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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. Cyanosis is caused by
Fraction (%age) of inspired oxygen
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Hypoventilation or modest changes in the PaO2
Increased amounts of unsaturated hemoglobin in capillary blood

2. within limits - increased temperature =
Partial pressure of carbon dioxide in the alveoli
release of O2 from Hb - as heat is a by-product of metabolism.
Partial pressure of oxygen (PO2)
respiration

3. The normal FEV1 /FVC ratio is...
Spirometry
Either inspiration or expiration
70%
The total amount of air that can be exhaled following a maximal inhalation

4. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Immediate oxygenation with or without intubation
Perfusion
Brief - discrete - non-musical sounds with a popping quality
A tracing of the lung volume against time in seconds

5. pain in lung conditions usually arises from
Brief - discrete - non-musical sounds with a popping quality
Expiration
Inflammation of the adjacent parietal pleura
Wheezes - high-pitched - musical sounds - distinct whistling quality

6. Airway resistance refers to...
Pressure required to drive air through the airways
The rib above it
Ventilation
To assess response to treatment

7. Abnormal lung sounds AKA

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8. Does lung tissue have pain fibers?
No
'scooped out' or bowl-shaped
release of O2 from Hb - as heat is a by-product of metabolism.
results in a lower than normal FEV1%

9. Pulse Oximetry is dependent on...
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Functional residual capacity (FRC)
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Soft - high-pitched and crisp

10. Late inspiratory crackles result from
right & left
500 to 800 mL
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

11. Discontinuous lung sounds are...
Decreased pressure
respiration
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Brief - discrete - non-musical sounds with a popping quality

12. Chest Radiography: The most common chest X-ray series is the...
Postero-anterior (PA) and lateral view series
Partial pressure of CO2 in the arterial blood
Dullness replaces resonance
quickly - usually reaching a plateau within 6.0 seconds

13. Continuous lung sounds occur during...
A reliable and consistent classification of auditory findings
Ventilation
Either inspiration or expiration
The atmospheric pressure

14. expiratory reserve
Mouth as well as through the chest wall
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
The amount of air that can be exhaled after expiration

15. Dyspnea is defined as
Increased work of breathing
Difficulty breathing or shortness of breath
Altering the respiratory rate and/or the tidal volume
require supplemental oxygenation and possibly ABG analysis

16. Expiratory stridor indicates
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Dyspnea that awakens the patient several hours after going to sleep
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

17. The trachea bifurcates into its mainstem bronchi at the level of...
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
The rib above it
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
A reduction in lung capacity - secondary to scarring or extraneous material

18. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Obstructive lung disease from restrictive lung disease
5 years - to detect obstruction and determine its reversibility
Diffusion
right

19. During inspiration the diaphragm
Partial pressure of CO2 in the arterial blood
Contracts
Diffusion
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

20. HCO3
Either inspiration or expiration
Bicarbonate
Nitrogen
Tongue

21. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Inspiration
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

22. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Mouth as well as through the chest wall
respiration

23. FEV1/FVC
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Excessive secretions and abnormal airway collapsibility
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Speed of airflow - the higher the flow - the greater the resistance

24. Oxygen moves from the...
80 to 120% of predicted value
Alveoli to the blood
Dyspnea upon assuming a recumbent position
Lung volumes - but find it difficult to exhale rapidly

25. Pectoriloquy
Increased amounts of unsaturated hemoglobin in capillary blood
The examiner can clearly distinguish the word that the pt speak or whispers
Total lung capacity (TLC)
right & left

26. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Functional residual capacity (FRC)
Increase the intrathoracic space
Perfusion
Diaphragm and the intercostal muscles

27. The acini consist of the...
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
reduced in size - compared with a normal curve - due to lower lung volume
Dullness replaces resonance
Obstructive lung disease from restrictive lung disease

28. Abnormal lung sounds are classified as
Oxygen-Hemoglobin Dissociation Curve
Louder - lower-pitched - and slightly longer in duration
Either continuous or discontinuous
Increased amounts of unsaturated hemoglobin in capillary blood

29. 20.95% Atmospheric Composition
Oxygen (O2)
Excessive secretions and abnormal airway collapsibility
Altering the respiratory rate and/or the tidal volume
Mediastinum

30. increased volume results in
Partial pressure of CO2 in the arterial blood
Overcome some of the problems associated with low blood flow to the probe site
The right middle lobe
Decreased pressure

31. Continuous lung sounds often audible at the...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Ventilation - Diffusion - Perfusion
Outer surface of each lung
Mouth as well as through the chest wall

32. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Spirometry
Carboxyhemoglobin
Total lung capacity (TLC)
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

33. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Spirometry
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Altering the respiratory rate and/or the tidal volume

34. The tracheo-bronchial tree is a tubular system that provides a pathway for
Perfusion
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Air to move from the upper airway to the farthest alveolar reaches
Decreased pressure

35. Peripheral cyanosis results from
respiration
Upper respiratory obstruction - usually in the trachea or larynx
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Interstitial diseases or early pulmonary edema

36. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Blood to the alveoli
To assess response to treatment
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Manubrio-sternal junction (angle of Louis)

37. Rhonchi originate in the...
require supplemental oxygenation and possibly ABG analysis
Larger airways
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
Inflammation of the adjacent parietal pleura

38. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Left upper lobe
Upper respiratory obstruction - usually in the trachea or larynx
A tracing of the lung volume against time in seconds
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

39. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Expiration
A good effort
Oxygen-Hemoglobin Dissociation Curve
Immediate oxygenation with or without intubation

40. Carbon dioxide moves from the...
Blood to the alveoli
Left upper lobe
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Increase the intrathoracic space

41. FEV1% in restrictive disease
Normal to increased FEV1%
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
reduced in size - compared with a normal curve - due to lower lung volume
Diffusion

42. terminal respiratory unit
Larger airways
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Overcome some of the problems associated with low blood flow to the probe site
Acinus

43. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Blood to the alveoli
There is an inverse relationship between pressure and volume
Altering the respiratory rate and/or the tidal volume

44. Cyanosis appears when
Insufficient oxygenation of hemoglobin in the lungs
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
release of O2 from Hb - as heat is a by-product of metabolism.
Ventilation - Diffusion - Perfusion

45. The muscles of expiration are the...
Altering the respiratory rate and/or the tidal volume
A sensor placed over a translucent area of arterial pulsation
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
A tracing of the lung volume against time in seconds

46. Obstructive disease refers to...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
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
The atmospheric pressure
Right

47. Egophony

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48. The trachea divides into right and left mainstem bronchi At what level?
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
T4 or T5 - and just below the manubrio-sternal joint
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Sternocleidomastoid - Scalene Muscles

49. The external intercostal muscles increase the antero-posterior chest diameter during
Perfusion
Inspiration
Expiration
right and left mainstem bronchi

50. With restrictive disease - the flow-volume curve is...
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
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
The rib above it