Respiratory Mechanics and Gas Exchange · USMLE Step 1

What happens to alveolar oxygen partial pressure (PAO₂) and arterial oxygenation if V/Q mismatch causes negligible ventilation but maintained perfusion in a lung region?

  1. PAO₂ rises, arterial oxygenation increases
  2. PAO₂ falls toward venous levels, arterial oxygenation decreases
  3. PAO₂ remains normal, arterial oxygenation increases
  4. PAO₂ falls, but arterial oxygenation unaffected due to compensation
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Correct answer: PAO₂ falls toward venous levels, arterial oxygenation decreases

If ventilation drops but perfusion remains, alveolar gas equilibrates with poorly oxygenated blood, causing low PAO₂ and decreased arterial oxygen — similar to a physiological shunt.

Difficulty: Medium Question 13 of 20

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