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Pulmonology

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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. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
quickly - usually reaching a plateau within 6.0 seconds
Mediastinum
Cough
Louder - lower-pitched - and slightly longer in duration

2. Bohr Effect of pH: left shift
release of O2 from Hb
Increased Hb-O2 affinity
Insufficient oxygenation of hemoglobin in the lungs
The total amount of air in the lungs at the end of a maximal inhalation

3. Bohr Effect of pH: right shift
Functional residual capacity (FRC)
The rib above it
A tracing of the lung volume against time in seconds
Decreased Hb-O2 affinity

4. Respiration involves
Oxygen (O2)
Diffusion
The right middle lobe
Ventilation - Diffusion - Perfusion

5. movement of blood through the capillaries in direct communication with the alveoli
Dullness replaces resonance
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Outer surface of each lung
Perfusion

6. An efficient approach to examination of the patient begins with
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
To assess response to treatment
Observing the pattern of breathing
Increased work of breathing

7. Carbon dioxide moves from the...
Blood to the alveoli
No
Diffusion
Either inspiration or expiration

8. gas exchange across the alveolar-pulmonary capillary membranes
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Diffusion
Inspiration
A sensor placed over a translucent area of arterial pulsation

9. The tracheo-bronchial tree is a tubular system that provides a pathway for
Immediate oxygenation with or without intubation
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Air to move from the upper airway to the farthest alveolar reaches
right and left mainstem bronchi

10. Expiratory stridor indicates
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Partial pressure of carbon dioxide in the alveoli
Binding of O2 to Hb

11. PACO2
Total lung capacity (TLC)
Partial pressure of carbon dioxide in the alveoli
Altering the respiratory rate and/or the tidal volume
The amount of air that can be exhaled after expiration

12. The acini consist of the...
Increase the intrathoracic space
Air-filled - fluid-filled - or solid
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Observing the pattern of breathing

13. Restrictive Disease: Expiratory volume is reduced more than
Obstructive lung disease from restrictive lung disease
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Brief - discrete - non-musical sounds with a popping quality
Right

14. pH
Obstructive lung disease from restrictive lung disease
Functional residual capacity (FRC)
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The negative logarithm of hydrogen ions in the blood

15. Cyanosis appears when
Bicarbonate
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Ventilation

16. The most reliable site for detecting central cyanosis is the...
Oxygen-Hemoglobin Dissociation Curve
Tongue
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Outer surface of each lung

17. dead space ventilation
80%
The gas in the conducting airways does not participate in alveolar exchange
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Inflammation of the adjacent parietal pleura

18. Late inspiratory crackles result from
The total amount of air that can be exhaled following a maximal inhalation
Increased rate of breathing and is commonly associated with a decrease in tidal volume
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Significant pulmonary impairment

19. HCO3
Bicarbonate
To assess response to treatment
Oxygen-Hemoglobin Dissociation Curve
The examiner can clearly distinguish the word that the pt speak or whispers

20. increased volume results in
Decreased pressure
Diffusion
Overcome some of the problems associated with low blood flow to the probe site
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

21. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Air bubbles flowing through secretions or slightly closed airways during respiration
Immediate oxygenation with or without intubation
Upper respiratory obstruction - usually in the trachea or larynx
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

22. Which lung has an oblique fissure?
The total amount of air in the lungs at the end of a maximal inhalation
right & left
Right
A tracing of the lung volume against time in seconds

23. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
80%
Bicarbonate

24. Factors that influence the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Oxygen (O2)
Dyspnea upon assuming a recumbent position
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

25. Continuous lung sounds occur in the setting of...
Binding of O2 to Hb
Air-filled - fluid-filled - or solid
Speed of airflow - the higher the flow - the greater the resistance
Bronchospasm - mucosal edema - or excessive secretions

26. Which lobe has an inferior tongue-like projection called the lingula?
Speed of airflow - the higher the flow - the greater the resistance
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
The amount of air that can be exhaled after expiration
Left upper lobe

27. Hyperventilation is defined as
Dyspnea that awakens the patient several hours after going to sleep
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
Brief - discrete - non-musical sounds with a popping quality
Increased minute volume ventilation - which results in a lowered carbon dioxide level

28. Does lung tissue have pain fibers?
Total lung capacity (TLC)
No
Pneumonia - obstructive lung disease - and late pulmonary edema
Blue or bluish-gray discoloration of the skin or mucous membranes

29. Egophony

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30. Vesicular breath sounds
Carboxyhemoglobin
reduced in size - compared with a normal curve - due to lower lung volume
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
Pulse oximetry

31. The pattern of breathing refers to...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Insufficient oxygenation of hemoglobin in the lungs
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
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

32. The normal FEV1 /FVC ratio is...
Expiration
'scooped out' or bowl-shaped
70%
Inspiration

33. Compliance
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
No respiration for > 20 seconds
Soft - high-pitched and crisp
10 to 11 cm long and about 2 cm in diameter

34. The trachea divides into
Lowered carbon dioxide level - results from hyperventilation
Spirometry
right & left
right and left mainstem bronchi

35. inspiratory reserve
The negative logarithm of hydrogen ions in the blood
The amount of air that can be inhaled after normal inspiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Difficulty breathing or shortness of breath

36. high CO2 = high acidity =
Right
release of O2 from Hb
Blue or bluish-gray discoloration of the skin or mucous membranes
50%

37. PaO2
Either continuous or discontinuous
Partial pressure of O2 in the arterial blood
Speed of airflow - the higher the flow - the greater the resistance
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

38. Discontinuous lung sounds are...
Perfusion
Dyspnea that awakens the patient several hours after going to sleep
Dullness replaces resonance
Brief - discrete - non-musical sounds with a popping quality

39. Chest Radiography: The most common chest X-ray series is the...
Either inspiration or expiration
Spirometry
Postero-anterior (PA) and lateral view series
respiration

40. Pulmonary ventilation is varied by
The amount of air that can be exhaled after expiration
Altering the respiratory rate and/or the tidal volume
Diaphragm and the intercostal muscles
Dyspnea that awakens the patient several hours after going to sleep

41. normal subjects expel approximately how much of the FVC in the 1st second?
To assess response to treatment
Soft - high-pitched and crisp
80%
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

42. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The atmospheric pressure
The amount of air that can be exhaled after expiration
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
release of O2 from Hb - as heat is a by-product of metabolism.

43. within limits - increased temperature =
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
release of O2 from Hb - as heat is a by-product of metabolism.
Soft - high-pitched and crisp

44. Oxygen moves from the...
Alveoli to the blood
Expiration
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Either inspiration or expiration

45. Bronchial breath sounds
Partial pressure of oxygen in the alveoli
No respiration for > 20 seconds
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

46. expiratory reserve
Normal to increased FEV1%
Bicarbonate
The amount of air that can be exhaled after expiration
10 to 11 cm long and about 2 cm in diameter

47. PAO2
There is an inverse relationship between pressure and volume
Partial pressure of oxygen in the alveoli
Blue or bluish-gray discoloration of the skin or mucous membranes
Postero-anterior (PA) and lateral view series

48. residual volume
A tracing of the lung volume against time in seconds
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
Immediate oxygenation with or without intubation
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

49. Abnormal lung sounds AKA

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50. most important factor that influences the oxygen carrying capacity of hemoglobin
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
70% occlusion of the airway
Postero-anterior (PA) and lateral view series
Partial pressure of oxygen (PO2)

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Pulmonology

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