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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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1. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
Nitrogen
Expiratory volume - and there is a prolonged expiratory time
Altering the respiratory rate and/or the tidal volume

2. FIO2
Fraction (%age) of inspired oxygen
Altering the respiratory rate and/or the tidal volume
Left upper lobe
5 years - to detect obstruction and determine its reversibility

3. Rhonchi are due to...
Partial pressure of oxygen (PO2)
Excessive secretions and abnormal airway collapsibility
Decreased pressure
Partial pressure of carbon dioxide in the alveoli

4. gas exchange across the alveolar-pulmonary capillary membranes
reduced in size - compared with a normal curve - due to lower lung volume
Narrowed nearly to the point of closure
Diffusion
Portable antero-posterior (AP) view

5. Discontinuous lung sounds are also called

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6. Continuous lung sounds occur during...
Either inspiration or expiration
Oxygen (O2)
right and left mainstem bronchi
Cough

7. PaCO2
Inspiration
'adventitious' breath sounds
Partial pressure of CO2 in the arterial blood
Either continuous or discontinuous

8. expiratory reserve
The amount of air that can be exhaled after expiration
Diffusion
A tracing of the lung volume against time in seconds
Ventilation

9. Orthopnea is quantified by
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Binding of O2 to Hb
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
The negative logarithm of hydrogen ions in the blood

10. Restrictive Disease: Expiratory volume is reduced more than
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Diaphragm - External Intercostals
right & left

11. high CO2 = high acidity =
Pressure required to drive air through the airways
Dullness replaces resonance
release of O2 from Hb
Inspiration

12. Compliance
500 to 800 mL
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
Increase the intrathoracic space
reduced in size - compared with a normal curve - due to lower lung volume

13. Fine crackles are heard in
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
The total amount of air in the lungs at the end of a maximal inhalation
Interstitial diseases or early pulmonary edema
To assess response to treatment

14. Late inspiratory crackles result from
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
The atmospheric pressure
T4 or T5 - and just below the manubrio-sternal joint

15. The accessory muscles are the...
Increased work of breathing
Sternocleidomastoid - Scalene Muscles
Left upper lobe
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

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

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17. hypocapnia
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Oxygen-Hemoglobin Dissociation Curve
Lowered carbon dioxide level - results from hyperventilation
Outer surface of each lung

18. What occurs passively as muscles relax?
Expiration
Portable antero-posterior (AP) view
Contracts
70% occlusion of the airway

19. Which lung has a horizontal fissure?
A reliable and consistent classification of auditory findings
Saturated with oxygen or unsaturated
right
Sternocleidomastoid - Scalene Muscles

20. HCO3
35 to 45 mmHg
Bicarbonate
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

21. The parietal pleura lines the...
The right middle lobe
Postero-anterior (PA) and lateral view series
The amount of air that can be exhaled after expiration
Inside of the thoracic cavity wall and the upper surface of the diaphragm

22. most important factor that influences the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2)
The examiner can clearly distinguish the word that the pt speak or whispers
Acinus
'scooped out' or bowl-shaped

23. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Alveoli to the blood
quickly - usually reaching a plateau within 6.0 seconds
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Increase the intrathoracic space

24. Patients with obstructive disease have normal
Binding of O2 to Hb
Nitrogen
Lung volumes - but find it difficult to exhale rapidly
2 - each wavelength is partially absorbed by hemoglobin

25. The trachea bifurcates into its mainstem bronchi at the level of...
Brief - discrete - non-musical sounds with a popping quality
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
release of O2 from Hb
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

26. The upper airway accounts For what % of airway resistance?
The amount of air that can be exhaled after expiration
Either inspiration or expiration
Oxygen (O2)
50%

27. PACO2
Alveoli to the blood
Partial pressure of carbon dioxide in the alveoli
Pneumonia - obstructive lung disease - and late pulmonary edema
Diaphragm - External Intercostals

28. PaO2
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Right
Partial pressure of O2 in the arterial blood

29. At rest - the use of accessory muscles is a sign of...
Significant pulmonary impairment
Alveoli to the blood
Oxygen (O2)
require supplemental oxygenation and possibly ABG analysis

30. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
The rib above it
Perfusion
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
70% occlusion of the airway

31. Obstructive disease refers to...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Overcome some of the problems associated with low blood flow to the probe site
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
A tracing of the lung volume against time in seconds

32. An efficient approach to examination of the patient begins with
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Observing the pattern of breathing
Perfusion
Diffusion

33. total lung capacity (TLC)
Obstructive lung disease from restrictive lung disease
Lung volumes - but no difficulty or delay in exhaling what volume they do have
No respiration for > 20 seconds
The total amount of air in the lungs at the end of a maximal inhalation

34. Factors that influence the oxygen carrying capacity of hemoglobin
Bicarbonate
release of O2 from Hb
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Contracts

35. Pulse Oximetry does not detect
Hypoventilation or modest changes in the PaO2
Excessive secretions and abnormal airway collapsibility
Upper respiratory obstruction - usually in the trachea or larynx
right & left

36. Pectoriloquy
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Alveoli to the blood
Inside of the thoracic cavity wall and the upper surface of the diaphragm
The examiner can clearly distinguish the word that the pt speak or whispers

37. Vesicular breath sounds
Mouth as well as through the chest wall
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 total amount of air that can be exhaled following a maximal inhalation
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

38. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Speed of airflow - the higher the flow - the greater the resistance
Spirometry
'adventitious' breath sounds
Larger airways

39. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
80 to 120% of predicted value
Expiration
The atmospheric pressure
Either inspiration or expiration

40. 78.08% Atmospheric Composition
A reliable and consistent classification of auditory findings
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Air bubbles flowing through secretions or slightly closed airways during respiration
Nitrogen

41. The trachea divides into
right and left mainstem bronchi
The atmospheric pressure
Acinus
Either inspiration or expiration

42. The vital capacity and the residual volume together constitute the...
Air-filled - fluid-filled - or solid
Total lung capacity (TLC)
Tongue
Speed of airflow - the higher the flow - the greater the resistance

43. The normal FEV1 /FVC ratio is...
70%
Upper respiratory obstruction - usually in the trachea or larynx
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

44. Obstructive Disease: Expiratory airflow is reduced more than
Expiratory volume - and there is a prolonged expiratory time
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Either continuous or discontinuous

45. vital capacity (VC)
80%
Bronchospasm - mucosal edema - or excessive secretions
Insufficient oxygenation of hemoglobin in the lungs
The total amount of air that can be exhaled following a maximal inhalation

46. Respiration involves
Ventilation - Diffusion - Perfusion
Normal to increased FEV1%
5 years - to detect obstruction and determine its reversibility
The right middle lobe

47. Bronchiovesicular breath sounds
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
A tracing of the lung volume against time in seconds
To assess response to treatment
The total amount of air in the lungs at the end of a maximal inhalation

48. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
70% occlusion of the airway
Dullness replaces resonance
'scooped out' or bowl-shaped
right

49. Pulse Oximetry is dependent on...
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
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Soft - high-pitched and crisp
Lung volumes - but find it difficult to exhale rapidly

50. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Brief - discrete - non-musical sounds with a popping quality
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Immediate oxygenation with or without intubation
Lung volumes - but find it difficult to exhale rapidly

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Pulmonology

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