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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
2 - each wavelength is partially absorbed by hemoglobin
The total amount of air that can be exhaled following a maximal inhalation
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
Spirometry

2. 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
80 to 120% of predicted value
Saturated with oxygen or unsaturated
Pressure required to drive air through the airways

3. PaCO2
Lung volumes - but find it difficult to exhale rapidly
Obstructive lung disease from restrictive lung disease
Outer surface of each lung
Partial pressure of CO2 in the arterial blood

4. Cyanosis
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
Saturated with oxygen or unsaturated
Blue or bluish-gray discoloration of the skin or mucous membranes
Functional residual capacity (FRC)

5. The most reliable site for detecting central cyanosis is the...
Perfusion
Left upper lobe
Pneumonia - obstructive lung disease - and late pulmonary edema
Tongue

6. The purpose of respiration is to...
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Either inspiration or expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
A reduction in lung capacity - secondary to scarring or extraneous material

7. vital capacity (VC)
The total amount of air that can be exhaled following a maximal inhalation
release of O2 from Hb - as heat is a by-product of metabolism.
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Wheezes - high-pitched - musical sounds - distinct whistling quality

8. Typically - in the presence of obstructive disease - the flow-volume curve looks

9. Inspiratory stridor indicates
Expiratory volume - and there is a prolonged expiratory time
Significant pulmonary impairment
Air to move from the upper airway to the farthest alveolar reaches
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

10. Percussion helps you establish whether the underlying tissues are...
Wheezes - high-pitched - musical sounds - distinct whistling quality
Air-filled - fluid-filled - or solid
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
35 to 45 mmHg

11. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Immediate oxygenation with or without intubation
right
Functional residual capacity (FRC)
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

12. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Immediate oxygenation with or without intubation
Upper respiratory obstruction - usually in the trachea or larynx
There is an inverse relationship between pressure and volume
Increased work of breathing

13. Oxygen moves from the...
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Bronchospasm - mucosal edema - or excessive secretions
No respiration for > 20 seconds
Alveoli to the blood

14. Apnea is defined as
A good effort
Total lung capacity (TLC)
No respiration for > 20 seconds
No

15. dead space ventilation
Blue or bluish-gray discoloration of the skin or mucous membranes
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Diffusion
The gas in the conducting airways does not participate in alveolar exchange

16. Does lung tissue have pain fibers?
No
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Expiratory volume - and there is a prolonged expiratory time
Saturated with oxygen or unsaturated

17. PACO2
Partial pressure of carbon dioxide in the alveoli
results in a lower than normal FEV1%
Outer surface of each lung
Inside of the thoracic cavity wall and the upper surface of the diaphragm

18. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
require supplemental oxygenation and possibly ABG analysis
Narrowed nearly to the point of closure
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
A sensor placed over a translucent area of arterial pulsation

19. The best indicator of adequate ventilation is the...
PaCO2
Pleural space
Cough
Saturated with oxygen or unsaturated

20. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Inspiration
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
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
A reduction in lung capacity - secondary to scarring or extraneous material

21. Carbon dioxide moves from the...
Nitrogen
Blood to the alveoli
Total lung capacity (TLC)
Functional residual capacity (FRC)

22. Dyspnea is defined as
Inspiration
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Difficulty breathing or shortness of breath
right & left

23. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Mediastinum
There is an inverse relationship between pressure and volume
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

24. Rhonchi occur during
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Either inspiration or expiration
Immediate oxygenation with or without intubation
release of O2 from Hb - as heat is a by-product of metabolism.

25. Central cyanosis results from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Insufficient oxygenation of hemoglobin in the lungs
A reduction in lung capacity - secondary to scarring or extraneous material
Observing the pattern of breathing

26. Auscultation of the chest depends on...
A reliable and consistent classification of auditory findings
Perfusion
To assess response to treatment
Obstructive lung disease from restrictive lung disease

27. Hyperventilation is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Dullness replaces resonance
Increased amounts of unsaturated hemoglobin in capillary blood
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

28. Restrictive Disease: Expiratory volume is reduced more than
50%
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The amount of air that can be inhaled after normal inspiration
right

29. Late inspiratory crackles result from
Dyspnea that awakens the patient several hours after going to sleep
A sensor placed over a translucent area of arterial pulsation
Pulse oximetry
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

30. Bohr Effect of pH: right shift
Significant pulmonary impairment
Either inspiration or expiration
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Decreased Hb-O2 affinity

31. the lingula is analogous to...
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
respiration
A tracing of the lung volume against time in seconds
The right middle lobe

32. Orthopnea is defined as
500 to 800 mL
Dyspnea upon assuming a recumbent position
Air bubbles flowing through secretions or slightly closed airways during respiration
Increased minute volume ventilation - which results in a lowered carbon dioxide level

33. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Increased Hb-O2 affinity
Inflammation of the adjacent parietal pleura

34. Rhonchi originate in the...
Increased Hb-O2 affinity
Larger airways
To assess response to treatment
Immediate oxygenation with or without intubation

35. Bohr Effect of pH: left shift
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Increased Hb-O2 affinity
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

36. Which lung has a horizontal fissure?
right
70%
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

37. 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
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Speed of airflow - the higher the flow - the greater the resistance
Pulse oximetry
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

38. Spirometry is useful in distinguishing
release of O2 from Hb
Obstructive lung disease from restrictive lung disease
Carboxyhemoglobin
Interstitial diseases or early pulmonary edema

39. The accessory muscles are the...
Right
Sternocleidomastoid - Scalene Muscles
Either inspiration or expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

40. Coarse crackles are heard in
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
35 to 45 mmHg
Pneumonia - obstructive lung disease - and late pulmonary edema
The gas in the conducting airways does not participate in alveolar exchange

41. The tracheo-bronchial tree is a tubular system that provides a pathway for
Diaphragm - External Intercostals
Air to move from the upper airway to the farthest alveolar reaches
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Overcome some of the problems associated with low blood flow to the probe site

42. The upper airway accounts For what % of airway resistance?
50%
right
Pneumonia - obstructive lung disease - and late pulmonary edema
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

43. Airway resistance refers to...
Pressure required to drive air through the airways
The amount of air that can be inhaled after normal inspiration
Spirometry
Air-filled - fluid-filled - or solid

44. The active movement of gases between the ambient air and the lungs
Ventilation
right and left mainstem bronchi
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
results in a lower than normal FEV1%

45. The trachea bifurcates into its mainstem bronchi at the level of...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The right middle lobe
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Manubrio-sternal junction (angle of Louis)

46. Cyanosis is caused by
Increased amounts of unsaturated hemoglobin in capillary blood
results in a lower than normal FEV1%
Altering the respiratory rate and/or the tidal volume
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

47. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Diaphragm and the intercostal muscles
Diffusion
The total amount of air that can be exhaled following a maximal inhalation
There is an inverse relationship between pressure and volume

48. Cyanosis appears when
A reduction in lung capacity - secondary to scarring or extraneous material
Either continuous or discontinuous
500 to 800 mL
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

49. normal subjects expel approximately how much of the FVC in the 1st second?
Diaphragm - External Intercostals
80%
80 to 120% of predicted value
Manubrio-sternal junction (angle of Louis)

50. expiratory reserve
Upper respiratory obstruction - usually in the trachea or larynx
right
The amount of air that can be exhaled after expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide