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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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. What may prevent cyanosis from appearing?
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Speed of airflow - the higher the flow - the greater the resistance

2. The normal FEV1 /FVC ratio is...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
70%
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
Manubrio-sternal junction (angle of Louis)

3. At rest - the use of accessory muscles is a sign of...
Nitrogen
Significant pulmonary impairment
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Air to move from the upper airway to the farthest alveolar reaches

4. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Pleural space
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Manubrio-sternal junction (angle of Louis)
Insufficient oxygenation of hemoglobin in the lungs

5. A state-of-the-art - inexpensive - non-invasive - simple method to monitor a patient's percent hemoglobin saturation with oxygen (SaO2) - without having to obtain an arterial blood specimen
Pulse oximetry
The examiner can clearly distinguish the word that the pt speak or whispers
Contracts
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

6. Apnea is defined as
Partial pressure of oxygen in the alveoli
No respiration for > 20 seconds
Tongue
Hypoventilation or modest changes in the PaO2

7. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Upper respiratory obstruction - usually in the trachea or larynx
Narrowed nearly to the point of closure
Dyspnea upon assuming a recumbent position
Expiration

8. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Tongue
Lung volumes - but no difficulty or delay in exhaling what volume they do have
To assess response to treatment
Perfusion

9. Obstructive Disease: Expiratory airflow is reduced more than
The gas in the conducting airways does not participate in alveolar exchange
Air bubbles flowing through secretions or slightly closed airways during respiration
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Expiratory volume - and there is a prolonged expiratory time

10. Bohr Effect of pH: right shift
Binding of O2 to Hb
Partial pressure of O2 in the arterial blood
Decreased Hb-O2 affinity
Inspiration

11. Rhonchi originate in the...
Larger airways
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Excessive secretions and abnormal airway collapsibility
To assess response to treatment

12. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Upper respiratory obstruction - usually in the trachea or larynx
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
The examiner can clearly distinguish the word that the pt speak or whispers
2 - each wavelength is partially absorbed by hemoglobin

13. Discontinuous lung sounds are also called

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14. Abnormal lung sounds are classified as
Narrowed nearly to the point of closure
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Either continuous or discontinuous
Obstruction below the vocal cords (subglottic or tracheal obstruction)

15. Oximetry readings of < 94%
Sternocleidomastoid - Scalene Muscles
require supplemental oxygenation and possibly ABG analysis
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Increased minute volume ventilation - which results in a lowered carbon dioxide level

16. Orthopnea is defined as
Left upper lobe
Blue or bluish-gray discoloration of the skin or mucous membranes
Dyspnea upon assuming a recumbent position
Inside of the thoracic cavity wall and the upper surface of the diaphragm

17. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiration
Obstructive lung disease from restrictive lung disease
Carboxyhemoglobin
Bronchospasm - mucosal edema - or excessive secretions

18. Cyanosis appears when
Expiration
Ventilation - Diffusion - Perfusion
50%
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

19. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Diaphragm and the intercostal muscles
Soft - high-pitched and crisp
Manubrio-sternal junction (angle of Louis)
Inspiration

20. office-based spirometry is recommended for patients as young as
Increase the intrathoracic space
Difficulty breathing or shortness of breath
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
5 years - to detect obstruction and determine its reversibility

21. With restrictive disease - the flow-volume curve is...
Normal to increased FEV1%
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
reduced in size - compared with a normal curve - due to lower lung volume
70%

22. Auscultation of the chest depends on...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
A reliable and consistent classification of auditory findings
Immediate oxygenation with or without intubation
Expiration

23. Resistance is dependent upon
Air bubbles flowing through secretions or slightly closed airways during respiration
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
The amount of air that can be exhaled after expiration
Speed of airflow - the higher the flow - the greater the resistance

24. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
release of O2 from Hb - as heat is a by-product of metabolism.
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
35 to 45 mmHg

25. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
right
Partial pressure of O2 in the arterial blood
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Diffusion

26. dead space ventilation
The gas in the conducting airways does not participate in alveolar exchange
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Oxygen (O2)
Pulse oximetry

27. Cyanosis is caused by
Mediastinum
Increased amounts of unsaturated hemoglobin in capillary blood
Expiratory volume - and there is a prolonged expiratory time
Spirometry

28. Patients with restrictive disease have low
Lung volumes - but no difficulty or delay in exhaling what volume they do have
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Inflammation of the adjacent parietal pleura
Partial pressure of oxygen (PO2)

29. Peripheral cyanosis results from
right
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Bicarbonate
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

30. low CO2 = low acidity =
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Binding of O2 to Hb
Inflammation of the adjacent parietal pleura
Air to move from the upper airway to the farthest alveolar reaches

31. Percussion helps you establish whether the underlying tissues are...
A sensor placed over a translucent area of arterial pulsation
Air-filled - fluid-filled - or solid
Obstructive lung disease from restrictive lung disease
Carboxyhemoglobin

32. Tachypnea is an
The examiner can clearly distinguish the word that the pt speak or whispers
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Increased rate of breathing and is commonly associated with a decrease in tidal volume
80%

33. Rhonchi occur during
Either inspiration or expiration
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
Excessive secretions and abnormal airway collapsibility
There is an inverse relationship between pressure and volume

34. increased volume results in
Carboxyhemoglobin
Decreased pressure
Normal to increased FEV1%
Acinus

35. During inspiration the diaphragm
Louder - lower-pitched - and slightly longer in duration
Contracts
Right
require supplemental oxygenation and possibly ABG analysis

36. Continuous lung sounds occur during...
require supplemental oxygenation and possibly ABG analysis
The amount of air that can be exhaled after expiration
Mouth as well as through the chest wall
Either inspiration or expiration

37. forced vital capacity (FVC)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
A reliable and consistent classification of auditory findings
The amount of air that can be inhaled after normal inspiration
A sensor placed over a translucent area of arterial pulsation

38. Spirometry plots
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Increased amounts of unsaturated hemoglobin in capillary blood
A tracing of the lung volume against time in seconds

39. Cyanosis
Tongue
Blue or bluish-gray discoloration of the skin or mucous membranes
Brief - discrete - non-musical sounds with a popping quality
Increased rate of breathing and is commonly associated with a decrease in tidal volume

40. Bohr Effect of pH: left shift
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Alveoli to the blood
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
Increased Hb-O2 affinity

41. The main bronchi are divided into smaller branches that begin to subdivide into
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Postero-anterior (PA) and lateral view series
The amount of air that can be exhaled after expiration
'adventitious' breath sounds

42. Abnormal lung sounds AKA

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43. Orthopnea is quantified by
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
Postero-anterior (PA) and lateral view series
Inspiration
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

44. Continuous lung sounds occur in the setting of...
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
A reliable and consistent classification of auditory findings
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Bronchospasm - mucosal edema - or excessive secretions

45. 78.08% Atmospheric Composition
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
Partial pressure of oxygen in the alveoli
Nitrogen
results in a lower than normal FEV1%

46. Obstructive disease refers to...
No
Hypoventilation or modest changes in the PaO2
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Perfusion

47. 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
Air-filled - fluid-filled - or solid
Outer surface of each lung
Lung volumes - but no difficulty or delay in exhaling what volume they do have

48. Coarse crackles result from
The examiner can clearly distinguish the word that the pt speak or whispers
Pressure required to drive air through the airways
Air bubbles flowing through secretions or slightly closed airways during respiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

49. The acini consist of the...
Mouth as well as through the chest wall
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
right and left mainstem bronchi
Louder - lower-pitched - and slightly longer in duration

50. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Diaphragm - External Intercostals
Bicarbonate
The atmospheric pressure