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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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1. Continuous lung sounds occur during...
release of O2 from Hb
Hypoventilation or modest changes in the PaO2
Decreased pressure
Either inspiration or expiration

2. Bohr Effect of pH is graphed as
The amount of air that can be exhaled after expiration
Oxygen-Hemoglobin Dissociation Curve
Perfusion
Expiration

3. residual volume
A reduction in lung capacity - secondary to scarring or extraneous material
Expiration
Dyspnea that awakens the patient several hours after going to sleep
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

4. 20.95% Atmospheric Composition
Oxygen (O2)
Cough
Pulse oximetry
80 to 120% of predicted value

5. The upper airway accounts For what % of airway resistance?
right and left mainstem bronchi
50%
Hypoventilation or modest changes in the PaO2
Inspiration

6. pain in lung conditions usually arises from
Decreased pressure
Insufficient oxygenation of hemoglobin in the lungs
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

7. forced vital capacity (FVC)
The total amount of air that can be exhaled following a maximal inhalation
Dyspnea upon assuming a recumbent position
35 to 45 mmHg
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

8. Patients with obstructive disease have normal
Mediastinum
Lung volumes - but find it difficult to exhale rapidly
Expiratory volume - and there is a prolonged expiratory time
T4 or T5 - and just below the manubrio-sternal joint

9. The pattern of breathing refers to...
Upper respiratory obstruction - usually in the trachea or larynx
Pneumonia - obstructive lung disease - and late pulmonary edema
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
The negative logarithm of hydrogen ions in the blood

10. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Pulse oximetry
Functional residual capacity (FRC)
A tracing of the lung volume against time in seconds
A reduction in lung capacity - secondary to scarring or extraneous material

11. Continuous lung sounds occur in the setting of...
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Bronchospasm - mucosal edema - or excessive secretions
A reliable and consistent classification of auditory findings
Narrowed nearly to the point of closure

12. A normal volume-time curve rises
Soft - high-pitched and crisp
Portable antero-posterior (AP) view
Expiration
quickly - usually reaching a plateau within 6.0 seconds

13. Bronchophony
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Normal to increased FEV1%
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
5 years - to detect obstruction and determine its reversibility

14. high CO2 = high acidity =
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
release of O2 from Hb
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
Partial pressure of O2 in the arterial blood

15. The trachea divides into
Either inspiration or expiration
right and left mainstem bronchi
Dyspnea that awakens the patient several hours after going to sleep
release of O2 from Hb - as heat is a by-product of metabolism.

16. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Observing the pattern of breathing
Diaphragm and the intercostal muscles
Increased minute volume ventilation - which results in a lowered carbon dioxide level

17. Nitroglycerin applied to the probe area has been reported to...
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The total amount of air in the lungs at the end of a maximal inhalation
Partial pressure of oxygen (PO2)
Overcome some of the problems associated with low blood flow to the probe site

18. Paroxysmal nocturnal dyspnea (PND) is...
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Dyspnea that awakens the patient several hours after going to sleep
No respiration for > 20 seconds

19. Expiratory stridor indicates
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The atmospheric pressure
reduced in size - compared with a normal curve - due to lower lung volume
The gas in the conducting airways does not participate in alveolar exchange

20. FEV1/FVC
Louder - lower-pitched - and slightly longer in duration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Total lung capacity (TLC)
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

21. 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
Perfusion
Immediate oxygenation with or without intubation
Right

22. Which bronchus is wider - shorter - and more vertically placed?
Right
Dullness replaces resonance
Air to move from the upper airway to the farthest alveolar reaches
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

23. Discontinuous lung sounds are...
Air-filled - fluid-filled - or solid
Decreased pressure
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Brief - discrete - non-musical sounds with a popping quality

24. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Spirometry
The right middle lobe
Binding of O2 to Hb
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

25. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Pleural space
Larger airways
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Upper respiratory obstruction - usually in the trachea or larynx

26. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
80 to 120% of predicted value
The total amount of air that can be exhaled following a maximal inhalation
Speed of airflow - the higher the flow - the greater the resistance
Diffusion

27. Airway resistance refers to...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
35 to 45 mmHg
Pressure required to drive air through the airways

28. The spirometry printout usually includes

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29. Pulse Oximetry does not detect
Hypoventilation or modest changes in the PaO2
Altering the respiratory rate and/or the tidal volume
Inspiration
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

30. Pulmonary ventilation is varied by
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Bronchospasm - mucosal edema - or excessive secretions
Altering the respiratory rate and/or the tidal volume
Increased minute volume ventilation - which results in a lowered carbon dioxide level

31. Orthopnea is quantified by
right and left mainstem bronchi
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Oxygen (O2)
Functional residual capacity (FRC)

32. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Decreased pressure
Perfusion
Saturated with oxygen or unsaturated

33. The accessory muscles are the...
The right middle lobe
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Sternocleidomastoid - Scalene Muscles
Perfusion

34. Factors that influence the oxygen carrying capacity of hemoglobin
Hypoventilation or modest changes in the PaO2
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Partial pressure of oxygen (PO2)
Expiration

35. Percussion helps you establish whether the underlying tissues are...
2 - each wavelength is partially absorbed by hemoglobin
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Air-filled - fluid-filled - or solid
Dyspnea that awakens the patient several hours after going to sleep

36. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Diaphragm - External Intercostals
70%
Mediastinum
Inflammation of the adjacent parietal pleura

37. Does lung tissue have pain fibers?
Increased work of breathing
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
No
Portable antero-posterior (AP) view

38. normal adult tidal volume
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Difficulty breathing or shortness of breath
Dullness replaces resonance
500 to 800 mL

39. The main bronchi are divided into smaller branches that begin to subdivide into
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Observing the pattern of breathing
A good effort
Bronchospasm - mucosal edema - or excessive secretions

40. forced expiratory volume in one second (FEV1)
Partial pressure of O2 in the arterial blood
Obstruction below the vocal cords (subglottic or tracheal obstruction)
quickly - usually reaching a plateau within 6.0 seconds
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

41. Cyanosis is caused by
Mouth as well as through the chest wall
Partial pressure of CO2 in the arterial blood
Increased amounts of unsaturated hemoglobin in capillary blood
Dullness replaces resonance

42. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
2 - each wavelength is partially absorbed by hemoglobin
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Fraction (%age) of inspired oxygen
Postero-anterior (PA) and lateral view series

43. The trachea is how long/wide?
Bicarbonate
10 to 11 cm long and about 2 cm in diameter
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
'adventitious' breath sounds

44. Respiration involves
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
Blue or bluish-gray discoloration of the skin or mucous membranes
Ventilation - Diffusion - Perfusion
Increase the intrathoracic space

45. Restrictive Disease: Expiratory volume is reduced more than
Mouth as well as through the chest wall
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
Increased work of breathing
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

46. Oximetry readings of < 94%
Air bubbles flowing through secretions or slightly closed airways during respiration
Hypoventilation or modest changes in the PaO2
require supplemental oxygenation and possibly ABG analysis
Oxygen-Hemoglobin Dissociation Curve

47. Auscultation of the chest depends on...
The total amount of air that can be exhaled following a maximal inhalation
80 to 120% of predicted value
Diffusion
A reliable and consistent classification of auditory findings

48. Spirometry is useful in distinguishing
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
A reliable and consistent classification of auditory findings
Obstructive lung disease from restrictive lung disease
Air bubbles flowing through secretions or slightly closed airways during respiration

49. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Diffusion
Mouth as well as through the chest wall
Perfusion

50. Pulse Oximetry is dependent on...
Partial pressure of CO2 in the arterial blood
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
A good effort
Hypoventilation or modest changes in the PaO2

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Pulmonology

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