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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. dead space ventilation
'crackles' or 'rales'
The gas in the conducting airways does not participate in alveolar exchange
'adventitious' breath sounds
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

2. Which lobe has an inferior tongue-like projection called the lingula?
The right middle lobe
Total lung capacity (TLC)
Increased amounts of unsaturated hemoglobin in capillary blood
Left upper lobe

3. Continuous lung sounds occur during...
Either inspiration or expiration
Pleural space
Decreased Hb-O2 affinity
Bronchospasm - mucosal edema - or excessive secretions

4. Which bronchus is wider - shorter - and more vertically placed?
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Right
Air bubbles flowing through secretions or slightly closed airways during respiration
right & left

5. The active movement of gases between the ambient air and the lungs
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Ventilation
right & left
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

6. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Pressure required to drive air through the airways
There is an inverse relationship between pressure and volume
The atmospheric pressure

7. The trachea is how long/wide?
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Significant pulmonary impairment
10 to 11 cm long and about 2 cm in diameter
Lung volumes - but find it difficult to exhale rapidly

8. Rhonchi are due to...
Excessive secretions and abnormal airway collapsibility
The right middle lobe
Decreased pressure
Diaphragm and the intercostal muscles

9. Bronchial breath sounds
Overcome some of the problems associated with low blood flow to the probe site
Pneumonia - obstructive lung disease - and late pulmonary edema
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Bronchospasm - mucosal edema - or excessive secretions

10. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Difficulty breathing or shortness of breath
80%
Carboxyhemoglobin

11. The most reliable site for detecting central cyanosis is the...
Tongue
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

12. Restrictive Disease: Expiratory volume is reduced more than
Cough
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
right & left
2 - each wavelength is partially absorbed by hemoglobin

13. 20.95% Atmospheric Composition
Perfusion
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Oxygen (O2)

14. Rhonchi
A reduction in lung capacity - secondary to scarring or extraneous material
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Either continuous or discontinuous

15. Spirometry can be used to determine the severity of functional impairment as well as
Increased 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
35 to 45 mmHg
To assess response to treatment

16. The spirometry printout usually includes

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17. Respiration involves
Either inspiration or expiration
Ventilation - Diffusion - Perfusion
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
70% occlusion of the airway

18. At rest - the use of accessory muscles is a sign of...
Increased work of breathing
right
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Significant pulmonary impairment

19. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Speed of airflow - the higher the flow - the greater the resistance
Pleural space
Pneumonia - obstructive lung disease - and late pulmonary edema

20. Factors that influence the oxygen carrying capacity of hemoglobin
Manubrio-sternal junction (angle of Louis)
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The examiner can clearly distinguish the word that the pt speak or whispers
Acinus

21. Vesicular breath sounds
Either continuous or discontinuous
Interstitial diseases or early pulmonary edema
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
Dullness replaces resonance

22. Carbon dioxide moves from the...
Louder - lower-pitched - and slightly longer in duration
Partial pressure of oxygen in the alveoli
Significant pulmonary impairment
Blood to the alveoli

23. Cyanosis
right
Blue or bluish-gray discoloration of the skin or mucous membranes
Normal to increased FEV1%
Overcome some of the problems associated with low blood flow to the probe site

24. PAO2
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
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Partial pressure of oxygen in the alveoli
Inspiration

25. Bohr Effect of pH is graphed as
Significant pulmonary impairment
Pleural space
A sensor placed over a translucent area of arterial pulsation
Oxygen-Hemoglobin Dissociation Curve

26. The best indicator of adequate ventilation is the...
PaCO2
Oxygen-Hemoglobin Dissociation Curve
A tracing of the lung volume against time in seconds
Larger airways

27. within limits - increased temperature =
The atmospheric pressure
Hypoventilation or modest changes in the PaO2
Partial pressure of carbon dioxide in the alveoli
release of O2 from Hb - as heat is a by-product of metabolism.

28. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Outer surface of each lung
respiration
Pressure required to drive air through the airways

29. Obstructive Disease: Expiratory airflow is reduced more than
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Expiratory volume - and there is a prolonged expiratory time
right & left
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

30. Examples of obstructive disease
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Either inspiration or expiration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

31. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Increase the intrathoracic space
Hypoventilation or modest changes in the PaO2
The atmospheric pressure
Pneumonia - obstructive lung disease - and late pulmonary edema

32. The trachea divides into right and left mainstem bronchi At what level?
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
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
T4 or T5 - and just below the manubrio-sternal joint

33. HCO3
Bicarbonate
Pulse oximetry
A sensor placed over a translucent area of arterial pulsation
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

34. Which lung has an oblique fissure?
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Nitrogen
Total lung capacity (TLC)
right & left

35. Patients with restrictive disease have low
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Soft - high-pitched and crisp
Lung volumes - but no difficulty or delay in exhaling what volume they do have
No

36. PaCO2
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Outer surface of each lung
Partial pressure of CO2 in the arterial blood
require supplemental oxygenation and possibly ABG analysis

37. What is the potential space between the visceral and parietal pleurae?
Diffusion
Pleural space
Tongue
Hypoventilation or modest changes in the PaO2

38. Continuous lung sounds
Postero-anterior (PA) and lateral view series
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Wheezes - high-pitched - musical sounds - distinct whistling quality
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

39. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Increased amounts of unsaturated hemoglobin in capillary blood
Dullness replaces resonance
Total lung capacity (TLC)
Dyspnea upon assuming a recumbent position

40. Spirometry normal range
Increase the intrathoracic space
Increased Hb-O2 affinity
To assess response to treatment
80 to 120% of predicted value

41. The presence of pressure gradients causes respiratory gases to move from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Acinus
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Bicarbonate

42. vital capacity (VC)
Blue or bluish-gray discoloration of the skin or mucous membranes
The total amount of air that can be exhaled following a maximal inhalation
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

43. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
A tracing of the lung volume against time in seconds
Expiratory volume - and there is a prolonged expiratory time
Increase the intrathoracic space

44. Airway resistance refers to...
Left upper lobe
Sternocleidomastoid - Scalene Muscles
Pressure required to drive air through the airways
The examiner can clearly distinguish the word that the pt speak or whispers

45. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Partial pressure of carbon dioxide in the alveoli
35 to 45 mmHg
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

46. Bronchophony
Portable antero-posterior (AP) view
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
'crackles' or 'rales'
'adventitious' breath sounds

47. normal adult tidal volume
Decreased pressure
500 to 800 mL
Partial pressure of CO2 in the arterial blood
PaCO2

48. The volume of gas remaining in the lungs at the end of normal expiration is called the...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Functional residual capacity (FRC)
require supplemental oxygenation and possibly ABG analysis
Inspiration

49. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Significant pulmonary impairment
Diffusion

50. Compliance
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
Hypoventilation or modest changes in the PaO2
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height