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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 purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Pressure required to drive air through the airways
Mouth as well as through the chest wall
Inspiration

2. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Increased Hb-O2 affinity
Altering the respiratory rate and/or the tidal volume
The amount of air that can be inhaled after normal inspiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

3. Respiration involves
Ventilation - Diffusion - Perfusion
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Increased work of breathing
Diaphragm and the intercostal muscles

4. residual volume
Postero-anterior (PA) and lateral view series
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
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

5. Which lung has an oblique fissure?
Normal to increased FEV1%
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
right & left
Increased work of breathing

6. pH
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
The negative logarithm of hydrogen ions in the blood
Binding of O2 to Hb
Fraction (%age) of inspired oxygen

7. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Brief - discrete - non-musical sounds with a popping quality

8. Abnormal lung sounds AKA

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9. Patients with restrictive disease have low
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Difficulty breathing or shortness of breath
Diaphragm - External Intercostals
Lung volumes - but no difficulty or delay in exhaling what volume they do have

10. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Perfusion
Observing the pattern of breathing
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
respiration

11. terminal respiratory unit
Expiration
Pneumonia - obstructive lung disease - and late pulmonary edema
Acinus
5 years - to detect obstruction and determine its reversibility

12. normal subjects expel approximately how much of the FVC in the 1st second?
80%
Ventilation
Contracts
Inspiration

13. The active movement of gases between the ambient air and the lungs
results in a lower than normal FEV1%
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Postero-anterior (PA) and lateral view series
Ventilation

14. Bronchial breath sounds
Right
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
A sensor placed over a translucent area of arterial pulsation

15. Orthopnea is quantified by
A good effort
35 to 45 mmHg
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

16. Inspiratory stridor becomes evident at about
Increased rate of breathing and is commonly associated with a decrease in tidal volume
35 to 45 mmHg
70% occlusion of the airway
Lung volumes - but find it difficult to exhale rapidly

17. Percussion helps you establish whether the underlying tissues are...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Total lung capacity (TLC)
Air-filled - fluid-filled - or solid
Portable antero-posterior (AP) view

18. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Saturated with oxygen or unsaturated
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
The atmospheric pressure
Dyspnea upon assuming a recumbent position

19. PaO2
Partial pressure of O2 in the arterial blood
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Air-filled - fluid-filled - or solid
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

20. Dyspnea is defined as
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
80 to 120% of predicted value
Larger airways
Difficulty breathing or shortness of breath

21. The primary muscles of respiration are the...
Brief - discrete - non-musical sounds with a popping quality
'scooped out' or bowl-shaped
right & left
Diaphragm and the intercostal muscles

22. The acini consist of the...
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Spirometry
Larger airways
Normal to increased FEV1%

23. Obstructive Disease: Expiratory airflow is reduced more than
Cough
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Expiratory volume - and there is a prolonged expiratory time
50%

24. Discontinuous lung sounds are also called

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25. gas exchange across the alveolar-pulmonary capillary membranes
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Increased Hb-O2 affinity
Diffusion
The negative logarithm of hydrogen ions in the blood

26. The internal intercostals decrease the transverse diameter of the chest during
Expiration
Right
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Saturated with oxygen or unsaturated

27. office-based spirometry is recommended for patients as young as
Cough
5 years - to detect obstruction and determine its reversibility
Either continuous or discontinuous
The negative logarithm of hydrogen ions in the blood

28. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Insufficient oxygenation of hemoglobin in the lungs
Partial pressure of O2 in the arterial blood
Diffusion
Narrowed nearly to the point of closure

29. movement of blood through the capillaries in direct communication with the alveoli
Oxygen-Hemoglobin Dissociation Curve
Perfusion
The total amount of air that can be exhaled following a maximal inhalation
Increase the intrathoracic space

30. 20.95% Atmospheric Composition
The amount of air that can be inhaled after normal inspiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Oxygen (O2)
Contracts

31. Normal lung sounds
Inspiration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Hypoventilation or modest changes in the PaO2
A reliable and consistent classification of auditory findings

32. Pectoriloquy
Brief - discrete - non-musical sounds with a popping quality
Tongue
The examiner can clearly distinguish the word that the pt speak or whispers
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

33. Auscultation of the chest depends on...
Pulse oximetry
A reliable and consistent classification of auditory findings
Functional residual capacity (FRC)
'adventitious' breath sounds

34. At rest - the use of accessory muscles is a sign of...
Difficulty breathing or shortness of breath
Significant pulmonary impairment
release of O2 from Hb - as heat is a by-product of metabolism.
5 years - to detect obstruction and determine its reversibility

35. Inspiratory stridor indicates
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Oxygen (O2)
Either inspiration or expiration
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

36. Restrictive disease refers to...
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
A reduction in lung capacity - secondary to scarring or extraneous material
There is an inverse relationship between pressure and volume

37. Cyanosis appears when
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Bicarbonate
Difficulty breathing or shortness of breath
Obstructive lung disease from restrictive lung disease

38. Coarse crackles result from
Narrowed nearly to the point of closure
The negative logarithm of hydrogen ions in the blood
Air bubbles flowing through secretions or slightly closed airways during respiration
Spirometry

39. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
80 to 120% of predicted value
Oxygen-Hemoglobin Dissociation Curve
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

40. Pulse Oximetry does not detect
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Hypoventilation or modest changes in the PaO2
A sensor placed over a translucent area of arterial pulsation
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

41. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Functional residual capacity (FRC)
Air bubbles flowing through secretions or slightly closed airways during respiration

42. Fine crackles are...
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Soft - high-pitched and crisp
Postero-anterior (PA) and lateral view series
Total lung capacity (TLC)

43. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Diffusion
Partial pressure of oxygen in the alveoli
Tongue
Altering the respiratory rate and/or the tidal volume

44. Vesicular breath sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A reliable and consistent classification of auditory findings
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
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

45. Central cyanosis results from
'scooped out' or bowl-shaped
Insufficient oxygenation of hemoglobin in the lungs
Manubrio-sternal junction (angle of Louis)
The atmospheric pressure

46. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
reduced in size - compared with a normal curve - due to lower lung volume
A reduction in lung capacity - secondary to scarring or extraneous material
Increased work of breathing
Spirometry

47. The pattern of breathing refers to...
Blood to the alveoli
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Wheezes - high-pitched - musical sounds - distinct whistling quality
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

48. 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
Spirometry
A sensor placed over a translucent area of arterial pulsation
A good effort

49. The normal FEV1 /FVC ratio is...
70%
right & left
500 to 800 mL
A sensor placed over a translucent area of arterial pulsation

50. Pulse Oximetry is dependent on...
Immediate oxygenation with or without intubation
80 to 120% of predicted value
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

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Pulmonology

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