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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. increased volume results in
release of O2 from Hb
Decreased pressure
Pressure required to drive air through the airways
results in a lower than normal FEV1%

2. The trachea divides into
Overcome some of the problems associated with low blood flow to the probe site
right and left mainstem bronchi
Oxygen (O2)
Outer surface of each lung

3. FEV1/FVC
release of O2 from Hb
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Air-filled - fluid-filled - or solid
The examiner can clearly distinguish the word that the pt speak or whispers

4. The upper airway accounts For what % of airway resistance?
50%
Upper respiratory obstruction - usually in the trachea or larynx
Contracts
Functional residual capacity (FRC)

5. forced vital capacity (FVC)
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Increased Hb-O2 affinity
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Tongue

6. Spirometry is useful in distinguishing
The negative logarithm of hydrogen ions in the blood
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Obstructive lung disease from restrictive lung disease
The right middle lobe

7. Airway resistance refers to...
Increased amounts of unsaturated hemoglobin in capillary blood
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Pressure required to drive air through the airways

8. The most reliable site for detecting central cyanosis is the...
PaCO2
Obstructive lung disease from restrictive lung disease
Diffusion
Tongue

9. Rhonchi
Perfusion
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Speed of airflow - the higher the flow - the greater the resistance
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

10. PaCO2
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Partial pressure of oxygen in the alveoli
Oxygen-Hemoglobin Dissociation Curve
Partial pressure of CO2 in the arterial blood

11. Obstructive Disease: Expiratory airflow is reduced more than
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Excessive secretions and abnormal airway collapsibility
Expiratory volume - and there is a prolonged expiratory time
Decreased pressure

12. Restrictive Disease: Expiratory volume is reduced more than
Increased amounts of unsaturated hemoglobin in capillary blood
Air to move from the upper airway to the farthest alveolar reaches
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Expiratory volume - and there is a prolonged expiratory time

13. Vesicular breath sounds
Heard over the periphery of the lung - are soft - low-pitched sounds - heard throughout inspiration - continue without pause through expiration - fade away about one third of the way through expiration
Pleural space
release of O2 from Hb - as heat is a by-product of metabolism.
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

14. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
Increased minute volume ventilation - which results in a lowered carbon dioxide level
require supplemental oxygenation and possibly ABG analysis
Difficulty breathing or shortness of breath

15. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
release of O2 from Hb
Pneumonia - obstructive lung disease - and late pulmonary edema
Inside of the thoracic cavity wall and the upper surface of the diaphragm

16. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
No
'adventitious' breath sounds
The atmospheric pressure
Ventilation

17. hypocapnia
Lowered carbon dioxide level - results from hyperventilation
Interstitial diseases or early pulmonary edema
Bicarbonate
right and left mainstem bronchi

18. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A sensor placed over a translucent area of arterial pulsation
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Diffusion

19. Cyanosis is caused by
Larger airways
Increased amounts of unsaturated hemoglobin in capillary blood
Lowered carbon dioxide level - results from hyperventilation
Air bubbles flowing through secretions or slightly closed airways during respiration

20. Continuous lung sounds often audible at the...
Brief - discrete - non-musical sounds with a popping quality
Blue or bluish-gray discoloration of the skin or mucous membranes
Mouth as well as through the chest wall
80%

21. Cyanosis
Pneumonia - obstructive lung disease - and late pulmonary edema
The negative logarithm of hydrogen ions in the blood
Functional residual capacity (FRC)
Blue or bluish-gray discoloration of the skin or mucous membranes

22. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
The amount of air that can be exhaled after expiration
Saturated with oxygen or unsaturated
Immediate oxygenation with or without intubation
Elasticity of the lung - reflects a measure of the ease of its distension - or the volume change resulting from the application of a pressure differential

23. forced expiratory volume in one second (FEV1)
A reliable and consistent classification of auditory findings
Outer surface of each lung
The volume of air that is forcefully expired during the first second after a deep breath - or the portion of the FVC exhaled in one second
To assess response to treatment

24. PaO2
No
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Partial pressure of O2 in the arterial blood
Left upper lobe

25. Discontinuous lung sounds are also called

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26. Bohr Effect of pH is graphed as
T4 or T5 - and just below the manubrio-sternal joint
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Oxygen-Hemoglobin Dissociation Curve
Functional residual capacity (FRC)

27. PACO2
Oxygen (O2)
Partial pressure of carbon dioxide in the alveoli
A sensor placed over a translucent area of arterial pulsation
The gas in the conducting airways does not participate in alveolar exchange

28. The parietal pleura lines the...
Inside of the thoracic cavity wall and the upper surface of the diaphragm
The right middle lobe
Blood to the alveoli
Total lung capacity (TLC)

29. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
right
Carboxyhemoglobin
10 to 11 cm long and about 2 cm in diameter
Right

30. The vital capacity and the residual volume together constitute the...
Observing the pattern of breathing
Increased amounts of unsaturated hemoglobin in capillary blood
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Total lung capacity (TLC)

31. Bronchophony
To assess response to treatment
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
'scooped out' or bowl-shaped
While ascultating remote from the bronchi & larynx - the examiner can hear the speaking pts laryngeal (bronchial) sounds - while not being able to distinguish the words

32. within limits - increased temperature =
release of O2 from Hb - as heat is a by-product of metabolism.
50%
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Diaphragm - External Intercostals

33. The presence of pressure gradients causes respiratory gases to move from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
No
Mediastinum
PaCO2

34. Typically - in the presence of obstructive disease - the flow-volume curve looks

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35. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Brief - discrete - non-musical sounds with a popping quality
Increase the intrathoracic space
The total amount of air that can be exhaled following a maximal inhalation
5 years - to detect obstruction and determine its reversibility

36. Bohr Effect of pH: left shift
Manubrio-sternal junction (angle of Louis)
Normal to increased FEV1%
Functional residual capacity (FRC)
Increased Hb-O2 affinity

37. Cyanosis appears when
Functional residual capacity (FRC)
Total lung capacity (TLC)
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
No

38. inspiratory reserve
Louder - lower-pitched - and slightly longer in duration
reduced in size - compared with a normal curve - due to lower lung volume
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The amount of air that can be inhaled after normal inspiration

39. Which bronchus is more susceptible to aspiration of foreign bodies?
Inflammation of the adjacent parietal pleura
Ventilation - Diffusion - Perfusion
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Right

40. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Perfusion
Inflammation of the adjacent parietal pleura
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

41. Rhonchi occur during
Lung volumes - but find it difficult to exhale rapidly
The total amount of air that can be exhaled following a maximal inhalation
Either inspiration or expiration
Sternocleidomastoid - Scalene Muscles

42. Bronchiovesicular breath sounds
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Immediate oxygenation with or without intubation
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Pulse oximetry

43. Pectoriloquy
Ventilation - Diffusion - Perfusion
The examiner can clearly distinguish the word that the pt speak or whispers
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
release of O2 from Hb

44. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Left upper lobe
The gas in the conducting airways does not participate in alveolar exchange
Spirometry
Increased rate of breathing and is commonly associated with a decrease in tidal volume

45. What is the potential space between the visceral and parietal pleurae?
Expiratory volume - and there is a prolonged expiratory time
Pleural space
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Heard over the periphery of the lung - are soft - low-pitched sounds - heard throughout inspiration - continue without pause through expiration - fade away about one third of the way through expiration

46. Orthopnea is defined as
Narrowed nearly to the point of closure
require supplemental oxygenation and possibly ABG analysis
Dyspnea upon assuming a recumbent position
results in a lower than normal FEV1%

47. Fine crackles are...
Soft - high-pitched and crisp
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Total lung capacity (TLC)

48. Resistance is dependent upon
right
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
The rib above it
Speed of airflow - the higher the flow - the greater the resistance

49. Respiration involves
Perfusion
Ventilation - Diffusion - Perfusion
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
A reduction in lung capacity - secondary to scarring or extraneous material

50. Continuous lung sounds occur during...
There is an inverse relationship between pressure and volume
Either inspiration or expiration
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
quickly - usually reaching a plateau within 6.0 seconds