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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. Which bronchus is more susceptible to aspiration of foreign bodies?
The amount of air that can be exhaled after expiration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Right
Increased minute volume ventilation - which results in a lowered carbon dioxide level

2. Spirometry normal range
Tongue
The total amount of air in the lungs at the end of a maximal inhalation
80 to 120% of predicted value
Pulse oximetry

3. Spirometry plots
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Obstructive lung disease from restrictive lung disease
A tracing of the lung volume against time in seconds
Partial pressure of carbon dioxide in the alveoli

4. Orthopnea is quantified by
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Mouth as well as through the chest wall
reduced in size - compared with a normal curve - due to lower lung volume
Expiration

5. Rhonchi occur during
Either inspiration or expiration
The negative logarithm of hydrogen ions in the blood
A tracing of the lung volume against time in seconds
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

6. FIO2
The amount of air that can be inhaled after normal inspiration
Dyspnea upon assuming a recumbent position
Fraction (%age) of inspired oxygen
Spirometry

7. The active movement of gases between the ambient air and the lungs
Increased amounts of unsaturated hemoglobin in capillary blood
There is an inverse relationship between pressure and volume
The examiner can clearly distinguish the word that the pt speak or whispers
Ventilation

8. FEV1% in restrictive disease
Upper respiratory obstruction - usually in the trachea or larynx
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Normal to increased FEV1%

9. high CO2 = high acidity =
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
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
release of O2 from Hb

10. PaCO2
Partial pressure of CO2 in the arterial blood
Air-filled - fluid-filled - or solid
Right
Increased minute volume ventilation - which results in a lowered carbon dioxide level

11. Spirometry: The result is stated as
require supplemental oxygenation and possibly ABG analysis
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
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

12. Airway resistance refers to...
Pressure required to drive air through the airways
Left upper lobe
PaCO2
Perfusion

13. Abnormal lung sounds AKA

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14. Inspiratory stridor becomes evident at about
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
70% occlusion of the airway
'adventitious' breath sounds

15. expiratory reserve
No
Dyspnea that awakens the patient several hours after going to sleep
The amount of air that can be exhaled after expiration
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

16. Bohr Effect of pH is graphed as
Partial pressure of oxygen (PO2)
Insufficient oxygenation of hemoglobin in the lungs
Partial pressure of oxygen in the alveoli
Oxygen-Hemoglobin Dissociation Curve

17. Bohr Effect of pH: left shift
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
Perfusion
Increased Hb-O2 affinity
Increased rate of breathing and is commonly associated with a decrease in tidal volume

18. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
The amount of air that can be exhaled after expiration
Inspiration
Brief - discrete - non-musical sounds with a popping quality
Dullness replaces resonance

19. Continuous lung sounds occur in the setting of...
Increased minute volume ventilation - which results in a lowered carbon dioxide level
80 to 120% of predicted value
Bronchospasm - mucosal edema - or excessive secretions
Pressure required to drive air through the airways

20. the lingula is analogous to...
Air-filled - fluid-filled - or solid
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Diaphragm - External Intercostals
The right middle lobe

21. tidal volume (Vt)
Expiration
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
There is an inverse relationship between pressure and volume
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

22. The trachea divides into
Obstructive lung disease from restrictive lung disease
Significant pulmonary impairment
70% occlusion of the airway
right and left mainstem bronchi

23. HCO3
Bicarbonate
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
70%
Saturated with oxygen or unsaturated

24. The presence of pressure gradients causes respiratory gases to move from
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
A tracing of the lung volume against time in seconds
Bicarbonate
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

25. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
No respiration for > 20 seconds
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
'scooped out' or bowl-shaped
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

26. Continuous lung sounds
Narrowed nearly to the point of closure
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Hypoventilation or modest changes in the PaO2
Wheezes - high-pitched - musical sounds - distinct whistling quality

27. Auscultation of the chest depends on...
A reliable and consistent classification of auditory findings
There is an inverse relationship between pressure and volume
respiration
Increased rate of breathing and is commonly associated with a decrease in tidal volume

28. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Perfusion
Increased amounts of unsaturated hemoglobin in capillary blood
Air to move from the upper airway to the farthest alveolar reaches

29. Normal range of PaCO2
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Either continuous or discontinuous
35 to 45 mmHg
Tongue

30. Bronchiovesicular breath sounds
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Partial pressure of CO2 in the arterial blood
Either continuous or discontinuous
Partial pressure of oxygen (PO2)

31. Rhonchi frequently clear after
release of O2 from Hb
Cough
Outer surface of each lung
right and left mainstem bronchi

32. Egophony

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33. Oximetry readings of < 94%
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
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
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
require supplemental oxygenation and possibly ABG analysis

34. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
80 to 120% of predicted value
right and left mainstem bronchi
The amount of air that can be exhaled after expiration
The atmospheric pressure

35. Hyperventilation is defined as
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Increased minute volume ventilation - which results in a lowered carbon dioxide level
release of O2 from Hb - as heat is a by-product of metabolism.

36. Orthopnea is defined as
Partial pressure of oxygen in the alveoli
Dyspnea upon assuming a recumbent position
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Perfusion

37. Central cyanosis results from
Insufficient oxygenation of hemoglobin in the lungs
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Either inspiration or expiration
Increased amounts of unsaturated hemoglobin in capillary blood

38. Bohr Effect of pH: right shift
Decreased Hb-O2 affinity
respiration
The examiner can clearly distinguish the word that the pt speak or whispers
80 to 120% of predicted value

39. The spirometry printout usually includes

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40. The best indicator of adequate ventilation is the...
Insufficient oxygenation of hemoglobin in the lungs
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Saturated with oxygen or unsaturated
PaCO2

41. PaO2
Blood to the alveoli
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Partial pressure of O2 in the arterial blood
Perfusion

42. Spirometry can be used to determine the severity of functional impairment as well as
The examiner can clearly distinguish the word that the pt speak or whispers
To assess response to treatment
Excessive secretions and abnormal airway collapsibility
require supplemental oxygenation and possibly ABG analysis

43. Discontinuous lung sounds are also called

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44. What may prevent cyanosis from appearing?
Air to move from the upper airway to the farthest alveolar reaches
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Pulse oximetry
'crackles' or 'rales'

45. During inspiration the diaphragm
Speed of airflow - the higher the flow - the greater the resistance
Contracts
Ventilation - Diffusion - Perfusion
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

46. FEV1/FVC
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Partial pressure of carbon dioxide in the alveoli
Postero-anterior (PA) and lateral view series
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

47. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Increase the intrathoracic space
Spirometry
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

48. The internal intercostals decrease the transverse diameter of the chest during
Expiration
Saturated with oxygen or unsaturated
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Lung volumes - but no difficulty or delay in exhaling what volume they do have

49. Rhonchi
Outer surface of each lung
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Dullness replaces resonance
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

50. Pulmonary ventilation is varied by
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Altering the respiratory rate and/or the tidal volume
Upper respiratory obstruction - usually in the trachea or larynx
2 - each wavelength is partially absorbed by hemoglobin