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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. Rhonchi frequently clear after
Cough
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Increased work of breathing
Ventilation - Diffusion - Perfusion

2. Bohr Effect of pH is graphed as
Carboxyhemoglobin
release of O2 from Hb - as heat is a by-product of metabolism.
The rib above it
Oxygen-Hemoglobin Dissociation Curve

3. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Expiration
500 to 800 mL
Mediastinum
Outer surface of each lung

4. Egophony

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5. normal adult tidal volume
Speed of airflow - the higher the flow - the greater the resistance
Spirometry
respiration
500 to 800 mL

6. movement of blood through the capillaries in direct communication with the alveoli
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
The right middle lobe
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Perfusion

7. Normal lung sounds
The rib above it
Air-filled - fluid-filled - or solid
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

8. Oxygen moves from the...
Alveoli to the blood
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Excessive secretions and abnormal airway collapsibility
70% occlusion of the airway

9. Discontinuous lung sounds are also called

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10. Abnormal lung sounds are classified as
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Sternocleidomastoid - Scalene Muscles
Overcome some of the problems associated with low blood flow to the probe site
Either continuous or discontinuous

11. residual volume
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
The volume of air left in the lungs after maximal expiration that cannot be exhaled due to the limit of elasticity - or because of the trapping of air in disease states
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

12. Fine crackles are heard in
Decreased Hb-O2 affinity
Alveoli to the blood
Air bubbles flowing through secretions or slightly closed airways during respiration
Interstitial diseases or early pulmonary edema

13. Continuous lung sounds
Either inspiration or expiration
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality

14. Examples of obstructive disease
A sensor placed over a translucent area of arterial pulsation
Contracts
results in a lower than normal FEV1%
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

15. FIO2
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Fraction (%age) of inspired oxygen

16. Bohr Effect of pH: left shift
2 - each wavelength is partially absorbed by hemoglobin
500 to 800 mL
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Increased Hb-O2 affinity

17. Expiratory stridor indicates
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Bicarbonate
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
right

18. The active movement of gases between the ambient air and the lungs
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Dyspnea upon assuming a recumbent position
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Ventilation

19. The presence of pressure gradients causes respiratory gases to move from
Louder - lower-pitched - and slightly longer in duration
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
10 to 11 cm long and about 2 cm in diameter
Normal to increased FEV1%

20. During inspiration the diaphragm
Right
Contracts
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Brief - discrete - non-musical sounds with a popping quality

21. The interspace between two ribs (intercostal space) is numbered by
The rib above it
Bicarbonate
reduced in size - compared with a normal curve - due to lower lung volume
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

22. Spirometry plots
Contracts
A tracing of the lung volume against time in seconds
Lung volumes - but find it difficult to exhale rapidly
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

23. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
70%
The examiner can clearly distinguish the word that the pt speak or whispers
Portable antero-posterior (AP) view
Pneumonia - obstructive lung disease - and late pulmonary edema

24. the lingula is analogous to...
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
The right middle lobe
Right
Binding of O2 to Hb

25. Hyperventilation is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Bronchospasm - mucosal edema - or excessive secretions
Ventilation
Partial pressure of CO2 in the arterial blood

26. Inspiratory stridor becomes evident at about
70% occlusion of the airway
2 - each wavelength is partially absorbed by hemoglobin
Speed of airflow - the higher the flow - the greater the resistance
Fraction (%age) of inspired oxygen

27. Continuous lung sounds occur in the setting of...
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Oxygen-Hemoglobin Dissociation Curve
No respiration for > 20 seconds
Bronchospasm - mucosal edema - or excessive secretions

28. A normal volume-time curve rises
Air-filled - fluid-filled - or solid
quickly - usually reaching a plateau within 6.0 seconds
Immediate oxygenation with or without intubation
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

29. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
Inflammation of the adjacent parietal pleura
Inspiration
Overcome some of the problems associated with low blood flow to the probe site

30. The upper airway accounts For what % of airway resistance?
Lung volumes - but find it difficult to exhale rapidly
Fraction (%age) of inspired oxygen
Sternocleidomastoid - Scalene Muscles
50%

31. PACO2
Dullness replaces resonance
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Outer surface of each lung
Partial pressure of carbon dioxide in the alveoli

32. Rhonchi originate in the...
Increase the intrathoracic space
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Immediate oxygenation with or without intubation
Larger airways

33. Rhonchi
Left upper lobe
Soft - high-pitched and crisp
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

34. Continuous lung sounds occur during...
Diffusion
Either inspiration or expiration
Louder - lower-pitched - and slightly longer in duration
Diaphragm - External Intercostals

35. Dyspnea is defined as
Difficulty breathing or shortness of breath
Ventilation - Diffusion - Perfusion
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Decreased pressure

36. The pattern of breathing refers to...
10 to 11 cm long and about 2 cm in diameter
'crackles' or 'rales'
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Inside of the thoracic cavity wall and the upper surface of the diaphragm

37. 78.08% Atmospheric Composition
Soft - high-pitched and crisp
Ventilation
Portable antero-posterior (AP) view
Nitrogen

38. office-based spirometry is recommended for patients as young as
5 years - to detect obstruction and determine its reversibility
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Lowered carbon dioxide level - results from hyperventilation
Contracts

39. Auscultation of the chest depends on...
Dullness replaces resonance
Total lung capacity (TLC)
Lowered carbon dioxide level - results from hyperventilation
A reliable and consistent classification of auditory findings

40. Orthopnea is defined as
quickly - usually reaching a plateau within 6.0 seconds
Dyspnea upon assuming a recumbent position
10 to 11 cm long and about 2 cm in diameter
Increased amounts of unsaturated hemoglobin in capillary blood

41. pH
Contracts
Partial pressure of oxygen in the alveoli
Hypoventilation or modest changes in the PaO2
The negative logarithm of hydrogen ions in the blood

42. Tachypnea is an
Air to move from the upper airway to the farthest alveolar reaches
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Blood to the alveoli
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

43. Peripheral cyanosis results from
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
50%
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Decreased Hb-O2 affinity

44. Factors that influence the oxygen carrying capacity of hemoglobin
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
500 to 800 mL
Expiration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

45. high CO2 = high acidity =
release of O2 from Hb
Expiratory volume - and there is a prolonged expiratory time
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
right

46. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Spirometry
Outer surface of each lung
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

47. The main bronchi are divided into smaller branches that begin to subdivide into
Increased work of breathing
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Difficulty breathing or shortness of breath
Cough

48. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Dullness replaces resonance
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
No respiration for > 20 seconds

49. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
Wheezes - high-pitched - musical sounds - distinct whistling quality
Perfusion
No respiration for > 20 seconds

50. The trachea is how long/wide?
right
10 to 11 cm long and about 2 cm in diameter
Left upper lobe
Binding of O2 to Hb