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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

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. Late inspiratory crackles result from
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Louder - lower-pitched - and slightly longer in duration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Partial pressure of oxygen (PO2)

2. The muscles of inspiration are the...
Increased Hb-O2 affinity
Diaphragm - External Intercostals
Decreased Hb-O2 affinity
A sensor placed over a translucent area of arterial pulsation

3. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Significant pulmonary impairment
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Difficulty breathing or shortness of breath
Increased work of breathing

4. During inspiration the diaphragm
Partial pressure of CO2 in the arterial blood
Louder - lower-pitched - and slightly longer in duration
Contracts
Oxygen-Hemoglobin Dissociation Curve

5. Does lung tissue have pain fibers?
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Either inspiration or expiration
No
Blood to the alveoli

6. Restrictive Disease: Expiratory volume is reduced more than
A good effort
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The right middle lobe

7. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
5 years - to detect obstruction and determine its reversibility
Expiration
Binding of O2 to Hb

8. Continuous lung sounds occur when air flows rapidly through bronchi that are...
A reliable and consistent classification of auditory findings
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
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Narrowed nearly to the point of closure

9. Bronchophony
70%
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
Fraction (%age) of inspired oxygen
The atmospheric pressure

10. Which lung has a horizontal fissure?
right and left mainstem bronchi
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
right
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

11. 78.08% Atmospheric Composition
Nitrogen
Brief - discrete - non-musical sounds with a popping quality
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Functional residual capacity (FRC)

12. Which bronchus is more susceptible to aspiration of foreign bodies?
Right
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
Portable antero-posterior (AP) view
Tongue

13. forced expiratory volume in one second (FEV1)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
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
The total amount of air in the lungs at the end of a maximal inhalation

14. Normal lung sounds
right and left mainstem bronchi
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
There is an inverse relationship between pressure and volume
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

15. Pulse Oximetry is dependent on...
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
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

16. Spirometry can be used to determine the severity of functional impairment as well as
Brief - discrete - non-musical sounds with a popping quality
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Partial pressure of oxygen (PO2)
To assess response to treatment

17. Rhonchi occur during
The amount of air that can be exhaled after expiration
Functional residual capacity (FRC)
Bicarbonate
Either inspiration or expiration

18. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Postero-anterior (PA) and lateral view series
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
Manubrio-sternal junction (angle of Louis)

19. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
'crackles' or 'rales'
The right middle lobe

20. Restrictive disease refers to...
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Inspiration
Air to move from the upper airway to the farthest alveolar reaches
A reduction in lung capacity - secondary to scarring or extraneous material

21. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Spirometry
Immediate oxygenation with or without intubation
Larger airways
The total amount of air in the lungs at the end of a maximal inhalation

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

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23. Orthopnea is defined as
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
Dyspnea upon assuming a recumbent position
release of O2 from Hb - as heat is a by-product of metabolism.
The total amount of air in the lungs at the end of a maximal inhalation

24. pain in lung conditions usually arises from
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
Inflammation of the adjacent parietal pleura
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Perfusion

25. Obstructive disease refers to...
Normal to increased FEV1%
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
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
'scooped out' or bowl-shaped

26. Bohr Effect of pH: right shift
Wheezes - high-pitched - musical sounds - distinct whistling quality
Lung volumes - but find it difficult to exhale rapidly
Decreased Hb-O2 affinity
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

27. the lingula is analogous to...
Diffusion
Perfusion
The right middle lobe
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

28. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Ventilation - Diffusion - Perfusion
The total amount of air that can be exhaled following a maximal inhalation
Difficulty breathing or shortness of breath
Increase the intrathoracic space

29. The vital capacity and the residual volume together constitute the...
The total amount of air that can be exhaled following a maximal inhalation
Partial pressure of oxygen (PO2)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Total lung capacity (TLC)

30. gas exchange across the alveolar-pulmonary capillary membranes
Diffusion
Significant pulmonary impairment
Sternocleidomastoid - Scalene Muscles
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

31. Continuous lung sounds
Overcome some of the problems associated with low blood flow to the probe site
Dullness replaces resonance
Wheezes - high-pitched - musical sounds - distinct whistling quality
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

32. Discontinuous lung sounds are also called

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33. Which bronchus is wider - shorter - and more vertically placed?
'scooped out' or bowl-shaped
Right
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Bicarbonate

34. Pulmonary ventilation is varied by
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
70% occlusion of the airway
Altering the respiratory rate and/or the tidal volume
release of O2 from Hb - as heat is a by-product of metabolism.

35. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Mediastinum
Outer surface of each lung
Perfusion
Lowered carbon dioxide level - results from hyperventilation

36. The primary muscles of respiration are the...
Pleural space
Oxygen-Hemoglobin Dissociation Curve
Diaphragm and the intercostal muscles
Binding of O2 to Hb

37. 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
Inflammation of the adjacent parietal pleura
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Soft - high-pitched and crisp

38. Respiration involves
Ventilation - Diffusion - Perfusion
Upper respiratory obstruction - usually in the trachea or larynx
There is an inverse relationship between pressure and volume
The rib above it

39. Continuous lung sounds occur in the setting of...
Ventilation
Bronchospasm - mucosal edema - or excessive secretions
Lung volumes - but find it difficult to exhale rapidly
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

40. Fine crackles are heard in
Pleural space
500 to 800 mL
To assess response to treatment
Interstitial diseases or early pulmonary edema

41. Spirometry: The result is stated as
A reduction in lung capacity - secondary to scarring or extraneous material
Either continuous or discontinuous
Inflammation of the adjacent parietal pleura
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

42. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Wheezes - high-pitched - musical sounds - distinct whistling quality
Spirometry
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Hypoventilation or modest changes in the PaO2

43. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
'crackles' or 'rales'
80%
Spirometry

44. PaCO2
Partial pressure of CO2 in the arterial blood
Spirometry
Right
Contracts

45. forced vital capacity (FVC)
Decreased pressure
Decreased Hb-O2 affinity
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Carboxyhemoglobin

46. Airway resistance refers to...
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Pressure required to drive air through the airways
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

47. Apnea is defined as
Insufficient oxygenation of hemoglobin in the lungs
Increase the intrathoracic space
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
No respiration for > 20 seconds

48. terminal respiratory unit
80%
Bicarbonate
Acinus
Decreased Hb-O2 affinity

49. The presence of pressure gradients causes respiratory gases to move from
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Sternocleidomastoid - Scalene Muscles
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

50. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Diffusion
Partial pressure of oxygen (PO2)
'crackles' or 'rales'
Upper respiratory obstruction - usually in the trachea or larynx