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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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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. Fine crackles are...
Soft - high-pitched and crisp
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
10 to 11 cm long and about 2 cm in diameter
Lung volumes - but no difficulty or delay in exhaling what volume they do have

2. Which bronchus is more susceptible to aspiration of foreign bodies?
release of O2 from Hb - as heat is a by-product of metabolism.
Right
Mediastinum
respiration

3. increased volume results in
Increase the intrathoracic space
Dyspnea upon assuming a recumbent position
Decreased pressure
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

4. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Mediastinum
'scooped out' or bowl-shaped
The gas in the conducting airways does not participate in alveolar exchange
Interstitial diseases or early pulmonary edema

5. Abnormal lung sounds are classified as
Either continuous or discontinuous
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
35 to 45 mmHg

6. The main bronchi are divided into smaller branches that begin to subdivide into
The total amount of air that can be exhaled following a maximal inhalation
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Increased Hb-O2 affinity

7. Does lung tissue have pain fibers?
No
Expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Obstruction below the vocal cords (subglottic or tracheal obstruction)

8. FIO2
Fraction (%age) of inspired oxygen
Pressure required to drive air through the airways
Speed of airflow - the higher the flow - the greater the resistance
A tracing of the lung volume against time in seconds

9. vital capacity (VC)
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
The total amount of air that can be exhaled following a maximal inhalation
Pulse oximetry
Normal to increased FEV1%

10. Obstructive disease refers to...
Portable antero-posterior (AP) view
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Insufficient oxygenation of hemoglobin in the lungs
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

11. FEV1% in obstructive disease
Diaphragm and the intercostal muscles
quickly - usually reaching a plateau within 6.0 seconds
results in a lower than normal FEV1%
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

12. within limits - increased temperature =
Obstructive lung disease from restrictive lung disease
release of O2 from Hb - as heat is a by-product of metabolism.
right and left mainstem bronchi
results in a lower than normal FEV1%

13. The external intercostal muscles increase the antero-posterior chest diameter during
A reliable and consistent classification of auditory findings
Inspiration
Air bubbles flowing through secretions or slightly closed airways during respiration
Either continuous or discontinuous

14. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Oxygen-Hemoglobin Dissociation Curve
Dullness replaces resonance

15. Oximetry readings of < 94%
require supplemental oxygenation and possibly ABG analysis
Expiration
Cough
Partial pressure of CO2 in the arterial blood

16. At rest - the use of accessory muscles is a sign of...
Pressure required to drive air through the airways
Either continuous or discontinuous
Significant pulmonary impairment
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

17. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Blood to the alveoli
Partial pressure of CO2 in the arterial blood
quickly - usually reaching a plateau within 6.0 seconds
respiration

18. forced expiratory volume in one second (FEV1)
Nitrogen
Inflammation of the adjacent parietal pleura
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

19. Orthopnea is defined as
Dyspnea upon assuming a recumbent position
Right
A good effort
Excessive secretions and abnormal airway collapsibility

20. Inspiratory stridor indicates
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Upper respiratory obstruction - usually in the trachea or larynx
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Perfusion

21. Stridor is a high-pitched - noisy respiration - Which is indicative of...
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
Decreased pressure
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Upper respiratory obstruction - usually in the trachea or larynx

22. Factors that influence the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Partial pressure of carbon dioxide in the alveoli
Sternocleidomastoid - Scalene Muscles
'crackles' or 'rales'

23. Continuous lung sounds occur during...
Pressure required to drive air through the airways
The total amount of air in the lungs at the end of a maximal inhalation
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

24. terminal respiratory unit
The right middle lobe
Acinus
Tongue
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

25. The pattern of breathing refers to...
70% occlusion of the airway
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Dullness replaces resonance

26. pH
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Decreased pressure
The negative logarithm of hydrogen ions in the blood

27. The trachea divides into
right and left mainstem bronchi
Dullness replaces resonance
right & left
Brief - discrete - non-musical sounds with a popping quality

28. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Right
Significant pulmonary impairment
Total lung capacity (TLC)
Spirometry

29. high CO2 = high acidity =
release of O2 from Hb
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Difficulty breathing or shortness of breath
The negative logarithm of hydrogen ions in the blood

30. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The atmospheric pressure
reduced in size - compared with a normal curve - due to lower lung volume
Partial pressure of oxygen in the alveoli
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

31. total lung capacity (TLC)
A reduction in lung capacity - secondary to scarring or extraneous material
The examiner can clearly distinguish the word that the pt speak or whispers
The total amount of air in the lungs at the end of a maximal inhalation
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

32. Continuous lung sounds occur when air flows rapidly through bronchi that are...
70% occlusion of the airway
Narrowed nearly to the point of closure
Bicarbonate
No respiration for > 20 seconds

33. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
Overcome some of the problems associated with low blood flow to the probe site
5 years - to detect obstruction and determine its reversibility
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

34. Inspiratory stridor becomes evident at about
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Bicarbonate
70% occlusion of the airway
reduced in size - compared with a normal curve - due to lower lung volume

35. Restrictive disease refers to...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Insufficient oxygenation of hemoglobin in the lungs
A reduction in lung capacity - secondary to scarring or extraneous material
respiration

36. What occurs passively as muscles relax?
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Expiration
Postero-anterior (PA) and lateral view series
The amount of air that can be inhaled after normal inspiration

37. The parietal pleura lines the...
'scooped out' or bowl-shaped
Inside of the thoracic cavity wall and the upper surface of the diaphragm
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Dyspnea that awakens the patient several hours after going to sleep

38. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Either continuous or discontinuous
T4 or T5 - and just below the manubrio-sternal joint
Nitrogen
A sensor placed over a translucent area of arterial pulsation

39. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Either continuous or discontinuous
Immediate oxygenation with or without intubation
Pneumonia - obstructive lung disease - and late pulmonary edema
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

40. Spirometry: The result is stated as
Louder - lower-pitched - and slightly longer in duration
Lung volumes - but find it difficult to exhale rapidly
The right middle lobe
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

41. Spirometry plots
A tracing of the lung volume against time in seconds
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Oxygen (O2)
Inside of the thoracic cavity wall and the upper surface of the diaphragm

42. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Inspiration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

43. What is the potential space between the visceral and parietal pleurae?
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Dyspnea that awakens the patient several hours after going to sleep
Pleural space
Normal to increased FEV1%

44. Discontinuous lung sounds are...
The negative logarithm of hydrogen ions in the blood
release of O2 from Hb
Oxygen-Hemoglobin Dissociation Curve
Brief - discrete - non-musical sounds with a popping quality

45. FEV1% in restrictive disease
Perfusion
A reliable and consistent classification of auditory findings
Normal to increased FEV1%
Binding of O2 to Hb

46. 78.08% Atmospheric Composition
Nitrogen
Dyspnea upon assuming a recumbent position
Insufficient oxygenation of hemoglobin in the lungs
respiration

47. 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
Diffusion
Pulse oximetry
'scooped out' or bowl-shaped
No respiration for > 20 seconds

48. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
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
Functional residual capacity (FRC)

49. Discontinuous lung sounds are also called

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50. residual volume
Larger airways
Postero-anterior (PA) and lateral view series
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
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