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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Vesicular breath sounds
Partial pressure of carbon dioxide in the alveoli
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
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
Sternocleidomastoid - Scalene Muscles

2. HCO3
Ventilation - Diffusion - Perfusion
Outer surface of each lung
Decreased Hb-O2 affinity
Bicarbonate

3. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Altering the respiratory rate and/or the tidal volume
Partial pressure of O2 in the arterial blood
right

4. The muscles of inspiration are the...
35 to 45 mmHg
The gas in the conducting airways does not participate in alveolar exchange
Diaphragm - External Intercostals
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

5. Which bronchus is more susceptible to aspiration of foreign bodies?
release of O2 from Hb - as heat is a by-product of metabolism.
Speed of airflow - the higher the flow - the greater the resistance
Expiration
Right

6. Auscultation of the chest depends on...
Increased work of breathing
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Observing the pattern of breathing
A reliable and consistent classification of auditory findings

7. Spirometry can be used to determine the severity of functional impairment as well as
To assess response to treatment
Partial pressure of oxygen in the alveoli
70%
70% occlusion of the airway

8. Nitroglycerin applied to the probe area has been reported to...
PaCO2
release of O2 from Hb - as heat is a by-product of metabolism.
Inflammation of the adjacent parietal pleura
Overcome some of the problems associated with low blood flow to the probe site

9. Orthopnea is defined as
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Dyspnea upon assuming a recumbent position
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 rate of breathing and is commonly associated with a decrease in tidal volume

10. Continuous lung sounds
require supplemental oxygenation and possibly ABG analysis
Diffusion
Wheezes - high-pitched - musical sounds - distinct whistling quality
Brief - discrete - non-musical sounds with a popping quality

11. Compliance
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
5 years - to detect obstruction and determine its reversibility
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
Either continuous or discontinuous

12. most important factor that influences the oxygen carrying capacity of hemoglobin
A sensor placed over a translucent area of arterial pulsation
Overcome some of the problems associated with low blood flow to the probe site
Partial pressure of oxygen (PO2)
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

13. Cyanosis is caused by
Increased amounts of unsaturated hemoglobin in capillary blood
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
Obstruction below the vocal cords (subglottic or tracheal obstruction)
No

14. Paroxysmal nocturnal dyspnea (PND) is...
The amount of air that can be exhaled after expiration
Dyspnea that awakens the patient several hours after going to sleep
Ventilation - Diffusion - Perfusion
Inspiration

15. Bronchophony
Mediastinum
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Excessive secretions and abnormal airway collapsibility
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

16. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Expiratory volume - and there is a prolonged expiratory time
Air-filled - fluid-filled - or solid
A sensor placed over a translucent area of arterial pulsation

17. Which bronchus is wider - shorter - and more vertically placed?
No respiration for > 20 seconds
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Overcome some of the problems associated with low blood flow to the probe site
Right

18. high CO2 = high acidity =
release of O2 from Hb - as heat is a by-product of metabolism.
The amount of air that can be exhaled after expiration
release of O2 from Hb
Spirometry

19. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
results in a lower than normal FEV1%
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

20. Late inspiratory crackles result from
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Tongue
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

21. Discontinuous lung sounds are...
Diaphragm - External Intercostals
Brief - discrete - non-musical sounds with a popping quality
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
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

22. Expiratory stridor indicates
Saturated with oxygen or unsaturated
The right middle lobe
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The amount of air that can be exhaled after expiration

23. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
respiration
release of O2 from Hb
Pleural space

24. With restrictive disease - the flow-volume curve is...
Expiration
reduced in size - compared with a normal curve - due to lower lung volume
The amount of air that can be inhaled after normal inspiration
Pulse oximetry

25. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Partial pressure of oxygen in the alveoli
Partial pressure of oxygen (PO2)
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Functional residual capacity (FRC)

26. forced vital capacity (FVC)
Left upper lobe
Observing the pattern of breathing
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

27. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Diffusion
Either inspiration or expiration
The gas in the conducting airways does not participate in alveolar exchange

28. Carbon dioxide moves from the...
right
Blood to the alveoli
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

29. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Lung volumes - but find it difficult to exhale rapidly
'scooped out' or bowl-shaped

30. Oxygen moves from the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
There is an inverse relationship between pressure and volume
Air to move from the upper airway to the farthest alveolar reaches
Alveoli to the blood

31. Resistance is dependent upon
80%
Speed of airflow - the higher the flow - the greater the resistance
Hypoventilation or modest changes in the PaO2
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

32. Patients with restrictive disease have low
Lung volumes - but no difficulty or delay in exhaling what volume they do have
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
PaCO2

33. 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
Expiratory volume - and there is a prolonged expiratory time
35 to 45 mmHg
Pulse oximetry
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

34. Pulmonary ventilation is varied by
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
The amount of air that can be exhaled after expiration
Altering the respiratory rate and/or the tidal volume
Alveoli to the blood

35. Chest Radiography: The most common chest X-ray series is the...
Postero-anterior (PA) and lateral view series
Contracts
Functional residual capacity (FRC)
Partial pressure of O2 in the arterial blood

36. The parietal pleura lines the...
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
respiration
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Dullness replaces resonance

37. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The atmospheric pressure
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

38. forced expiratory volume in one second (FEV1)
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
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
Partial pressure of O2 in the arterial blood
'adventitious' breath sounds

39. Abnormal lung sounds AKA

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

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41. What may prevent cyanosis from appearing?
Nitrogen
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
reduced in size - compared with a normal curve - due to lower lung volume
PaCO2

42. Rhonchi occur during
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Either inspiration or expiration
Observing the pattern of breathing
No

43. The interspace between two ribs (intercostal space) is numbered by
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
A good effort
The total amount of air in the lungs at the end of a maximal inhalation
The rib above it

44. The muscles of expiration are the...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Postero-anterior (PA) and lateral view series
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Observing the pattern of breathing

45. Cyanosis appears when
The atmospheric pressure
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Diffusion
Either inspiration or expiration

46. Coarse crackles result from
Perfusion
Air bubbles flowing through secretions or slightly closed airways during respiration
quickly - usually reaching a plateau within 6.0 seconds
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

47. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
2 - each wavelength is partially absorbed by hemoglobin
Oxygen-Hemoglobin Dissociation Curve
Lung volumes - but no difficulty or delay in exhaling what volume they do have

48. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Narrowed nearly to the point of closure
There is an inverse relationship between pressure and volume
Difficulty breathing or shortness of breath
Expiratory volume - and there is a prolonged expiratory time

49. Boyle's Gas Law
Binding of O2 to Hb
Oxygen (O2)
There is an inverse relationship between pressure and volume
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

50. Coarse crackles are...
Perfusion
The amount of air that can be inhaled after normal inspiration
Louder - lower-pitched - and slightly longer in duration
80 to 120% of predicted value