Basic and Clinical Sciences (BCSE) Practice Exam

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What characterizes hypoxemic respiratory failure?

  1. Decreased PaO2 with increased PaCO2

  2. Decreased PaO2 with normal PaCO2

  3. Normal PaO2 and decreased PaCO2

  4. Increased PaO2 with normal PaCO2

The correct answer is: Decreased PaO2 with normal PaCO2

Hypoxemic respiratory failure is characterized primarily by low arterial oxygen tension (PaO2) while maintaining normal levels of carbon dioxide tension (PaCO2). In this scenario, the ability of the lungs to transfer oxygen into the bloodstream is impaired, leading to a decrease in PaO2. However, ventilation remains adequate enough to prevent an accumulation of carbon dioxide, resulting in normal PaCO2 levels. Conditions causing hypoxemic respiratory failure can include pneumonia, pulmonary edema, and pulmonary embolism, among others. In contrast, significant increases in PaCO2 would indicate hypoventilation or respiratory failure of a hypercapnic nature rather than hypoxemic. Understanding this distinction is crucial for diagnosing and treating respiratory disorders effectively.