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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 process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Diffusion
Sternocleidomastoid - Scalene Muscles
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Partial pressure of oxygen (PO2)

2. Pectoriloquy
Air-filled - fluid-filled - or solid
Increased work of breathing
The examiner can clearly distinguish the word that the pt speak or whispers
Significant pulmonary impairment

3. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
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
right
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. pain in lung conditions usually arises from
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Fraction (%age) of inspired oxygen
Inflammation of the adjacent parietal pleura
The rib above it

5. Auscultation of the chest depends on...
Pneumonia - obstructive lung disease - and late pulmonary edema
A reliable and consistent classification of auditory findings
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
right and left mainstem bronchi

6. Spirometry: The result is stated as
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Expiration
Dyspnea upon assuming a recumbent position
respiration

7. PACO2
right & left
Partial pressure of carbon dioxide in the alveoli
require supplemental oxygenation and possibly ABG analysis
Acinus

8. 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
Perfusion
Spirometry
Pulse oximetry
Total lung capacity (TLC)

9. During inspiration the diaphragm
Cough
A reliable and consistent classification of auditory findings
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Contracts

10. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
No
Narrowed nearly to the point of closure
A good effort

11. The most reliable site for detecting central cyanosis is the...
Oxygen-Hemoglobin Dissociation Curve
Tongue
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

12. total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
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
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

13. Which lobe has an inferior tongue-like projection called the lingula?
Spirometry
Left upper lobe
Partial pressure of oxygen (PO2)
Narrowed nearly to the point of closure

14. Continuous lung sounds occur in the setting of...
Blue or bluish-gray discoloration of the skin or mucous membranes
Bronchospasm - mucosal edema - or excessive secretions
'scooped out' or bowl-shaped
Sternocleidomastoid - Scalene Muscles

15. The active movement of gases between the ambient air and the lungs
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Bronchospasm - mucosal edema - or excessive secretions
Ventilation
Partial pressure of CO2 in the arterial blood

16. Pulse Oximetry does not detect
Partial pressure of oxygen in the alveoli
Hypoventilation or modest changes in the PaO2
Increased amounts of unsaturated hemoglobin in capillary blood
The amount of air that can be inhaled after normal inspiration

17. Pulse Oximetry is dependent on...
The total amount of air in the lungs at the end of a maximal inhalation
5 years - to detect obstruction and determine its reversibility
respiration
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

18. Spirometry can be used to determine the severity of functional impairment as well as
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
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
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
To assess response to treatment

19. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Observing the pattern of breathing
Right
A reduction in lung capacity - secondary to scarring or extraneous material
Mediastinum

20. Patients with restrictive disease have low
Lung volumes - but no difficulty or delay in exhaling what volume they do have
quickly - usually reaching a plateau within 6.0 seconds
Diffusion
80 to 120% of predicted value

21. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Significant pulmonary impairment
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The total amount of air in the lungs at the end of a maximal inhalation

22. Coarse crackles are...
2 - each wavelength is partially absorbed by hemoglobin
Pulse oximetry
require supplemental oxygenation and possibly ABG analysis
Louder - lower-pitched - and slightly longer in duration

23. increased volume results in
Decreased pressure
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Diaphragm and the intercostal muscles
Pleural space

24. The tracheo-bronchial tree is a tubular system that provides a pathway for
Pressure required to drive air through the airways
Air to move from the upper airway to the farthest alveolar reaches
Insufficient oxygenation of hemoglobin in the lungs
The negative logarithm of hydrogen ions in the blood

25. The interspace between two ribs (intercostal space) is numbered by
Upper respiratory obstruction - usually in the trachea or larynx
The rib above it
Inspiration
Pleural space

26. Does lung tissue have pain fibers?
Significant pulmonary impairment
Either continuous or discontinuous
No
Increased rate of breathing and is commonly associated with a decrease in tidal volume

27. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Portable antero-posterior (AP) view
2 - each wavelength is partially absorbed by hemoglobin
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

28. Cyanosis is caused by
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Spirometry
Increased amounts of unsaturated hemoglobin in capillary blood
Brief - discrete - non-musical sounds with a popping quality

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

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30. Rhonchi are due to...
Binding of O2 to Hb
T4 or T5 - and just below the manubrio-sternal joint
Hypoventilation or modest changes in the PaO2
Excessive secretions and abnormal airway collapsibility

31. Rhonchi
Difficulty breathing or shortness of breath
Expiration
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Either inspiration or expiration

32. Bronchiovesicular breath sounds
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Pressure required to drive air through the airways
Air bubbles flowing through secretions or slightly closed airways during respiration
Right

33. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Partial pressure of oxygen (PO2)
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
Increased amounts of unsaturated hemoglobin in capillary blood

34. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Altering the respiratory rate and/or the tidal volume
Nitrogen
Carboxyhemoglobin

35. The trachea divides into right and left mainstem bronchi At what level?
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
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
T4 or T5 - and just below the manubrio-sternal joint
The total amount of air that can be exhaled following a maximal inhalation

36. Factors that influence the oxygen carrying capacity of hemoglobin
Either inspiration or expiration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
results in a lower than normal FEV1%

37. Vesicular breath sounds
Diaphragm and the intercostal muscles
A reliable and consistent classification of auditory findings
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 gas in the conducting airways does not participate in alveolar exchange

38. The muscles of expiration are the...
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Overcome some of the problems associated with low blood flow to the probe site
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

39. tidal volume (Vt)
Spirometry
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
The gas in the conducting airways does not participate in alveolar exchange
Louder - lower-pitched - and slightly longer in duration

40. What is the potential space between the visceral and parietal pleurae?
Perfusion
Pleural space
Observing the pattern of breathing
Obstruction below the vocal cords (subglottic or tracheal obstruction)

41. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
70% occlusion of the airway
The total amount of air that can be exhaled following a maximal inhalation
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
A sensor placed over a translucent area of arterial pulsation

42. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
Expiration
Decreased pressure
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

43. The muscles of inspiration are the...
reduced in size - compared with a normal curve - due to lower lung volume
The negative logarithm of hydrogen ions in the blood
Diaphragm - External Intercostals
Difficulty breathing or shortness of breath

44. Discontinuous lung sounds are...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
70%
Wheezes - high-pitched - musical sounds - distinct whistling quality
Brief - discrete - non-musical sounds with a popping quality

45. Boyle's Gas Law
Decreased pressure
No
Functional residual capacity (FRC)
There is an inverse relationship between pressure and volume

46. Continuous lung sounds
Portable antero-posterior (AP) view
Nitrogen
Wheezes - high-pitched - musical sounds - distinct whistling quality
Either inspiration or expiration

47. The vital capacity and the residual volume together constitute the...
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Total lung capacity (TLC)
Insufficient oxygenation of hemoglobin in the lungs
Manubrio-sternal junction (angle of Louis)

48. Patients with obstructive disease have normal
Lung volumes - but find it difficult to exhale rapidly
'crackles' or 'rales'
Mediastinum
Total lung capacity (TLC)

49. The upper airway accounts For what % of airway resistance?
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
50%
Diaphragm and the intercostal muscles
Hypoventilation or modest changes in the PaO2

50. pH
50%
The negative logarithm of hydrogen ions in the blood
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Spirometry