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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. Bronchial breath sounds
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Increased minute volume ventilation - which results in a lowered carbon dioxide level
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

2. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Left upper lobe
Air bubbles flowing through secretions or slightly closed airways during respiration
Narrowed nearly to the point of closure
Speed of airflow - the higher the flow - the greater the resistance

3. total lung capacity (TLC)
release of O2 from Hb
Functional residual capacity (FRC)
The total amount of air in the lungs at the end of a maximal inhalation
Bicarbonate

4. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Increased work of breathing
A sensor placed over a translucent area of arterial pulsation
require supplemental oxygenation and possibly ABG analysis
Upper respiratory obstruction - usually in the trachea or larynx

5. Vesicular breath sounds
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
The negative logarithm of hydrogen ions in the blood
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

6. Which bronchus is more susceptible to aspiration of foreign bodies?
Inflammation of the adjacent parietal pleura
Functional residual capacity (FRC)
Right
Soft - high-pitched and crisp

7. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
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
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Bicarbonate

8. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Spirometry
The right middle lobe
Lung volumes - but find it difficult to exhale rapidly

9. A state-of-the-art - inexpensive - non-invasive - simple method to monitor a patient's percent hemoglobin saturation with oxygen (SaO2) - without having to obtain an arterial blood specimen
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Pulse oximetry
Manubrio-sternal junction (angle of Louis)

10. Rhonchi occur during
release of O2 from Hb - as heat is a by-product of metabolism.
Insufficient oxygenation of hemoglobin in the lungs
Either inspiration or expiration
Obstruction below the vocal cords (subglottic or tracheal obstruction)

11. Oxygen moves from the...
No respiration for > 20 seconds
right
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Alveoli to the blood

12. Rhonchi are due to...
Excessive secretions and abnormal airway collapsibility
Left upper lobe
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

13. Continuous lung sounds often audible at the...
Total lung capacity (TLC)
Mouth as well as through the chest wall
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
respiration

14. Tachypnea is an
Carboxyhemoglobin
The amount of air that can be exhaled after expiration
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Increased rate of breathing and is commonly associated with a decrease in tidal volume

15. Peripheral cyanosis results from
'adventitious' breath sounds
Increased rate of breathing and is commonly associated with a decrease in tidal volume
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

16. normal adult tidal volume
Bronchospasm - mucosal edema - or excessive secretions
500 to 800 mL
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Right

17. An efficient approach to examination of the patient begins with
Observing the pattern of breathing
80%
Bronchospasm - mucosal edema - or excessive secretions
Carboxyhemoglobin

18. normal subjects expel approximately how much of the FVC in the 1st second?
80 to 120% of predicted value
80%
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Tongue

19. Continuous lung sounds occur during...
A good effort
Diaphragm and the intercostal muscles
Either inspiration or expiration
PaCO2

20. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Inflammation of the adjacent parietal pleura
results in a lower than normal FEV1%
Cough
Increase the intrathoracic space

21. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
A good effort
Alveoli to the blood
Increased amounts of unsaturated hemoglobin in capillary blood

22. With restrictive disease - the flow-volume curve is...
Nitrogen
The gas in the conducting airways does not participate in alveolar exchange
5 years - to detect obstruction and determine its reversibility
reduced in size - compared with a normal curve - due to lower lung volume

23. FIO2
Inflammation of the adjacent parietal pleura
Blue or bluish-gray discoloration of the skin or mucous membranes
Fraction (%age) of inspired oxygen
quickly - usually reaching a plateau within 6.0 seconds

24. Obstructive disease refers to...
require supplemental oxygenation and possibly ABG analysis
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
The atmospheric pressure
Pneumonia - obstructive lung disease - and late pulmonary edema

25. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
Decreased Hb-O2 affinity
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
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

26. inspiratory reserve
Partial pressure of oxygen in the alveoli
The amount of air that can be inhaled after normal inspiration
Manubrio-sternal junction (angle of Louis)
Normal to increased FEV1%

27. A normal volume-time curve rises
Hypoventilation or modest changes in the PaO2
right
right and left mainstem bronchi
quickly - usually reaching a plateau within 6.0 seconds

28. The vital capacity and the residual volume together constitute the...
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Pneumonia - obstructive lung disease - and late pulmonary edema
PaCO2
Total lung capacity (TLC)

29. Oximetry readings of < 94%
The rib above it
70% occlusion of the airway
Pressure required to drive air through the airways
require supplemental oxygenation and possibly ABG analysis

30. hypocapnia
Lowered carbon dioxide level - results from hyperventilation
'crackles' or 'rales'
500 to 800 mL
Either inspiration or expiration

31. Fine crackles are heard in
Interstitial diseases or early pulmonary edema
Functional residual capacity (FRC)
Ventilation
Air bubbles flowing through secretions or slightly closed airways during respiration

32. Respiration involves
5 years - to detect obstruction and determine its reversibility
Blood to the alveoli
Outer surface of each lung
Ventilation - Diffusion - Perfusion

33. Normal range of PaCO2
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
35 to 45 mmHg
Nitrogen
Total lung capacity (TLC)

34. dead space ventilation
Decreased pressure
Soft - high-pitched and crisp
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The gas in the conducting airways does not participate in alveolar exchange

35. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Diffusion
quickly - usually reaching a plateau within 6.0 seconds
The atmospheric pressure
right

36. The main bronchi are divided into smaller branches that begin to subdivide into
Spirometry
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
'adventitious' breath sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

37. Compliance
reduced in size - compared with a normal curve - due to lower lung volume
Diffusion
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
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

38. Apnea is defined as
Left upper lobe
Lung volumes - but no difficulty or delay in exhaling what volume they do have
No respiration for > 20 seconds
'scooped out' or bowl-shaped

39. Pectoriloquy
require supplemental oxygenation and possibly ABG analysis
T4 or T5 - and just below the manubrio-sternal joint
The examiner can clearly distinguish the word that the pt speak or whispers
Mouth as well as through the chest wall

40. The tracheo-bronchial tree is a tubular system that provides a pathway for
Partial pressure of O2 in the arterial blood
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Air to move from the upper airway to the farthest alveolar reaches
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

41. The normal FEV1 /FVC ratio is...
70%
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
The amount of air that can be exhaled after expiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

42. PAO2
Partial pressure of oxygen in the alveoli
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Brief - discrete - non-musical sounds with a popping quality
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

43. Bronchiovesicular breath sounds
10 to 11 cm long and about 2 cm in diameter
80 to 120% of predicted value
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Partial pressure of oxygen (PO2)

44. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Decreased Hb-O2 affinity
Increased work of breathing
10 to 11 cm long and about 2 cm in diameter
Difficulty breathing or shortness of breath

45. The visceral pleura lines the...
Increase the intrathoracic space
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Outer surface of each lung
Increased minute volume ventilation - which results in a lowered carbon dioxide level

46. Pulse Oximetry does not detect
The amount of air that can be exhaled after expiration
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Hypoventilation or modest changes in the PaO2
Either continuous or discontinuous

47. Rhonchi originate in the...
Larger airways
80%
Outer surface of each lung
Cough

48. Discontinuous lung sounds are...
The examiner can clearly distinguish the word that the pt speak or whispers
70%
Spirometry
Brief - discrete - non-musical sounds with a popping quality

49. Bronchophony
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Diffusion
Tongue
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

50. 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
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
results in a lower than normal FEV1%

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Pulmonology

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