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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. PACO2
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
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
Partial pressure of carbon dioxide in the alveoli

2. Bohr Effect of pH: left shift
Significant pulmonary impairment
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Increased Hb-O2 affinity
Obstruction below the vocal cords (subglottic or tracheal obstruction)

3. An efficient approach to examination of the patient begins with
Observing the pattern of breathing
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
No
Carboxyhemoglobin

4. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Increased work of breathing
80%
Narrowed nearly to the point of closure
Perfusion

5. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Either inspiration or expiration
Dullness replaces resonance
Left upper lobe

6. During inspiration the diaphragm
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Contracts
5 years - to detect obstruction and determine its reversibility
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

7. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Air-filled - fluid-filled - or solid
Upper respiratory obstruction - usually in the trachea or larynx
Immediate oxygenation with or without intubation
Pressure required to drive air through the airways

8. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Increased Hb-O2 affinity
Narrowed nearly to the point of closure
Mediastinum
Larger airways

9. Cyanosis is caused by
Inspiration
Immediate oxygenation with or without intubation
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Increased amounts of unsaturated hemoglobin in capillary blood

10. The tracheo-bronchial tree is a tubular system that provides a pathway for
Total lung capacity (TLC)
Air to move from the upper airway to the farthest alveolar reaches
right and left mainstem bronchi
right

11. PaCO2
2 - each wavelength is partially absorbed by hemoglobin
Partial pressure of CO2 in the arterial blood
Increase the intrathoracic space
35 to 45 mmHg

12. Coarse crackles are heard in
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
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Inflammation of the adjacent parietal pleura

13. total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
Expiration
Pneumonia - obstructive lung disease - and late pulmonary edema
80%

14. Apnea is defined as
No respiration for > 20 seconds
The total amount of air in the lungs at the end of a maximal inhalation
Functional residual capacity (FRC)
Normal to increased FEV1%

15. With restrictive disease - the flow-volume curve is...
Either inspiration or expiration
The amount of air that can be exhaled after expiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
reduced in size - compared with a normal curve - due to lower lung volume

16. most important factor that influences the oxygen carrying capacity of hemoglobin
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Partial pressure of oxygen (PO2)
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Expiration

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

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18. Bronchiovesicular breath sounds
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Functional residual capacity (FRC)
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
'adventitious' breath sounds

19. Orthopnea is quantified by
Acinus
The amount of air that can be exhaled after expiration
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
A reliable and consistent classification of auditory findings

20. Pulse Oximetry is dependent on...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
A reliable and consistent classification of auditory findings
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Upper respiratory obstruction - usually in the trachea or larynx

21. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
To assess response to treatment
Inside of the thoracic cavity wall and the upper surface of the diaphragm
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

22. A normal volume-time curve rises
The atmospheric pressure
quickly - usually reaching a plateau within 6.0 seconds
Ventilation - Diffusion - Perfusion
Upper respiratory obstruction - usually in the trachea or larynx

23. terminal respiratory unit
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Total lung capacity (TLC)
Perfusion
Acinus

24. Respiration involves
Ventilation - Diffusion - Perfusion
Significant pulmonary impairment
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Diaphragm - External Intercostals

25. Rhonchi frequently clear after
Cough
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
There is an inverse relationship between pressure and volume
Portable antero-posterior (AP) view

26. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Ventilation - Diffusion - Perfusion
Sternocleidomastoid - Scalene Muscles
Air bubbles flowing through secretions or slightly closed airways during respiration

27. office-based spirometry is recommended for patients as young as
Normal to increased FEV1%
Bicarbonate
5 years - to detect obstruction and determine its reversibility
The examiner can clearly distinguish the word that the pt speak or whispers

28. The normal FEV1 /FVC ratio is...
Air-filled - fluid-filled - or solid
70%
require supplemental oxygenation and possibly ABG analysis
Ventilation

29. 78.08% Atmospheric Composition
right
Nitrogen
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Lowered carbon dioxide level - results from hyperventilation

30. Continuous lung sounds
A reduction in lung capacity - secondary to scarring or extraneous material
Total lung capacity (TLC)
Wheezes - high-pitched - musical sounds - distinct whistling quality
A reliable and consistent classification of auditory findings

31. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
500 to 800 mL
70%
Brief - discrete - non-musical sounds with a popping quality
Saturated with oxygen or unsaturated

32. Abnormal lung sounds are classified as
Acinus
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
Partial pressure of oxygen in the alveoli
Either continuous or discontinuous

33. Continuous lung sounds often audible at the...
Mouth as well as through the chest wall
A reliable and consistent classification of auditory findings
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Larger airways

34. The interspace between two ribs (intercostal space) is numbered by
Air bubbles flowing through secretions or slightly closed airways during respiration
Interstitial diseases or early pulmonary edema
Blue or bluish-gray discoloration of the skin or mucous membranes
The rib above it

35. normal adult tidal volume
Sternocleidomastoid - Scalene Muscles
500 to 800 mL
Diaphragm - External Intercostals
Alveoli to the blood

36. Fine crackles are...
Air-filled - fluid-filled - or solid
Soft - high-pitched and crisp
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
The gas in the conducting airways does not participate in alveolar exchange

37. The volume of gas remaining in the lungs at the end of normal expiration is called the...
A reduction in lung capacity - secondary to scarring or extraneous material
The atmospheric pressure
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Functional residual capacity (FRC)

38. Central cyanosis results from
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Obstructive lung disease from restrictive lung disease
Insufficient oxygenation of hemoglobin in the lungs
Either inspiration or expiration

39. Oxygen moves from the...
Alveoli to the blood
Air to move from the upper airway to the farthest alveolar reaches
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Either inspiration or expiration

40. Normal range of PaCO2
35 to 45 mmHg
Larger airways
Inspiration
Excessive secretions and abnormal airway collapsibility

41. Patients with restrictive disease have low
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Hypoventilation or modest changes in the PaO2

42. vital capacity (VC)
The total amount of air that can be exhaled following a maximal inhalation
'crackles' or 'rales'
Decreased pressure
Obstructive lung disease from restrictive lung disease

43. tidal volume (Vt)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
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
Decreased pressure
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

44. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Increased Hb-O2 affinity
Expiration

45. movement of blood through the capillaries in direct communication with the alveoli
Obstructive lung disease from restrictive lung disease
Upper respiratory obstruction - usually in the trachea or larynx
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Perfusion

46. Restrictive Disease: Expiratory volume is reduced more than
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Normal to increased FEV1%
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

47. expiratory reserve
The amount of air that can be exhaled after expiration
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Portable antero-posterior (AP) view
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

48. The external intercostal muscles increase the antero-posterior chest diameter during
A good effort
Inspiration
Diaphragm - External Intercostals
Louder - lower-pitched - and slightly longer in duration

49. The trachea is how long/wide?
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
'crackles' or 'rales'
Inspiration
10 to 11 cm long and about 2 cm in diameter

50. Boyle's Gas Law
There is an inverse relationship between pressure and volume
Expiratory volume - and there is a prolonged expiratory time
Excessive secretions and abnormal airway collapsibility
Immediate oxygenation with or without intubation

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Pulmonology

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