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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. Bronchophony
Pulse oximetry
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
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Air to move from the upper airway to the farthest alveolar reaches

2. Compliance
2 - each wavelength is partially absorbed by hemoglobin
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
Sternocleidomastoid - Scalene Muscles
Pleural space

3. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Wheezes - high-pitched - musical sounds - distinct whistling quality
Partial pressure of oxygen in the alveoli
5 years - to detect obstruction and determine its reversibility
Dullness replaces resonance

4. the lingula is analogous to...
Partial pressure of oxygen (PO2)
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 right middle lobe
Increased work of breathing

5. The visceral pleura lines the...
Narrowed nearly to the point of closure
Outer surface of each lung
A sensor placed over a translucent area of arterial pulsation
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

6. What may prevent cyanosis from appearing?
The examiner can clearly distinguish the word that the pt speak or whispers
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
release of O2 from Hb - as heat is a by-product of metabolism.
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

7. Rhonchi occur during
quickly - usually reaching a plateau within 6.0 seconds
Either inspiration or expiration
Binding of O2 to Hb
70% occlusion of the airway

8. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Either continuous or discontinuous
There is an inverse relationship between pressure and volume
A good effort
Air to move from the upper airway to the farthest alveolar reaches

9. Continuous lung sounds often audible at the...
Total lung capacity (TLC)
Mouth as well as through the chest wall
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Carboxyhemoglobin

10. Late inspiratory crackles result from
right and left mainstem bronchi
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
No respiration for > 20 seconds

11. PACO2
Dyspnea that awakens the patient several hours after going to sleep
Expiration
Partial pressure of carbon dioxide in the alveoli
80%

12. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Expiration
Narrowed nearly to the point of closure
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
There is an inverse relationship between pressure and volume

13. Airway resistance refers to...
Pressure required to drive air through the airways
The negative logarithm of hydrogen ions in the blood
Cough
Upper respiratory obstruction - usually in the trachea or larynx

14. Oximetry readings of < 94%
require supplemental oxygenation and possibly ABG analysis
Total lung capacity (TLC)
The atmospheric pressure
Bronchospasm - mucosal edema - or excessive secretions

15. Discontinuous lung sounds are...
Expiration
Brief - discrete - non-musical sounds with a popping quality
To assess response to treatment
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

16. 78.08% Atmospheric Composition
right & left
Significant pulmonary impairment
Nitrogen
Lung volumes - but find it difficult to exhale rapidly

17. FEV1% in restrictive disease
Expiration
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Increased amounts of unsaturated hemoglobin in capillary blood
Normal to increased FEV1%

18. The most reliable site for detecting central cyanosis is the...
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Expiratory volume - and there is a prolonged expiratory time
Tongue
Partial pressure of oxygen (PO2)

19. 20.95% Atmospheric Composition
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Oxygen (O2)
The right middle lobe
Soft - high-pitched and crisp

20. low CO2 = low acidity =
Pneumonia - obstructive lung disease - and late pulmonary edema
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Binding of O2 to Hb
Obstructive lung disease from restrictive lung disease

21. The purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Hypoventilation or modest changes in the PaO2
Expiration
reduced in size - compared with a normal curve - due to lower lung volume

22. Abnormal lung sounds are classified as
Increased amounts of unsaturated hemoglobin in capillary blood
Tongue
Cough
Either continuous or discontinuous

23. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
35 to 45 mmHg
Spirometry
A tracing of the lung volume against time in seconds

24. Auscultation of the chest depends on...
Partial pressure of oxygen in the alveoli
Either inspiration or expiration
A reliable and consistent classification of auditory findings
Pneumonia - obstructive lung disease - and late pulmonary edema

25. A normal volume-time curve rises
Immediate oxygenation with or without intubation
quickly - usually reaching a plateau within 6.0 seconds
Diffusion
Soft - high-pitched and crisp

26. During inspiration the diaphragm
Air bubbles flowing through secretions or slightly closed airways during respiration
Contracts
Spirometry
Expiratory volume - and there is a prolonged expiratory time

27. normal adult tidal volume
500 to 800 mL
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Partial pressure of oxygen (PO2)
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

28. 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
Perfusion
70% occlusion of the airway
The atmospheric pressure

29. Cyanosis is caused by
Postero-anterior (PA) and lateral view series
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Increased amounts of unsaturated hemoglobin in capillary blood

30. The internal intercostals decrease the transverse diameter of the chest during
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Dyspnea that awakens the patient several hours after going to sleep
Expiration
Blue or bluish-gray discoloration of the skin or mucous membranes

31. Obstructive disease refers to...
Right
The total amount of air that can be exhaled following a maximal inhalation
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Air-filled - fluid-filled - or solid

32. The main bronchi are divided into smaller branches that begin to subdivide into
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Expiration
500 to 800 mL
The gas in the conducting airways does not participate in alveolar exchange

33. Cyanosis
Blue or bluish-gray discoloration of the skin or mucous membranes
The total amount of air that can be exhaled following a maximal inhalation
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
Pneumonia - obstructive lung disease - and late pulmonary edema

34. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
Portable antero-posterior (AP) view
Increased work of breathing
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

35. Continuous lung sounds occur in the setting of...
The amount of air that can be exhaled after expiration
Bronchospasm - mucosal edema - or excessive secretions
The amount of air that can be inhaled after normal inspiration
Acinus

36. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
5 years - to detect obstruction and determine its reversibility
Louder - lower-pitched - and slightly longer in duration
Perfusion

37. Restrictive Disease: Expiratory volume is reduced more than
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
A reduction in lung capacity - secondary to scarring or extraneous material
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

38. Central cyanosis results from
Significant pulmonary impairment
Insufficient oxygenation of hemoglobin in the lungs
Normal to increased FEV1%
The rib above it

39. The muscles of inspiration are the...
A reliable and consistent classification of auditory findings
Diaphragm - External Intercostals
Binding of O2 to Hb
T4 or T5 - and just below the manubrio-sternal joint

40. forced expiratory volume in one second (FEV1)
Obstructive lung disease from restrictive lung disease
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
Expiration
The right middle lobe

41. FEV1/FVC
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Inflammation of the adjacent parietal pleura
Spirometry
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

42. Examples of obstructive disease
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Dyspnea upon assuming a recumbent position
50%
Insufficient oxygenation of hemoglobin in the lungs

43. The trachea divides into right and left mainstem bronchi At what level?
Significant pulmonary impairment
Diaphragm - External Intercostals
A reliable and consistent classification of auditory findings
T4 or T5 - and just below the manubrio-sternal joint

44. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
Manubrio-sternal junction (angle of Louis)
The atmospheric pressure
35 to 45 mmHg

45. FIO2
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
Fraction (%age) of inspired oxygen
A sensor placed over a translucent area of arterial pulsation
Larger airways

46. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Expiratory volume - and there is a prolonged expiratory time
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Increase the intrathoracic space
2 - each wavelength is partially absorbed by hemoglobin

47. office-based spirometry is recommended for patients as young as
5 years - to detect obstruction and determine its reversibility
Obstruction below the vocal cords (subglottic or tracheal obstruction)
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
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

48. The external intercostal muscles increase the antero-posterior chest diameter during
Inflammation of the adjacent parietal pleura
right & left
Spirometry
Inspiration

49. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
results in a lower than normal FEV1%
The total amount of air that can be exhaled following a maximal inhalation
Partial pressure of oxygen (PO2)
Perfusion

50. Which lung has an oblique fissure?
release of O2 from Hb
Pulse oximetry
right & left
Pressure required to drive air through the airways

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Pulmonology

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