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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. tidal volume (Vt)
Ventilation - Diffusion - Perfusion
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Interstitial diseases or early pulmonary edema

2. within limits - increased temperature =
release of O2 from Hb - as heat is a by-product of metabolism.
Dyspnea upon assuming a recumbent position
Increased work of breathing
Partial pressure of oxygen (PO2)

3. What occurs passively as muscles relax?
Manubrio-sternal junction (angle of Louis)
Contracts
Expiration
Mediastinum

4. Boyle's Gas Law
Blue or bluish-gray discoloration of the skin or mucous membranes
Bicarbonate
right & left
There is an inverse relationship between pressure and volume

5. The muscles of expiration are the...
Pneumonia - obstructive lung disease - and late pulmonary edema
Inflammation of the adjacent parietal pleura
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Diffusion

6. Rhonchi frequently clear after
Cough
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Pneumonia - obstructive lung disease - and late pulmonary edema

7. dead space ventilation
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
right & left
The gas in the conducting airways does not participate in alveolar exchange
Louder - lower-pitched - and slightly longer in duration

8. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Upper respiratory obstruction - usually in the trachea or larynx
Brief - discrete - non-musical sounds with a popping quality

9. normal adult tidal volume
Bronchospasm - mucosal edema - or excessive secretions
release of O2 from Hb - as heat is a by-product of metabolism.
Excessive secretions and abnormal airway collapsibility
500 to 800 mL

10. Dyspnea is defined as
A good effort
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
Increased minute volume ventilation - which results in a lowered carbon dioxide level

11. Orthopnea is defined as
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Dyspnea upon assuming a recumbent position
Sternocleidomastoid - Scalene Muscles
The amount of air that can be exhaled after expiration

12. The parietal pleura lines the...
reduced in size - compared with a normal curve - due to lower lung volume
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Pressure required to drive air through the airways
Increased work of breathing

13. Examples of restrictive disease
70% occlusion of the airway
500 to 800 mL
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

14. FEV1% in obstructive disease
The gas in the conducting airways does not participate in alveolar exchange
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
results in a lower than normal FEV1%
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

15. The upper airway accounts For what % of airway resistance?
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Perfusion
50%
Observing the pattern of breathing

16. Rhonchi
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
80%
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

17. The most reliable site for detecting central cyanosis is the...
Narrowed nearly to the point of closure
Tongue
Insufficient oxygenation of hemoglobin in the lungs
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

18. Bronchiovesicular breath sounds
The amount of air that can be exhaled after expiration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Air-filled - fluid-filled - or solid
The negative logarithm of hydrogen ions in the blood

19. Peripheral cyanosis results from
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Mouth as well as through the chest wall
Louder - lower-pitched - and slightly longer in duration
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

20. Restrictive Disease: Expiratory volume is reduced more than
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
Increase the intrathoracic space
Partial pressure of O2 in the arterial blood
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

21. Bohr Effect of pH: right shift
Brief - discrete - non-musical sounds with a popping quality
Perfusion
Decreased Hb-O2 affinity
Outer surface of each lung

22. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Diffusion
Bronchospasm - mucosal edema - or excessive secretions
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

23. Tachypnea is an
Increased amounts of unsaturated hemoglobin in capillary blood
Carboxyhemoglobin
2 - each wavelength is partially absorbed by hemoglobin
Increased rate of breathing and is commonly associated with a decrease in tidal volume

24. movement of blood through the capillaries in direct communication with the alveoli
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
80%
'scooped out' or bowl-shaped
Perfusion

25. expiratory reserve
A good effort
'crackles' or 'rales'
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
The amount of air that can be exhaled after expiration

26. Bronchial breath sounds
Partial pressure of CO2 in the arterial blood
Right
PaCO2
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

27. The spirometry printout usually includes

28. Compliance
Right
Carboxyhemoglobin
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
Lung volumes - but no difficulty or delay in exhaling what volume they do have

29. The internal intercostals decrease the transverse diameter of the chest during
Excessive secretions and abnormal airway collapsibility
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Expiration

30. Vesicular breath sounds
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
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 gas in the conducting airways does not participate in alveolar exchange
Perfusion

31. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Fraction (%age) of inspired oxygen
Increased work of breathing
Upper respiratory obstruction - usually in the trachea or larynx
release of O2 from Hb - as heat is a by-product of metabolism.

32. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Spirometry
release of O2 from Hb - as heat is a by-product of metabolism.
Oxygen-Hemoglobin Dissociation Curve

33. The external intercostal muscles increase the antero-posterior chest diameter during
2 - each wavelength is partially absorbed by hemoglobin
To assess response to treatment
Postero-anterior (PA) and lateral view series
Inspiration

34. low CO2 = low acidity =
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
PaCO2
Binding of O2 to Hb
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

35. 20.95% Atmospheric Composition
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Tongue
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Oxygen (O2)

36. Spirometry normal range
release of O2 from Hb
'crackles' or 'rales'
80 to 120% of predicted value
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

37. The trachea divides into right and left mainstem bronchi At what level?
T4 or T5 - and just below the manubrio-sternal joint
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Bronchospasm - mucosal edema - or excessive secretions
Outer surface of each lung

38. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
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
Mediastinum
Perfusion

39. Hyperventilation is defined as
Partial pressure of carbon dioxide in the alveoli
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Spirometry
The gas in the conducting airways does not participate in alveolar exchange

40. Which lung has a horizontal fissure?
right
respiration
'scooped out' or bowl-shaped
Mediastinum

41. PaCO2
A reliable and consistent classification of auditory findings
Increased amounts of unsaturated hemoglobin in capillary blood
A tracing of the lung volume against time in seconds
Partial pressure of CO2 in the arterial blood

42. The trachea is how long/wide?
10 to 11 cm long and about 2 cm in diameter
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Air to move from the upper airway to the farthest alveolar reaches
The amount of air that can be exhaled after expiration

43. pain in lung conditions usually arises from
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Inflammation of the adjacent parietal pleura
Decreased pressure
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

44. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
Increased work of breathing
Carboxyhemoglobin
Immediate oxygenation with or without intubation

45. Coarse crackles are heard in
Pneumonia - obstructive lung disease - and late pulmonary edema
Saturated with oxygen or unsaturated
Narrowed nearly to the point of closure
2 - each wavelength is partially absorbed by hemoglobin

46. The tracheo-bronchial tree is a tubular system that provides a pathway for
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Air to move from the upper airway to the farthest alveolar reaches
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Inside of the thoracic cavity wall and the upper surface of the diaphragm

47. Resistance is dependent upon
Speed of airflow - the higher the flow - the greater the resistance
Wheezes - high-pitched - musical sounds - distinct whistling quality
The total amount of air in the lungs at the end of a maximal inhalation
The gas in the conducting airways does not participate in alveolar exchange

48. 78.08% Atmospheric Composition
Nitrogen
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
right
Acinus

49. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Partial pressure of oxygen in the alveoli
respiration
Louder - lower-pitched - and slightly longer in duration
Increase the intrathoracic space

50. Orthopnea is quantified by
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
Altering the respiratory rate and/or the tidal volume
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Increased amounts of unsaturated hemoglobin in capillary blood