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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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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 trachea divides into right and left mainstem bronchi At what level?
T4 or T5 - and just below the manubrio-sternal joint
Perfusion
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

2. movement of blood through the capillaries in direct communication with the alveoli
Total lung capacity (TLC)
Pneumonia - obstructive lung disease - and late pulmonary edema
Perfusion
Expiratory volume - and there is a prolonged expiratory time

3. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
Blue or bluish-gray discoloration of the skin or mucous membranes
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Oxygen-Hemoglobin Dissociation Curve

4. within limits - increased temperature =
release of O2 from Hb - as heat is a by-product of metabolism.
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Speed of airflow - the higher the flow - the greater the resistance
Contracts

5. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Binding of O2 to Hb
A good effort
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
right

6. Spirometry is useful in distinguishing
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
35 to 45 mmHg
Dullness replaces resonance
Obstructive lung disease from restrictive lung disease

7. Pulmonary ventilation is varied by
Interstitial diseases or early pulmonary edema
The total amount of air that can be exhaled following a maximal inhalation
'adventitious' breath sounds
Altering the respiratory rate and/or the tidal volume

8. the lingula is analogous to...
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
'adventitious' breath sounds
The right middle lobe
Excessive secretions and abnormal airway collapsibility

9. low CO2 = low acidity =
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
quickly - usually reaching a plateau within 6.0 seconds
Binding of O2 to 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

10. Rhonchi are due to...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Increased rate of breathing and is commonly associated with a decrease in tidal volume
80%
Excessive secretions and abnormal airway collapsibility

11. Examples of restrictive disease
Ventilation
Dullness replaces resonance
Spirometry
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

12. Coarse crackles are heard in
Pneumonia - obstructive lung disease - and late pulmonary edema
Partial pressure of O2 in the arterial blood
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Cough

13. Respiration involves
The atmospheric pressure
5 years - to detect obstruction and determine its reversibility
Ventilation - Diffusion - Perfusion
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

14. Hyperventilation is defined as
Increased amounts of unsaturated hemoglobin in capillary blood
5 years - to detect obstruction and determine its reversibility
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Binding of O2 to Hb

15. The muscles of expiration are the...
'scooped out' or bowl-shaped
Oxygen (O2)
A reliable and consistent classification of auditory findings
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

16. Bohr Effect of pH: right shift
Lung volumes - but no difficulty or delay in exhaling what volume they do have
T4 or T5 - and just below the manubrio-sternal joint
Decreased Hb-O2 affinity
Lung volumes - but find it difficult to exhale rapidly

17. Pulse Oximetry does not detect
Expiration
Postero-anterior (PA) and lateral view series
Either inspiration or expiration
Hypoventilation or modest changes in the PaO2

18. Stridor is a high-pitched - noisy respiration - Which is indicative of...
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Upper respiratory obstruction - usually in the trachea or larynx
A tracing of the lung volume against time in seconds
5 years - to detect obstruction and determine its reversibility

19. Compliance
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Narrowed nearly to the point of closure
Nitrogen
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

20. Oxygen moves from the...
Alveoli to the blood
Lung volumes - but no difficulty or delay in exhaling what volume they do have
The total amount of air in the lungs at the end of a maximal inhalation
'adventitious' breath sounds

21. Oximetry readings of < 94%
Decreased pressure
Oxygen (O2)
require supplemental oxygenation and possibly ABG analysis
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

22. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
50%
Ventilation - Diffusion - Perfusion
The amount of air that can be exhaled after expiration
2 - each wavelength is partially absorbed by hemoglobin

23. The parietal pleura lines the...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
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

24. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Oxygen-Hemoglobin Dissociation Curve
Increase the intrathoracic space
results in a lower than normal FEV1%
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

25. The visceral pleura lines the...
Pleural space
Right
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Outer surface of each lung

26. Inspiratory stridor becomes evident at about
Pneumonia - obstructive lung disease - and late pulmonary edema
70% occlusion of the airway
The total amount of air that can be exhaled following a maximal inhalation
Pulse oximetry

27. The internal intercostals decrease the transverse diameter of the chest during
Decreased pressure
Oxygen (O2)
Expiration
Increased Hb-O2 affinity

28. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Spirometry
Increased Hb-O2 affinity
Altering the respiratory rate and/or the tidal volume
Inspiration

29. Rhonchi
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Binding of O2 to Hb
Ventilation
right & left

30. expiratory reserve
Partial pressure of O2 in the arterial blood
5 years - to detect obstruction and determine its reversibility
Either inspiration or expiration
The amount of air that can be exhaled after expiration

31. Which lobe has an inferior tongue-like projection called the lingula?
'crackles' or 'rales'
Significant pulmonary impairment
Left upper lobe
Decreased pressure

32. 78.08% Atmospheric Composition
Obstructive lung disease from restrictive lung disease
70% occlusion of the airway
Partial pressure of oxygen in the alveoli
Nitrogen

33. Vesicular 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
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
2 - each wavelength is partially absorbed by hemoglobin

34. residual volume
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Carboxyhemoglobin
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
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

35. inspiratory reserve
PaCO2
The amount of air that can be inhaled after normal inspiration
10 to 11 cm long and about 2 cm in diameter
Pressure required to drive air through the airways

36. PaCO2
Partial pressure of CO2 in the arterial blood
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
Spirometry

37. Which lung has an oblique fissure?
Larger airways
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
require supplemental oxygenation and possibly ABG analysis
right & left

38. Abnormal lung sounds AKA

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39. Cyanosis is caused by
Blood to the alveoli
Pleural space
Increased amounts of unsaturated hemoglobin in capillary blood
Air-filled - fluid-filled - or solid

40. Discontinuous lung sounds are...
Altering the respiratory rate and/or the tidal volume
Brief - discrete - non-musical sounds with a popping quality
Decreased pressure
500 to 800 mL

41. The spirometry printout usually includes

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42. Bronchial breath sounds
Perfusion
Air bubbles flowing through secretions or slightly closed airways during respiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
respiration

43. Cyanosis
Perfusion
A good effort
Blue or bluish-gray discoloration of the skin or mucous membranes
50%

44. Obstructive disease refers to...
10 to 11 cm long and about 2 cm in diameter
The gas in the conducting airways does not participate in alveolar exchange
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Partial pressure of CO2 in the arterial blood

45. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Interstitial diseases or early pulmonary edema
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Diffusion

46. dead space ventilation
Blue or bluish-gray discoloration of the skin or mucous membranes
The gas in the conducting airways does not participate in alveolar exchange
Outer surface of each lung
Inspiration

47. PaO2
Pulse oximetry
Partial pressure of O2 in the arterial blood
50%
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

48. The upper airway accounts For what % of airway resistance?
results in a lower than normal FEV1%
The negative logarithm of hydrogen ions in the blood
50%
Lowered carbon dioxide level - results from hyperventilation

49. Airway resistance refers to...
Outer surface of each lung
Pressure required to drive air through the airways
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
80%

50. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Blue or bluish-gray discoloration of the skin or mucous membranes
A sensor placed over a translucent area of arterial pulsation
80%
Spirometry

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Pulmonology

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