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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. The visceral pleura lines the...
Outer surface of each lung
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Blood to the alveoli
Increased Hb-O2 affinity

2. Factors that influence the oxygen carrying capacity of hemoglobin
Dyspnea that awakens the patient several hours after going to sleep
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
To assess response to treatment

3. most important factor that influences the oxygen carrying capacity of hemoglobin
results in a lower than normal FEV1%
Increased Hb-O2 affinity
Partial pressure of oxygen (PO2)
Air-filled - fluid-filled - or solid

4. Spirometry is useful in distinguishing
Increase the intrathoracic space
Right
Obstructive lung disease from restrictive lung disease
Inside of the thoracic cavity wall and the upper surface of the diaphragm

5. The parietal pleura lines the...
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Decreased pressure
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Tongue

6. 78.08% Atmospheric Composition
The right middle lobe
Nitrogen
Increased work of breathing
Increased Hb-O2 affinity

7. Which lung has an oblique fissure?
Hypoventilation or modest changes in the PaO2
right & left
80 to 120% of predicted value
Functional residual capacity (FRC)

8. Inspiratory stridor becomes evident at about
Difficulty breathing or shortness of breath
70% occlusion of the airway
80 to 120% of predicted value
'crackles' or 'rales'

9. Resistance is dependent upon
Partial pressure of CO2 in the arterial blood
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Immediate oxygenation with or without intubation
Speed of airflow - the higher the flow - the greater the resistance

10. high CO2 = high acidity =
500 to 800 mL
release of O2 from Hb
Acinus
35 to 45 mmHg

11. An efficient approach to examination of the patient begins with
The negative logarithm of hydrogen ions in the blood
2 - each wavelength is partially absorbed by hemoglobin
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Observing the pattern of breathing

12. pain in lung conditions usually arises from
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
A good effort
Overcome some of the problems associated with low blood flow to the probe site
Inflammation of the adjacent parietal pleura

13. Which lobe has an inferior tongue-like projection called the lingula?
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Left upper lobe
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

14. total lung capacity (TLC)
Overcome some of the problems associated with low blood flow to the probe site
Inspiration
Increased minute volume ventilation - which results in a lowered carbon dioxide level
The total amount of air in the lungs at the end of a maximal inhalation

15. increased volume results in
Normal to increased FEV1%
Louder - lower-pitched - and slightly longer in duration
Interstitial diseases or early pulmonary edema
Decreased pressure

16. The most reliable site for detecting central cyanosis is the...
Significant pulmonary impairment
Dyspnea upon assuming a recumbent position
Tongue
Dyspnea that awakens the patient several hours after going to sleep

17. Obstructive Disease: Expiratory airflow is reduced more than
Perfusion
Partial pressure of oxygen (PO2)
Contracts
Expiratory volume - and there is a prolonged expiratory time

18. The external intercostal muscles increase the antero-posterior chest diameter during
right & left
Inspiration
Right
500 to 800 mL

19. A normal volume-time curve rises
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Observing the pattern of breathing
quickly - usually reaching a plateau within 6.0 seconds
Spirometry

20. Discontinuous lung sounds are also called

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21. The active movement of gases between the ambient air and the lungs
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Ventilation
Obstruction below the vocal cords (subglottic or tracheal obstruction)
'scooped out' or bowl-shaped

22. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Mouth as well as through the chest wall
Inspiration
respiration
Lung volumes - but no difficulty or delay in exhaling what volume they do have

23. PACO2
50%
Pneumonia - obstructive lung disease - and late pulmonary edema
70% occlusion of the airway
Partial pressure of carbon dioxide in the alveoli

24. gas exchange across the alveolar-pulmonary capillary membranes
The total amount of air that can be exhaled following a maximal inhalation
Partial pressure of O2 in the arterial blood
require supplemental oxygenation and possibly ABG analysis
Diffusion

25. vital capacity (VC)
The total amount of air that can be exhaled following a maximal inhalation
No respiration for > 20 seconds
A reduction in lung capacity - secondary to scarring or extraneous material
right & left

