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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. Spirometry can be used to determine the severity of functional impairment as well as
Mouth as well as through the chest wall
To assess response to treatment
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Ventilation

2. expiratory reserve
Air bubbles flowing through secretions or slightly closed airways during respiration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Overcome some of the problems associated with low blood flow to the probe site
The amount of air that can be exhaled after expiration

3. Rhonchi originate in the...
Partial pressure of oxygen in the alveoli
quickly - usually reaching a plateau within 6.0 seconds
Larger airways
Total lung capacity (TLC)

4. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Oxygen-Hemoglobin Dissociation Curve
Right
Dullness replaces resonance
Inflammation of the adjacent parietal pleura

5. Continuous lung sounds occur in the setting of...
Partial pressure of oxygen (PO2)
Bronchospasm - mucosal edema - or excessive secretions
Perfusion
require supplemental oxygenation and possibly ABG analysis

6. PAO2
Functional residual capacity (FRC)
Ventilation
500 to 800 mL
Partial pressure of oxygen in the alveoli

7. Bohr Effect of pH: right shift
right and left mainstem bronchi
Decreased Hb-O2 affinity
The amount of air that can be inhaled after normal inspiration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

8. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Blood to the alveoli
Inspiration
Increased amounts of unsaturated hemoglobin in capillary blood
70% occlusion of the airway

9. PaCO2
Outer surface of each lung
Postero-anterior (PA) and lateral view series
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Partial pressure of CO2 in the arterial blood

10. FIO2
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
The gas in the conducting airways does not participate in alveolar exchange
Functional residual capacity (FRC)
Fraction (%age) of inspired oxygen

11. Which lobe has an inferior tongue-like projection called the lingula?
Difficulty breathing or shortness of breath
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Left upper lobe
Air-filled - fluid-filled - or solid

12. The presence of pressure gradients causes respiratory gases to move from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Right
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Observing the pattern of breathing

13. vital capacity (VC)
Carboxyhemoglobin
The total amount of air that can be exhaled following a maximal inhalation
Partial pressure of O2 in the arterial blood
Soft - high-pitched and crisp

14. With restrictive disease - the flow-volume curve is...
70%
Diffusion
reduced in size - compared with a normal curve - due to lower lung volume
Louder - lower-pitched - and slightly longer in duration

15. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Hypoventilation or modest changes in the PaO2
respiration
Immediate oxygenation with or without intubation

16. Resistance is dependent upon
Speed of airflow - the higher the flow - the greater the resistance
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Portable antero-posterior (AP) view
Postero-anterior (PA) and lateral view series

17. Restrictive disease refers to...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
80%
A reduction in lung capacity - secondary to scarring or extraneous material
Significant pulmonary impairment

18. Continuous lung sounds
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Wheezes - high-pitched - musical sounds - distinct whistling quality
Ventilation - Diffusion - Perfusion
Partial pressure of carbon dioxide in the alveoli

19. The parietal pleura lines the...
'scooped out' or bowl-shaped
70%
Normal to increased FEV1%
Inside of the thoracic cavity wall and the upper surface of the diaphragm

20. Rhonchi
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Either inspiration or expiration
Right
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

21. Patients with obstructive disease have normal
Manubrio-sternal junction (angle of Louis)
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
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

22. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
The atmospheric pressure
Oxygen (O2)
Diffusion

23. Which lung has a horizontal fissure?
Increased Hb-O2 affinity
Blue or bluish-gray discoloration of the skin or mucous membranes
Increased minute volume ventilation - which results in a lowered carbon dioxide level
right

24. Normal range of PaCO2
35 to 45 mmHg
Altering the respiratory rate and/or the tidal volume
Air bubbles flowing through secretions or slightly closed airways during respiration
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

25. What may prevent cyanosis from appearing?
Insufficient oxygenation of hemoglobin in the lungs
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Ventilation - Diffusion - Perfusion
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

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

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27. The upper airway accounts For what % of airway resistance?
Binding of O2 to Hb
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
50%
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

28. movement of blood through the capillaries in direct communication with the alveoli
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Perfusion
Dullness replaces resonance
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

29. Bohr Effect of pH is graphed as
Brief - discrete - non-musical sounds with a popping quality
Oxygen-Hemoglobin Dissociation Curve
Dullness replaces resonance
Narrowed nearly to the point of closure

30. Percussion helps you establish whether the underlying tissues are...
Air-filled - fluid-filled - or solid
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Cough
There is an inverse relationship between pressure and volume

31. increased volume results in
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Bicarbonate
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Decreased pressure

32. An efficient approach to examination of the patient begins with
Alveoli to the blood
Observing the pattern of breathing
Lung volumes - but find it difficult to exhale rapidly
right

33. within limits - increased temperature =
Immediate oxygenation with or without intubation
Postero-anterior (PA) and lateral view series
release of O2 from Hb - as heat is a by-product of metabolism.
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

34. PaO2
Partial pressure of O2 in the arterial blood
Dyspnea that awakens the patient several hours after going to sleep
A tracing of the lung volume against time in seconds
Perfusion

35. Vesicular breath sounds
Inflammation of the adjacent parietal pleura
Increased minute volume ventilation - which results in a lowered carbon dioxide level
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
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

36. During inspiration the diaphragm
Contracts
Mouth as well as through the chest wall
Inspiration
Tongue

37. 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
A tracing of the lung volume against time in seconds
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
35 to 45 mmHg

38. The tracheo-bronchial tree is a tubular system that provides a pathway for
Decreased pressure
10 to 11 cm long and about 2 cm in diameter
Air to move from the upper airway to the farthest alveolar reaches
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

39. Discontinuous lung sounds are also called

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40. Cyanosis is caused by
Increased amounts of unsaturated hemoglobin in capillary blood
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
80 to 120% of predicted value

41. Rhonchi frequently clear after
Perfusion
Cough
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Partial pressure of carbon dioxide in the alveoli

42. Spirometry plots
10 to 11 cm long and about 2 cm in diameter
A tracing of the lung volume against time in seconds
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Lung volumes - but find it difficult to exhale rapidly

43. Boyle's Gas Law
No respiration for > 20 seconds
'crackles' or 'rales'
80 to 120% of predicted value
There is an inverse relationship between pressure and volume

44. dead space ventilation
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 amount of air that can be inhaled after normal inspiration
The gas in the conducting airways does not participate in alveolar exchange
Either continuous or discontinuous

45. Orthopnea is defined as
Narrowed nearly to the point of closure
Outer surface of each lung
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Dyspnea upon assuming a recumbent position

46. the lingula is analogous to...
reduced in size - compared with a normal curve - due to lower lung volume
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Observing the pattern of breathing
The right middle lobe

47. low CO2 = low acidity =
T4 or T5 - and just below the manubrio-sternal joint
No respiration for > 20 seconds
Binding of O2 to Hb
Difficulty breathing or shortness of breath

48. Fine crackles are...
A good effort
'adventitious' breath sounds
Soft - high-pitched and crisp
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

49. Hyperventilation is defined as
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Functional residual capacity (FRC)
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Increased minute volume ventilation - which results in a lowered carbon dioxide level

50. Which bronchus is more susceptible to aspiration of foreign bodies?
Increase the intrathoracic space
T4 or T5 - and just below the manubrio-sternal joint
Right
80%

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Pulmonology

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