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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. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Spirometry
Interstitial diseases or early pulmonary edema
Nitrogen
Observing the pattern of breathing

2. The vital capacity and the residual volume together constitute the...
Either inspiration or expiration
Total lung capacity (TLC)
5 years - to detect obstruction and determine its reversibility
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

3. Apnea is defined as
Ventilation
No respiration for > 20 seconds
Perfusion
Diaphragm and the intercostal muscles

4. Paroxysmal nocturnal dyspnea (PND) is...
Portable antero-posterior (AP) view
Dyspnea that awakens the patient several hours after going to sleep
Blood to the alveoli
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

5. Bronchial breath sounds
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Diaphragm - External Intercostals
Either inspiration or expiration

6. The most reliable site for detecting central cyanosis is the...
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Tongue
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

7. PaCO2
Expiratory volume - and there is a prolonged expiratory time
Partial pressure of carbon dioxide in the alveoli
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Partial pressure of CO2 in the arterial blood

8. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Pneumonia - obstructive lung disease - and late pulmonary edema
Soft - high-pitched and crisp
Acinus

9. Expiratory stridor indicates
Right
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The amount of air that can be exhaled after expiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

10. Hyperventilation is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Carboxyhemoglobin
Hypoventilation or modest changes in the PaO2

11. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Interstitial diseases or early pulmonary edema
Partial pressure of oxygen (PO2)
Perfusion
A good effort

12. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Altering the respiratory rate and/or the tidal volume
respiration
Contracts
A good effort

13. Bohr Effect of pH: left shift
Carboxyhemoglobin
Normal to increased FEV1%
Increased Hb-O2 affinity
Soft - high-pitched and crisp

14. Pulse Oximetry is dependent on...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Dyspnea upon assuming a recumbent position
Increased work of breathing

15. Late inspiratory crackles result from
35 to 45 mmHg
PaCO2
Brief - discrete - non-musical sounds with a popping quality
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

16. normal subjects expel approximately how much of the FVC in the 1st second?
release of O2 from Hb
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
80%
The negative logarithm of hydrogen ions in the blood

17. high CO2 = high acidity =
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
release of O2 from Hb
Manubrio-sternal junction (angle of Louis)
Inflammation of the adjacent parietal pleura

18. Spirometry normal range
Outer surface of each lung
The atmospheric pressure
80 to 120% of predicted value
35 to 45 mmHg

19. The trachea is how long/wide?
Tongue
Either inspiration or expiration
10 to 11 cm long and about 2 cm in diameter
Blood to the alveoli

20. FIO2
Fraction (%age) of inspired oxygen
Increased minute volume ventilation - which results in a lowered carbon dioxide level
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
10 to 11 cm long and about 2 cm in diameter

21. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dullness replaces resonance
right
Difficulty breathing or shortness of breath
Interstitial diseases or early pulmonary edema

22. Continuous lung sounds occur during...
Decreased pressure
Either inspiration or expiration
80%
Postero-anterior (PA) and lateral view series

23. Spirometry plots
A tracing of the lung volume against time in seconds
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Cough

24. FEV1% in obstructive disease
Inflammation of the adjacent parietal pleura
Spirometry
right & left
results in a lower than normal FEV1%

25. office-based spirometry is recommended for patients as young as
quickly - usually reaching a plateau within 6.0 seconds
Right
5 years - to detect obstruction and determine its reversibility
There is an inverse relationship between pressure and volume

26. Carbon dioxide moves from the...
Blood to the alveoli
Sternocleidomastoid - Scalene Muscles
Alveoli to the blood
Manubrio-sternal junction (angle of Louis)

27. Compliance
Portable antero-posterior (AP) view
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
Diaphragm and the intercostal muscles
release of O2 from Hb - as heat is a by-product of metabolism.

28. Patients with restrictive disease have low
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Partial pressure of oxygen in the alveoli
require supplemental oxygenation and possibly ABG analysis
Lung volumes - but no difficulty or delay in exhaling what volume they do have

29. Boyle's Gas Law
Spirometry
Partial pressure of oxygen in the alveoli
There is an inverse relationship between pressure and volume
Dyspnea upon assuming a recumbent position

30. Obstructive disease refers to...
Decreased pressure
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Oxygen (O2)
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

31. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Pressure required to drive air through the airways
Total lung capacity (TLC)
right and left mainstem bronchi

32. An efficient approach to examination of the patient begins with
Observing the pattern of breathing
results in a lower than normal FEV1%
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Pleural space

33. The trachea divides into
Pulse oximetry
Postero-anterior (PA) and lateral view series
'crackles' or 'rales'
right and left mainstem bronchi

34. A state-of-the-art - inexpensive - non-invasive - simple method to monitor a patient's percent hemoglobin saturation with oxygen (SaO2) - without having to obtain an arterial blood specimen
Pulse oximetry
right & left
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Right

35. within limits - increased temperature =
Dullness replaces resonance
release of O2 from Hb - as heat is a by-product of metabolism.
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Outer surface of each lung

36. Coarse crackles result from
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Significant pulmonary impairment
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Air bubbles flowing through secretions or slightly closed airways during respiration

37. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Expiration
Either inspiration or expiration
Total lung capacity (TLC)

38. Fine crackles are heard in
Mediastinum
Blood to the alveoli
release of O2 from Hb - as heat is a by-product of metabolism.
Interstitial diseases or early pulmonary edema

39. Bronchophony
Acinus
Partial pressure of oxygen (PO2)
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
Alveoli to the blood

40. Rhonchi occur during
Significant pulmonary impairment
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Either inspiration or expiration
Upper respiratory obstruction - usually in the trachea or larynx

41. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
right & left
50%
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The amount of air that can be exhaled after expiration

42. the lingula is analogous to...
The right middle lobe
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
Bicarbonate
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

43. residual volume
Binding of O2 to Hb
Partial pressure of oxygen (PO2)
Diaphragm and the intercostal muscles
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

44. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Decreased pressure
Manubrio-sternal junction (angle of Louis)
Difficulty breathing or shortness of breath
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

45. Pulse Oximetry does not detect
Increased amounts of unsaturated hemoglobin in capillary blood
Partial pressure of oxygen in the alveoli
Hypoventilation or modest changes in the PaO2
Either inspiration or expiration

46. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Bronchospasm - mucosal edema - or excessive secretions
Alveoli to the blood
Soft - high-pitched and crisp
Spirometry

47. Inspiratory stridor becomes evident at about
reduced in size - compared with a normal curve - due to lower lung volume
Right
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
70% occlusion of the airway

48. HCO3
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Bicarbonate
The total amount of air that can be exhaled following a maximal inhalation
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

49. Obstructive Disease: Expiratory airflow is reduced more than
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Expiratory volume - and there is a prolonged expiratory time
Functional residual capacity (FRC)
Acinus

50. forced expiratory volume in one second (FEV1)
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
Dyspnea that awakens the patient several hours after going to sleep
A reliable and consistent classification of auditory findings
Diaphragm - External Intercostals