26. Bohr Effect of pH is graphed as
Portable antero-posterior (AP) view
Lung volumes - but no difficulty or delay in exhaling what volume they do have
5 years - to detect obstruction and determine its reversibility
Oxygen-Hemoglobin Dissociation Curve

27. Rhonchi originate in the...
Functional residual capacity (FRC)
Observing the pattern of breathing
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Larger airways

28. low CO2 = low acidity =
Speed of airflow - the higher the flow - the greater the resistance
reduced in size - compared with a normal curve - due to lower lung volume
Diaphragm and the intercostal muscles
Binding of O2 to Hb

29. Spirometry plots
Dyspnea upon assuming a recumbent position
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
Inspiration
A tracing of the lung volume against time in seconds

30. Rhonchi
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Right
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling 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

31. The trachea is how long/wide?
'scooped out' or bowl-shaped
Either continuous or discontinuous
10 to 11 cm long and about 2 cm in diameter
Narrowed nearly to the point of closure

32. the lingula is analogous to...
Mediastinum
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The right middle lobe
Increased Hb-O2 affinity

33. Patients with restrictive disease have low
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Hypoventilation or modest changes in the PaO2
35 to 45 mmHg
'scooped out' or bowl-shaped

34. Cyanosis
Blue or bluish-gray discoloration of the skin or mucous membranes
Partial pressure of CO2 in the arterial blood
Significant pulmonary impairment
Partial pressure of oxygen in the alveoli

35. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Increased amounts of unsaturated hemoglobin in capillary blood
Total lung capacity (TLC)

36. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Observing the pattern of breathing
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Immediate oxygenation with or without intubation

37. Late inspiratory crackles result from
Interstitial diseases or early pulmonary edema
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Outer surface of each lung
Lung volumes - but find it difficult to exhale rapidly

38. Cyanosis is caused by
A tracing of the lung volume against time in seconds
80%
Altering the respiratory rate and/or the tidal volume
Increased amounts of unsaturated hemoglobin in capillary blood

39. The normal FEV1 /FVC ratio is...
70%
Bicarbonate
Either inspiration or expiration
Bronchospasm - mucosal edema - or excessive secretions

40. Fine crackles are...
Soft - high-pitched and crisp
Mediastinum
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Air to move from the upper airway to the farthest alveolar reaches

41. The trachea divides into right and left mainstem bronchi At what level?
Diaphragm - External Intercostals
Nitrogen
T4 or T5 - and just below the manubrio-sternal joint
Larger airways

42. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
Pleural space
The atmospheric pressure
Immediate oxygenation with or without intubation

43. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Diffusion
'crackles' or 'rales'
Ventilation
Narrowed nearly to the point of closure

44. Bronchophony
Partial pressure of carbon dioxide in the alveoli
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
80%
35 to 45 mmHg

45. Pulse Oximetry does not detect
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
80%
70%
Hypoventilation or modest changes in the PaO2

46. The presence of pressure gradients causes respiratory gases to move from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
The gas in the conducting airways does not participate in alveolar exchange
Blue or bluish-gray discoloration of the skin or mucous membranes
Inspiration

47. PaCO2
Upper respiratory obstruction - usually in the trachea or larynx
Partial pressure of CO2 in the arterial blood
Carboxyhemoglobin
Total lung capacity (TLC)

48. With restrictive disease - the flow-volume curve is...
Alveoli to the blood
reduced in size - compared with a normal curve - due to lower lung volume
release of O2 from Hb - as heat is a by-product of metabolism.
Obstructive lung disease from restrictive lung disease

49. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Perfusion
Insufficient oxygenation of hemoglobin in the lungs
Observing the pattern of breathing

50. At rest - the use of accessory muscles is a sign of...
Contracts
The gas in the conducting airways does not participate in alveolar exchange
Significant pulmonary impairment
Either inspiration or expiration

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Pulmonology

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