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Pulmonology

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Answer 50 questions in 15 minutes.
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1. Bronchial breath sounds
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Saturated with oxygen or unsaturated
Lung volumes - but find it difficult to exhale rapidly
Inspiration

2. office-based spirometry is recommended for patients as young as
70%
5 years - to detect obstruction and determine its reversibility
Pulse oximetry
Expiratory volume - and there is a prolonged expiratory time

3. Factors that influence the oxygen carrying capacity of hemoglobin
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

4. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Left upper lobe
A good effort
Expiratory volume - and there is a prolonged expiratory time
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

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

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6. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Partial pressure of oxygen in the alveoli
Either inspiration or expiration
Spirometry
Inspiration

7. Resistance is dependent upon
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Speed of airflow - the higher the flow - the greater the resistance
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

8. The tracheo-bronchial tree is a tubular system that provides a pathway for
Dyspnea upon assuming a recumbent position
Diaphragm and the intercostal muscles
Air to move from the upper airway to the farthest alveolar reaches
'scooped out' or bowl-shaped

9. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Diffusion
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
right

10. Bronchophony
Binding of O2 to Hb
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
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
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

11. FIO2
The total amount of air that can be exhaled following a maximal inhalation
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Fraction (%age) of inspired oxygen
Expiration

12. HCO3
Diffusion
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Narrowed nearly to the point of closure
Bicarbonate

13. Spirometry: The result is stated as
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
right
Lung volumes - but find it difficult to exhale rapidly

14. Cyanosis appears when
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
respiration
Tongue
right & left

15. Fine crackles are heard in
Diaphragm and the intercostal muscles
80%
Interstitial diseases or early pulmonary edema
Mouth as well as through the chest wall

16. The acini consist of the...
The total amount of air that can be exhaled following a maximal inhalation
Inspiration
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Right

17. The trachea divides into
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
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 and left mainstem bronchi
There is an inverse relationship between pressure and volume

18. Carbon dioxide moves from the...
Larger airways
Blood to the alveoli
Insufficient oxygenation of hemoglobin in the lungs
Decreased Hb-O2 affinity

19. 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
Outer surface of each lung
Lung volumes - but find it difficult to exhale rapidly
Obstructive lung disease from restrictive lung disease

20. Rhonchi occur during
release of O2 from Hb
70% occlusion of the airway
'scooped out' or bowl-shaped
Either inspiration or expiration

21. within limits - increased temperature =
release of O2 from Hb - as heat is a by-product of metabolism.
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Expiratory volume - and there is a prolonged expiratory time
No

22. Late inspiratory crackles result from
right & left
70% occlusion of the airway
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Increase the intrathoracic space

23. vital capacity (VC)
The total amount of air in the lungs at the end of a maximal inhalation
The total amount of air that can be exhaled following a maximal inhalation
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
70%

24. gas exchange across the alveolar-pulmonary capillary membranes
10 to 11 cm long and about 2 cm in diameter
Diffusion
Mouth as well as through the chest wall
Lung volumes - but no difficulty or delay in exhaling what volume they do have

25. The external intercostal muscles increase the antero-posterior chest diameter during
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The negative logarithm of hydrogen ions in the blood
Inspiration
Wheezes - high-pitched - musical sounds - distinct whistling quality

26. Which bronchus is wider - shorter - and more vertically placed?
right and left mainstem bronchi
Right
The right middle lobe
Larger airways

27. Orthopnea is quantified by
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Obstruction below the vocal cords (subglottic or tracheal obstruction)
80%

28. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
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

29. The muscles of inspiration are the...
Blue or bluish-gray discoloration of the skin or mucous membranes
Inspiration
Diaphragm - External Intercostals
Increase the intrathoracic space

30. The primary muscles of respiration are the...
500 to 800 mL
Diaphragm and the intercostal muscles
Manubrio-sternal junction (angle of Louis)
Overcome some of the problems associated with low blood flow to the probe site

31. Normal range of PaCO2
35 to 45 mmHg
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
No

32. Which lung has an oblique fissure?
Decreased Hb-O2 affinity
Insufficient oxygenation of hemoglobin in the lungs
Nitrogen
right & left

33. tidal volume (Vt)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Ventilation - Diffusion - Perfusion
Hypoventilation or modest changes in the PaO2
release of O2 from Hb - as heat is a by-product of metabolism.

34. Oximetry readings of < 94%
require supplemental oxygenation and possibly ABG analysis
Mouth as well as through the chest wall
Spirometry
Decreased pressure

35. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
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
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

36. Stridor is a high-pitched - noisy respiration - Which is indicative of...
release of O2 from Hb - as heat is a by-product of metabolism.
Upper respiratory obstruction - usually in the trachea or larynx
Soft - high-pitched and crisp
Functional residual capacity (FRC)

37. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Perfusion
To assess response to treatment
PaCO2

38. Cyanosis
Air-filled - fluid-filled - or solid
Blue or bluish-gray discoloration of the skin or mucous membranes
Either continuous or discontinuous
70% occlusion of the airway

39. The internal intercostals decrease the transverse diameter of the chest during
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Significant pulmonary impairment
Expiration
Alveoli to the blood

40. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
Saturated with oxygen or unsaturated
Total lung capacity (TLC)
Altering the respiratory rate and/or the tidal volume

41. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Increased Hb-O2 affinity
Excessive secretions and abnormal airway collapsibility
Normal to increased FEV1%
Mediastinum

42. 78.08% Atmospheric Composition
The gas in the conducting airways does not participate in alveolar exchange
Nitrogen
Inspiration
Lung volumes - but no difficulty or delay in exhaling what volume they do have

43. Bohr Effect of pH is graphed as
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Oxygen-Hemoglobin Dissociation Curve
A reduction in lung capacity - secondary to scarring or extraneous material

44. Peripheral cyanosis results from
Inflammation of the adjacent parietal pleura
Bicarbonate
Narrowed nearly to the point of closure
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

45. Apnea is defined as
quickly - usually reaching a plateau within 6.0 seconds
Larger airways
No respiration for > 20 seconds
Lowered carbon dioxide level - results from hyperventilation

46. forced vital capacity (FVC)
Spirometry
The atmospheric pressure
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Sternocleidomastoid - Scalene Muscles

47. Obstructive disease refers to...
Bronchospasm - mucosal edema - or excessive secretions
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Normal to increased FEV1%
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

48. Which bronchus is more susceptible to aspiration of foreign bodies?
Right
Blood to the alveoli
Upper respiratory obstruction - usually in the trachea or larynx
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

49. expiratory reserve
Overcome some of the problems associated with low blood flow to the probe site
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
The amount of air that can be exhaled after expiration
The atmospheric pressure

50. Tachypnea is an
Ventilation
Upper respiratory obstruction - usually in the trachea or larynx
The amount of air that can be exhaled after expiration
Increased rate of breathing and is commonly associated with a decrease in tidal volume

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Pulmonology

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