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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 main bronchi are divided into smaller branches that begin to subdivide into
A tracing of the lung volume against time in seconds
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Mediastinum

2. The trachea is how long/wide?
'crackles' or 'rales'
Increased amounts of unsaturated hemoglobin in capillary blood
Left upper lobe
10 to 11 cm long and about 2 cm in diameter

3. Orthopnea is quantified by
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Spirometry
reduced in size - compared with a normal curve - due to lower lung volume
Diaphragm - External Intercostals

4. The accessory muscles are the...
Dyspnea upon assuming a recumbent position
'crackles' or 'rales'
Sternocleidomastoid - Scalene Muscles
Decreased Hb-O2 affinity

5. Spirometry normal range
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
80 to 120% of predicted value
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
quickly - usually reaching a plateau within 6.0 seconds

6. Rhonchi originate in the...
Larger airways
reduced in size - compared with a normal curve - due to lower lung volume
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
5 years - to detect obstruction and determine its reversibility

7. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
The right middle lobe
Decreased pressure
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

8. The muscles of inspiration are the...
Blue or bluish-gray discoloration of the skin or mucous membranes
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Diaphragm - External Intercostals
The amount of air that can be inhaled after normal inspiration

9. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Mouth as well as through the chest wall
Increased work of breathing
Perfusion
Decreased Hb-O2 affinity

10. Which bronchus is wider - shorter - and more vertically placed?
Bronchospasm - mucosal edema - or excessive secretions
Right
Upper respiratory obstruction - usually in the trachea or larynx
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

11. FEV1% in restrictive disease
5 years - to detect obstruction and determine its reversibility
Pneumonia - obstructive lung disease - and late pulmonary edema
Normal to increased FEV1%
Acinus

12. hypocapnia
The rib above it
A sensor placed over a translucent area of arterial pulsation
Lowered carbon dioxide level - results from hyperventilation
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

13. The best indicator of adequate ventilation is the...
Insufficient oxygenation of hemoglobin in the lungs
80%
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
PaCO2

14. high CO2 = high acidity =
Right
35 to 45 mmHg
Increased Hb-O2 affinity
release of O2 from Hb

15. Boyle's Gas Law
Contracts
No
Left upper lobe
There is an inverse relationship between pressure and volume

16. Restrictive Disease: Expiratory volume is reduced more than
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Inspiration
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

17. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Acinus
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

18. The upper airway accounts For what % of airway resistance?
Pressure required to drive air through the airways
50%
Speed of airflow - the higher the flow - the greater the resistance
The gas in the conducting airways does not participate in alveolar exchange

19. Continuous lung sounds
Perfusion
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Normal to increased FEV1%
Wheezes - high-pitched - musical sounds - distinct whistling quality

20. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Spirometry
Partial pressure of O2 in the arterial blood
The atmospheric pressure

21. Fine crackles are...
Partial pressure of oxygen (PO2)
Left upper lobe
Soft - high-pitched and crisp
Right

22. Paroxysmal nocturnal dyspnea (PND) is...
Dyspnea that awakens the patient several hours after going to sleep
Dullness replaces resonance
10 to 11 cm long and about 2 cm in diameter
Cough

23. Apnea is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
No respiration for > 20 seconds
Speed of airflow - the higher the flow - the greater the resistance
Pneumonia - obstructive lung disease - and late pulmonary edema

24. terminal respiratory unit
Acinus
There is an inverse relationship between pressure and volume
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
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

25. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Increase the intrathoracic space
Narrowed nearly to the point of closure
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Excessive secretions and abnormal airway collapsibility

26. dead space ventilation
The gas in the conducting airways does not participate in alveolar exchange
Manubrio-sternal junction (angle of Louis)
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Difficulty breathing or shortness of breath

27. FEV1% in obstructive disease
results in a lower than normal FEV1%
Speed of airflow - the higher the flow - the greater the resistance
80%
Upper respiratory obstruction - usually in the trachea or larynx

28. Peripheral cyanosis results from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Either continuous or discontinuous
50%

29. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Upper respiratory obstruction - usually in the trachea or larynx
5 years - to detect obstruction and determine its reversibility
Normal to increased FEV1%
T4 or T5 - and just below the manubrio-sternal joint

30. total lung capacity (TLC)
Observing the pattern of breathing
Total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
Inside of the thoracic cavity wall and the upper surface of the diaphragm

31. Obstructive Disease: Expiratory airflow is reduced more than
Expiratory volume - and there is a prolonged expiratory time
70%
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Obstructive lung disease from restrictive lung disease

32. The interspace between two ribs (intercostal space) is numbered by
Outer surface of each lung
The rib above it
right and left mainstem bronchi
Soft - high-pitched and crisp

33. PaO2
The atmospheric pressure
Partial pressure of O2 in the arterial blood
right and left mainstem bronchi
The examiner can clearly distinguish the word that the pt speak or whispers

34. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
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
Decreased Hb-O2 affinity
Overcome some of the problems associated with low blood flow to the probe site

35. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Inflammation of the adjacent parietal pleura
Dyspnea upon assuming a recumbent position
The rib above it

36. Rhonchi
reduced in size - compared with a normal curve - due to lower lung volume
Insufficient oxygenation of hemoglobin in the lungs
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
2 - each wavelength is partially absorbed by hemoglobin

37. Nitroglycerin applied to the probe area has been reported to...
Bronchospasm - mucosal edema - or excessive secretions
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Overcome some of the problems associated with low blood flow to the probe site
Mediastinum

38. The presence of pressure gradients causes respiratory gases to move from
Dyspnea that awakens the patient several hours after going to sleep
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Mouth as well as through the chest wall
Dullness replaces resonance

39. most important factor that influences the oxygen carrying capacity of hemoglobin
right & left
Partial pressure of oxygen (PO2)
The right middle lobe
Significant pulmonary impairment

40. PACO2
reduced in size - compared with a normal curve - due to lower lung volume
Functional residual capacity (FRC)
Partial pressure of carbon dioxide in the alveoli
Binding of O2 to Hb

41. Central cyanosis results from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
release of O2 from Hb - as heat is a by-product of metabolism.
Insufficient oxygenation of hemoglobin in the lungs
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

42. Rhonchi frequently clear after
Increased work of breathing
Overcome some of the problems associated with low blood flow to the probe site
Total lung capacity (TLC)
Cough

43. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Hypoventilation or modest changes in the PaO2
80%
No

44. At rest - the use of accessory muscles is a sign of...
Upper respiratory obstruction - usually in the trachea or larynx
Carboxyhemoglobin
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Significant pulmonary impairment

45. normal adult tidal volume
500 to 800 mL
The negative logarithm of hydrogen ions in the blood
Contracts
Left upper lobe

46. forced expiratory volume in one second (FEV1)
Difficulty breathing or shortness of breath
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
right and left mainstem bronchi
Overcome some of the problems associated with low blood flow to the probe site

47. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Alveoli to the blood
The examiner can clearly distinguish the word that the pt speak or whispers
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Inspiration

48. Rhonchi are due to...
Partial pressure of oxygen (PO2)
Excessive secretions and abnormal airway collapsibility
The total amount of air in the lungs at the end of 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

49. vital capacity (VC)
The total amount of air that can be exhaled following a maximal inhalation
No respiration for > 20 seconds
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
50%

50. Fine crackles are heard in
Expiration
Interstitial diseases or early pulmonary edema
Nitrogen
Pleural space

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Pulmonology

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