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West zone 1 — FRCA Primary MCQ

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HardPhysiologyWest zone 1FRCA Primary

A hypotensive ventilated patient has increased apical dead space. What is the most likely explanation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: CVentilation of poorly perfused alveoli increases dead space

When alveolar pressure exceeds pulmonary arterial pressure, alveolar dead space increases. Raised PaCO2 lowers alveolar oxygen tension is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Hypoxic pulmonary vasoconstriction diverts blood flow is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Closing capacity exceeding FRC causes airway closure is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Acidosis shifts the oxyhaemoglobin curve right is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA physiology, the correct answer is usually the variable that best explains the observed change in the anaesthetised patient.

Reference: West's Respiratory Physiology; Ganong Review of Medical Physiology; Primary FRCA textbooks