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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 use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
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
Increased work of breathing

2. Abnormal lung sounds AKA

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3. increased volume results in
Overcome some of the problems associated with low blood flow to the probe site
Brief - discrete - non-musical sounds with a popping quality
Decreased pressure
No respiration for > 20 seconds

4. Oximetry readings of < 94%
Carboxyhemoglobin
Saturated with oxygen or unsaturated
require supplemental oxygenation and possibly ABG analysis
70% occlusion of the airway

5. The presence of pressure gradients causes respiratory gases to move from
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
The examiner can clearly distinguish the word that the pt speak or whispers

6. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
80%
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Significant pulmonary impairment

7. The spirometry printout usually includes

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8. total lung capacity (TLC)
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Cough
The total amount of air in the lungs at the end of a maximal inhalation
No

9. Stridor is a high-pitched - noisy respiration - Which is indicative of...
The atmospheric pressure
Oxygen-Hemoglobin Dissociation Curve
Upper respiratory obstruction - usually in the trachea or larynx
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

10. Pectoriloquy
35 to 45 mmHg
No respiration for > 20 seconds
The examiner can clearly distinguish the word that the pt speak or whispers
Diffusion

11. The trachea is how long/wide?
10 to 11 cm long and about 2 cm in diameter
'crackles' or 'rales'
Dyspnea that awakens the patient several hours after going to sleep
Portable antero-posterior (AP) view

12. Pulse Oximetry does not detect
Partial pressure of carbon dioxide in the alveoli
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Spirometry
Hypoventilation or modest changes in the PaO2

13. Rhonchi frequently clear after
Cough
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Lung volumes - but find it difficult to exhale rapidly
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

14. Which lung has a horizontal fissure?
respiration
Acinus
right
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

15. Cyanosis is caused by
Increased amounts of unsaturated hemoglobin in capillary blood
Pleural space
Increased work of breathing
Pulse oximetry

16. Tachypnea is an
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
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
Ventilation - Diffusion - Perfusion

17. What occurs passively as muscles relax?
Partial pressure of CO2 in the arterial blood
Observing the pattern of breathing
Expiration
Perfusion

18. Continuous lung sounds
The right middle lobe
Mouth as well as through the chest wall
Wheezes - high-pitched - musical sounds - distinct whistling quality
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

19. Spirometry normal range
right and left mainstem bronchi
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Oxygen (O2)
80 to 120% of predicted value

20. tidal volume (Vt)
T4 or T5 - and just below the manubrio-sternal joint
80%
Altering the respiratory rate and/or the tidal volume
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

21. normal adult tidal volume
500 to 800 mL
Increase the intrathoracic space
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

22. The muscles of expiration are the...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Observing the pattern of breathing
Altering the respiratory rate and/or the tidal volume

23. pH
Partial pressure of carbon dioxide in the alveoli
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
Ventilation
The negative logarithm of hydrogen ions in the blood

24. 78.08% Atmospheric Composition
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Nitrogen
reduced in size - compared with a normal curve - due to lower lung volume
Alveoli to the blood

25. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Air to move from the upper airway to the farthest alveolar reaches
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
Carboxyhemoglobin
Inspiration

26. The vital capacity and the residual volume together constitute the...
Partial pressure of O2 in the arterial blood
A reduction in lung capacity - secondary to scarring or extraneous material
Acinus
Total lung capacity (TLC)

27. PAO2
70% occlusion of the airway
5 years - to detect obstruction and determine its reversibility
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
Partial pressure of oxygen in the alveoli

28. The tracheo-bronchial tree is a tubular system that provides a pathway for
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
reduced in size - compared with a normal curve - due to lower lung volume
Outer surface of each lung
Air to move from the upper airway to the farthest alveolar reaches

29. Coarse crackles are heard in
Pneumonia - obstructive lung disease - and late pulmonary edema
right
Partial pressure of O2 in the arterial blood
Partial pressure of oxygen in the alveoli

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

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31. Paroxysmal nocturnal dyspnea (PND) is...
Partial pressure of oxygen in the alveoli
Dyspnea that awakens the patient several hours after going to sleep
A good effort
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

32. low CO2 = low acidity =
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
Contracts
Binding of O2 to Hb

33. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Pressure required to drive air through the airways
Immediate oxygenation with or without intubation

34. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Partial pressure of O2 in the arterial blood
A sensor placed over a translucent area of arterial pulsation
Louder - lower-pitched - and slightly longer in duration

35. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
500 to 800 mL
Wheezes - high-pitched - musical sounds - distinct whistling quality
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
2 - each wavelength is partially absorbed by hemoglobin

36. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
A sensor placed over a translucent area of arterial pulsation
Partial pressure of O2 in the arterial blood
Increase the intrathoracic space
Increased amounts of unsaturated hemoglobin in capillary blood

37. Chest Radiography: The most common chest X-ray series is the...
Significant pulmonary impairment
Postero-anterior (PA) and lateral view series
Ventilation
Immediate oxygenation with or without intubation

38. FEV1% in restrictive disease
Functional residual capacity (FRC)
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
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
Normal to increased FEV1%

39. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Increased Hb-O2 affinity
right
No respiration for > 20 seconds
Dullness replaces resonance

40. Which bronchus is wider - shorter - and more vertically placed?
Right
Dyspnea upon assuming a recumbent position
Lowered carbon dioxide level - results from hyperventilation
release of O2 from Hb

41. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Decreased pressure
Bicarbonate
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

42. Carbon dioxide moves from the...
Blood to the alveoli
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
70%

43. With restrictive disease - the flow-volume curve is...
Expiratory volume - and there is a prolonged expiratory time
Wheezes - high-pitched - musical sounds - distinct whistling quality
reduced in size - compared with a normal curve - due to lower lung volume
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

44. Which bronchus is more susceptible to aspiration of foreign bodies?
Increase the intrathoracic space
Right
35 to 45 mmHg
Partial pressure of carbon dioxide in the alveoli

45. Discontinuous lung sounds are also called

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46. residual volume
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
Oxygen-Hemoglobin Dissociation Curve
Normal to increased FEV1%
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

47. inspiratory reserve
Dullness replaces resonance
Lung volumes - but no difficulty or delay in exhaling what volume they do have
The amount of air that can be inhaled after normal inspiration
Soft - high-pitched and crisp

48. Airway resistance refers to...
Bronchospasm - mucosal edema - or excessive secretions
Pressure required to drive air through the airways
Bicarbonate
Decreased pressure

49. Examples of restrictive disease
Partial pressure of CO2 in the arterial blood
70% occlusion of the airway
Blood to the alveoli
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

50. most important factor that influences the oxygen carrying capacity of hemoglobin
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
No respiration for > 20 seconds
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Partial pressure of oxygen (PO2)