vital capacity in one second because during a forced expiration intrapleural pressure becomes positive and the upper airways are compressed. Compression of the upper airway limits expiratory flow rates. (care of Kaplan Phys)
I think the answer would be lung volume because theres an inverse relationship between volume and resitance in the lung, so as volume increases resistance decreases and flow would increases (this last paragraph is just my 2 cents. but i think the above paragraph is correct). What was the answer?

  #4

I would say amount of surfactant, since it drastically increases the compliance of lungs, making it more stretchable n leading to increased lung vol per unit change in pressure, that shud increase the expiratory flow rate. and since the gradient of the graph can be a measure of lung compliance dat kud add to explaination

As regards the lung vol, it can be true but is a vague option since in diseases like emphysema the lung vol is increased but not the expiratory flow rate

absence of the graph really makes it difficult to reach a fair conclusion.smiling face

  #5

Just on a second thaught, laying stress over the the point of 'Isovolumetric ' signifies vol is unaltered, i'l go with F since high para activiy consides vid bronchocostriction dat kud limit expiratory flow rate with out changing lung vol

  #6

to increase the plateau value of the expiratory flow rate we most reduce resistance, and the only aswer that do it is "amount of surfactant"
I'm not sure, letme know if I'm wrongrolling eyes

  #7

Answ (b) because a-d-f means increase in airway resistance that is measured as a decrease in EFR rolling eyes

  #8

is there an answer to this question?

  #9

Does somebody has the final anwr?

  #10

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  #11

E I guess







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