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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. Pulse Oximetry does not detect
A tracing of the lung volume against time in seconds
T4 or T5 - and just below the manubrio-sternal joint
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Hypoventilation or modest changes in the PaO2

2. 20.95% Atmospheric Composition
release of O2 from Hb - as heat is a by-product of metabolism.
Partial pressure of O2 in the arterial blood
Oxygen (O2)
Diffusion

3. Late inspiratory crackles result from
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Portable antero-posterior (AP) view
Bronchospasm - mucosal edema - or excessive secretions
Increased rate of breathing and is commonly associated with a decrease in tidal volume

4. Spirometry can be used to determine the severity of functional impairment as well as
Lung volumes - but find it difficult to exhale rapidly
The atmospheric pressure
right
To assess response to treatment

5. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
respiration
Immediate oxygenation with or without intubation
results in a lower than normal FEV1%
PaCO2

6. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Increased work of breathing
80 to 120% of predicted value
Observing the pattern of breathing
Ventilation - Diffusion - Perfusion

7. The volume of gas remaining in the lungs at the end of normal expiration is called the...
respiration
To assess response to treatment
The negative logarithm of hydrogen ions in the blood
Functional residual capacity (FRC)

8. PAO2
Expiration
Partial pressure of oxygen in the alveoli
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
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

9. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
'crackles' or 'rales'
70%
Perfusion
Carboxyhemoglobin

10. gas exchange across the alveolar-pulmonary capillary membranes
Dullness replaces resonance
Diffusion
Inflammation of the adjacent parietal pleura
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

11. Discontinuous lung sounds are...
Manubrio-sternal junction (angle of Louis)
Brief - discrete - non-musical sounds with a popping quality
Air bubbles flowing through secretions or slightly closed airways during respiration
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

12. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Spirometry
Diffusion
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

13. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Expiratory volume - and there is a prolonged expiratory time
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The atmospheric pressure
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

14. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
right
Increased work of breathing
Portable antero-posterior (AP) view

15. FIO2
80 to 120% of predicted value
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Either inspiration or expiration
Fraction (%age) of inspired oxygen

16. The purpose of respiration is to...
T4 or T5 - and just below the manubrio-sternal joint
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
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

17. movement of blood through the capillaries in direct communication with the alveoli
Dyspnea upon assuming a recumbent position
results in a lower than normal FEV1%
Perfusion
Interstitial diseases or early pulmonary edema

18. A normal volume-time curve rises
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
quickly - usually reaching a plateau within 6.0 seconds
The amount of air that can be exhaled after expiration
Alveoli to the blood

19. The main bronchi are divided into smaller branches that begin to subdivide into
2 - each wavelength is partially absorbed by hemoglobin
Functional residual capacity (FRC)
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
70% occlusion of the airway

20. The presence of pressure gradients causes respiratory gases to move from
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
results in a lower than normal FEV1%
Increased amounts of unsaturated hemoglobin in capillary blood
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

21. Cyanosis appears when
release of O2 from Hb - as heat is a by-product of metabolism.
Obstructive lung disease from restrictive lung disease
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

22. Continuous lung sounds often audible at the...
No respiration for > 20 seconds
Perfusion
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
Mouth as well as through the chest wall

23. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Either inspiration or expiration
Saturated with oxygen or unsaturated
The amount of air that can be inhaled after normal inspiration
There is an inverse relationship between pressure and volume

24. Vesicular breath sounds
5 years - to detect obstruction and determine its reversibility
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Dyspnea that awakens the patient several hours after going to sleep
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

25. Spirometry is useful in distinguishing
A tracing of the lung volume against time in seconds
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Obstructive lung disease from restrictive lung disease
The amount of air that can be exhaled after expiration

26. inspiratory reserve
5 years - to detect obstruction and determine its reversibility
Pneumonia - obstructive lung disease - and late pulmonary edema
The amount of air that can be inhaled after normal inspiration
Partial pressure of carbon dioxide in the alveoli

27. HCO3
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Bicarbonate

28. PaCO2
Altering the respiratory rate and/or the tidal volume
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Air bubbles flowing through secretions or slightly closed airways during respiration
Partial pressure of CO2 in the arterial blood

29. Abnormal lung sounds are classified as
Either inspiration or expiration
Either continuous or discontinuous
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

30. 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
Diffusion
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Obstruction below the vocal cords (subglottic or tracheal obstruction)

31. Which lung has an oblique fissure?
Diaphragm and the intercostal muscles
right & left
Tongue
Saturated with oxygen or unsaturated

32. Dyspnea is defined as
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Difficulty breathing or shortness of breath
Tongue
Either continuous or discontinuous

33. The upper airway accounts For what % of airway resistance?
Soft - high-pitched and crisp
50%
A good effort
Lung volumes - but no difficulty or delay in exhaling what volume they do have

34. forced expiratory volume in one second (FEV1)
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
Portable antero-posterior (AP) view
results in a lower than normal FEV1%
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

35. normal subjects expel approximately how much of the FVC in the 1st second?
The negative logarithm of hydrogen ions in the blood
Normal to increased FEV1%
A reliable and consistent classification of auditory findings
80%

36. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Perfusion
The negative logarithm of hydrogen ions in the blood
Pneumonia - obstructive lung disease - and late pulmonary edema
Ventilation

37. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Narrowed nearly to the point of closure
Perfusion
right and left mainstem bronchi

38. The trachea bifurcates into its mainstem bronchi at the level of...
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
To assess response to treatment
respiration

39. Boyle's Gas Law
The rib above it
There is an inverse relationship between pressure and volume
Blue or bluish-gray discoloration of the skin or mucous membranes
500 to 800 mL

40. Expiratory stridor indicates
Obstruction below the vocal cords (subglottic or tracheal obstruction)
release of O2 from Hb
Normal to increased FEV1%
Altering the respiratory rate and/or the tidal volume

41. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
Altering the respiratory rate and/or the tidal volume
Outer surface of each lung
Inflammation of the adjacent parietal pleura

42. Continuous lung sounds occur during...
Lowered carbon dioxide level - results from hyperventilation
Difficulty breathing or shortness of breath
Either inspiration or expiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

43. terminal respiratory unit
Acinus
Air-filled - fluid-filled - or solid
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
PaCO2

44. low CO2 = low acidity =
Binding of O2 to Hb
Inspiration
Partial pressure of O2 in the arterial blood
Significant pulmonary impairment

45. Central cyanosis results from
Functional residual capacity (FRC)
Insufficient oxygenation of hemoglobin in the lungs
Partial pressure of oxygen (PO2)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

46. The tracheo-bronchial tree is a tubular system that provides a pathway for
Soft - high-pitched and crisp
Partial pressure of oxygen in the alveoli
Air to move from the upper airway to the farthest alveolar reaches
Obstruction below the vocal cords (subglottic or tracheal obstruction)

47. forced vital capacity (FVC)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Inside of the thoracic cavity wall and the upper surface of the diaphragm
'crackles' or 'rales'
Right

48. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
Mediastinum
Binding of O2 to Hb
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

49. During inspiration the diaphragm
The total amount of air in the lungs at the end of a maximal inhalation
Contracts
Perfusion
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

50. FEV1% in obstructive disease
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
Diffusion
results in a lower than normal FEV1%
70%