American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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In the context of oxygen delivery, what is the main consequence of a right shift in the oxygen dissociation curve?

  1. Increased oxygen affinity

  2. Increased oxygen offloading to tissues

  3. Decreased oxygen solubility

  4. Decreased oxygen demand

The correct answer is: Increased oxygen offloading to tissues

A right shift in the oxygen dissociation curve indicates a reduction in hemoglobin's affinity for oxygen. This physiological change allows for greater offloading of oxygen to the tissues, which is essential in circumstances where the tissues are metabolically active and require more oxygen. Various factors can cause this shift, including increased carbon dioxide levels, lower pH (which signifies acidosis), elevated temperatures, and higher concentrations of 2,3-bisphosphoglycerate (2,3-BPG). These conditions are often present in tissues that are experiencing increased metabolic activity, such as during exercise or in inflammatory states. As a result, hemoglobin releases oxygen more readily, which satisfies the heightened metabolic demands of the tissues. While the other options touch on important relationships within gas transport and metabolism, they do not accurately describe the primary effect of a rightward shift on the delivery of oxygen to tissues. Increased oxygen affinity would suggest a leftward shift, decreased oxygen solubility pertains to the complete oxygen content in the blood and does not directly relate to how hemoglobin interacts with oxygen, and decreased oxygen demand is not a consequence of this shift, but rather a separate physiological consideration.

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