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Pulmonology

Instructions:

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. Continuous lung sounds
Sternocleidomastoid - Scalene Muscles
The examiner can clearly distinguish the word that the pt speak or whispers
Wheezes - high-pitched - musical sounds - distinct whistling quality
Brief - discrete - non-musical sounds with a popping quality

2. FEV1/FVC
Either inspiration or expiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Upper respiratory obstruction - usually in the trachea or larynx
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

3. Fine crackles are...
Speed of airflow - the higher the flow - the greater the resistance
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
respiration
Soft - high-pitched and crisp

4. pain in lung conditions usually arises from
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Fraction (%age) of inspired oxygen
Inflammation of the adjacent parietal pleura
Pneumonia - obstructive lung disease - and late pulmonary edema

5. Vesicular breath sounds
Binding of O2 to Hb
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
right
Right

6. most important factor that influences the oxygen carrying capacity of hemoglobin
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Partial pressure of oxygen (PO2)
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

7. Coarse crackles result from
35 to 45 mmHg
Lowered carbon dioxide level - results from hyperventilation
Air bubbles flowing through secretions or slightly closed airways during respiration
Diaphragm and the intercostal muscles

8. PAO2
Partial pressure of oxygen in the alveoli
A good effort
Mediastinum
Expiration

9. The trachea divides into
right and left mainstem bronchi
Bronchospasm - mucosal edema - or excessive secretions
Functional residual capacity (FRC)
Diffusion

10. FEV1% in restrictive disease
Normal to increased FEV1%
35 to 45 mmHg
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
require supplemental oxygenation and possibly ABG analysis

11. Discontinuous lung sounds are...
Either inspiration or expiration
Brief - discrete - non-musical sounds with a popping quality
70%
Pleural space

12. Continuous lung sounds often audible at the...
Excessive secretions and abnormal airway collapsibility
Mouth as well as through the chest wall
Normal to increased FEV1%
reduced in size - compared with a normal curve - due to lower lung volume

13. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
2 - each wavelength is partially absorbed by hemoglobin
Inspiration

14. Spirometry can be used to determine the severity of functional impairment as well as
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Insufficient oxygenation of hemoglobin in the lungs
Blue or bluish-gray discoloration of the skin or mucous membranes
To assess response to treatment

15. within limits - increased temperature =
Dyspnea upon assuming a recumbent position
Nitrogen
release of O2 from Hb - as heat is a by-product of metabolism.
Partial pressure of carbon dioxide in the alveoli

16. Resistance is dependent upon
Speed of airflow - the higher the flow - the greater the resistance
Immediate oxygenation with or without intubation
Blood to the alveoli
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

17. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Inspiration
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Mediastinum
A sensor placed over a translucent area of arterial pulsation

18. vital capacity (VC)
Observing the pattern of breathing
The total amount of air that can be exhaled following a maximal inhalation
Portable antero-posterior (AP) view
70% occlusion of the airway

19. normal subjects expel approximately how much of the FVC in the 1st second?
Increased amounts of unsaturated hemoglobin in capillary blood
80%
There is an inverse relationship between pressure and volume
Diaphragm and the intercostal muscles

20. 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
A tracing of the lung volume against time in seconds
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Brief - discrete - non-musical sounds with a popping quality

21. Discontinuous lung sounds are also called

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22. Bronchophony
Air-filled - fluid-filled - or solid
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
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
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

23. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Mouth as well as through the chest wall
A good effort
80 to 120% of predicted value
Partial pressure of O2 in the arterial blood

24. Restrictive Disease: Expiratory volume is reduced more than
Dullness replaces resonance
35 to 45 mmHg
80 to 120% of predicted value
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

25. During inspiration the diaphragm
500 to 800 mL
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Contracts

26. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
50%
Insufficient oxygenation of hemoglobin in the lungs
Carboxyhemoglobin
70% occlusion of the airway

27. The purpose of respiration is to...
Narrowed nearly to the point of closure
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Soft - high-pitched and crisp
Sternocleidomastoid - Scalene Muscles

28. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Expiration
Dullness replaces resonance
Increased Hb-O2 affinity
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

29. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
2 - each wavelength is partially absorbed by hemoglobin
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

30. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Narrowed nearly to the point of closure
Saturated with oxygen or unsaturated
A good effort

31. total lung capacity (TLC)
Oxygen-Hemoglobin Dissociation Curve
Lowered carbon dioxide level - results from hyperventilation
The total amount of air in the lungs at the end of a maximal inhalation
70% occlusion of the airway

32. Which lobe has an inferior tongue-like projection called the lingula?
Increased amounts of unsaturated hemoglobin in capillary blood
Total lung capacity (TLC)
Interstitial diseases or early pulmonary edema
Left upper lobe

33. Normal lung sounds
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Alveoli to the blood
release of O2 from Hb
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

34. Rhonchi frequently clear after
Upper respiratory obstruction - usually in the trachea or larynx
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Cough

35. Carbon dioxide moves from the...
A good effort
Blood to the alveoli
The rib above it
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

36. Orthopnea is quantified by
Air bubbles flowing through secretions or slightly closed airways during respiration
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Functional residual capacity (FRC)
require supplemental oxygenation and possibly ABG analysis

37. forced expiratory volume in one second (FEV1)
70% occlusion of the airway
Brief - discrete - non-musical sounds with a popping quality
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
Dullness replaces resonance

38. Spirometry plots
quickly - usually reaching a plateau within 6.0 seconds
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
Hypoventilation or modest changes in the PaO2

39. An efficient approach to examination of the patient begins with
Partial pressure of oxygen (PO2)
quickly - usually reaching a plateau within 6.0 seconds
Observing the pattern of breathing
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

40. Patients with obstructive disease have normal
Fraction (%age) of inspired oxygen
5 years - to detect obstruction and determine its reversibility
Normal to increased FEV1%
Lung volumes - but find it difficult to exhale rapidly

41. Obstructive Disease: Expiratory airflow is reduced more than
35 to 45 mmHg
Expiratory volume - and there is a prolonged expiratory time
right & left
2 - each wavelength is partially absorbed by hemoglobin

42. Abnormal lung sounds are classified as
Contracts
Either continuous or discontinuous
Alveoli to the blood
Partial pressure of oxygen in the alveoli

43. Airway resistance refers to...
release of O2 from Hb - as heat is a by-product of metabolism.
Mouth as well as through the chest wall
Immediate oxygenation with or without intubation
Pressure required to drive air through the airways

44. Boyle's Gas Law
Sternocleidomastoid - Scalene Muscles
2 - each wavelength is partially absorbed by hemoglobin
There is an inverse relationship between pressure and volume
Perfusion

45. Spirometry: The result is stated as
No
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
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
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

46. FIO2
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Fraction (%age) of inspired oxygen
The total amount of air that can be exhaled following a maximal inhalation
Ventilation

47. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
The rib above it
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Pneumonia - obstructive lung disease - and late pulmonary edema

48. Obstructive disease refers to...
Alveoli to the blood
Larger airways
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

49. Inspiratory stridor indicates
Hypoventilation or modest changes in the PaO2
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
right & left
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

50. The pattern of breathing refers to...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
A sensor placed over a translucent area of arterial pulsation
Cough
reduced in size - compared with a normal curve - due to lower lung volume