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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. The purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Significant pulmonary impairment
The negative logarithm of hydrogen ions in the blood
Dyspnea that awakens the patient several hours after going to sleep

2. At rest - the use of accessory muscles is a sign of...
Insufficient oxygenation of hemoglobin in the lungs
Significant pulmonary impairment
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
Observing the pattern of breathing

3. Continuous lung sounds occur in the setting of...
Upper respiratory obstruction - usually in the trachea or larynx
Bronchospasm - mucosal edema - or excessive secretions
Interstitial diseases or early pulmonary edema
Soft - high-pitched and crisp

4. 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
Oxygen (O2)
Mediastinum
Lowered carbon dioxide level - results from hyperventilation

5. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Altering the respiratory rate and/or the tidal volume
Diaphragm and the intercostal muscles
A sensor placed over a translucent area of arterial pulsation
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

6. PaO2
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Partial pressure of O2 in the arterial blood
right & left
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

7. The spirometry printout usually includes

8. 20.95% Atmospheric Composition
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Oxygen (O2)
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

9. pain in lung conditions usually arises from
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Either continuous or discontinuous
Inflammation of the adjacent parietal pleura
The examiner can clearly distinguish the word that the pt speak or whispers

10. 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
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Cough

11. FEV1% in obstructive disease
results in a lower than normal FEV1%
Immediate oxygenation with or without intubation
right
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

12. Rhonchi frequently clear after
'adventitious' breath sounds
Cough
A reduction in lung capacity - secondary to scarring or extraneous material
Diaphragm - External Intercostals

13. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Increased minute volume ventilation - which results in a lowered carbon dioxide level
There is an inverse relationship between pressure and volume
Spirometry
Oxygen-Hemoglobin Dissociation Curve

14. Oxygen moves from the...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Inflammation of the adjacent parietal pleura
Partial pressure of carbon dioxide in the alveoli
Alveoli to the blood

15. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Speed of airflow - the higher the flow - the greater the resistance
Tongue
Air-filled - fluid-filled - or solid

16. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
Expiratory volume - and there is a prolonged expiratory time
Inspiration
The total amount of air that can be exhaled following a maximal inhalation

17. hypocapnia
Increased minute volume ventilation - which results in a lowered carbon dioxide level
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Lowered carbon dioxide level - results from hyperventilation
PaCO2

18. Spirometry plots
Narrowed nearly to the point of closure
Either inspiration or expiration
A tracing of the lung volume against time in seconds
Observing the pattern of breathing

19. Carbon dioxide moves from the...
Increased amounts of unsaturated hemoglobin in capillary blood
Blood to the alveoli
The gas in the conducting airways does not participate in alveolar exchange
Expiration

20. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
Brief - discrete - non-musical sounds with a popping quality
'crackles' or 'rales'
The gas in the conducting airways does not participate in alveolar exchange

21. The most reliable site for detecting central cyanosis is the...
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Tongue
Oxygen-Hemoglobin Dissociation Curve
Overcome some of the problems associated with low blood flow to the probe site

22. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Observing the pattern of breathing
Saturated with oxygen or unsaturated
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Altering the respiratory rate and/or the tidal volume

23. 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
Expiration
Dullness replaces resonance
Oxygen (O2)

24. FIO2
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Fraction (%age) of inspired oxygen
Diaphragm and the intercostal muscles
Outer surface of each lung

25. The trachea divides into
Manubrio-sternal junction (angle of Louis)
Lung volumes - but find it difficult to exhale rapidly
right and left mainstem bronchi
Ventilation

26. terminal respiratory unit
The right middle lobe
Obstructive lung disease from restrictive lung disease
Acinus
Air to move from the upper airway to the farthest alveolar reaches

27. Discontinuous lung sounds are...
Blue or bluish-gray discoloration of the skin or mucous membranes
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Brief - discrete - non-musical sounds with a popping quality
Tongue

28. normal subjects expel approximately how much of the FVC in the 1st second?
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
reduced in size - compared with a normal curve - due to lower lung volume
Altering the respiratory rate and/or the tidal volume
80%

29. Abnormal lung sounds are classified as
10 to 11 cm long and about 2 cm in diameter
PaCO2
Either continuous or discontinuous
reduced in size - compared with a normal curve - due to lower lung volume

30. Orthopnea is defined as
Right
A sensor placed over a translucent area of arterial pulsation
Dyspnea upon assuming a recumbent position
Excessive secretions and abnormal airway collapsibility

31. total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
Altering the respiratory rate and/or the tidal volume
Difficulty breathing or shortness of breath
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

32. The tracheo-bronchial tree is a tubular system that provides a pathway for
require supplemental oxygenation and possibly ABG analysis
Air to move from the upper airway to the farthest alveolar reaches
Soft - high-pitched and crisp
Partial pressure of O2 in the arterial blood

33. FEV1/FVC
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
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
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Ventilation

34. vital capacity (VC)
The total amount of air that can be exhaled following a maximal inhalation
2 - each wavelength is partially absorbed by hemoglobin
Partial pressure of CO2 in the arterial blood
Increased Hb-O2 affinity

35. The trachea divides into right and left mainstem bronchi At what level?
T4 or T5 - and just below the manubrio-sternal joint
Increased Hb-O2 affinity
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Carboxyhemoglobin

36. Examples of restrictive disease
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
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
Pressure required to drive air through the airways

37. forced vital capacity (FVC)
Diffusion
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
'crackles' or 'rales'
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

38. Spirometry normal range
Pulse oximetry
80 to 120% of predicted value
Either inspiration or expiration
70% occlusion of the airway

39. Continuous lung sounds occur during...
Either inspiration or expiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
release of O2 from Hb
The gas in the conducting airways does not participate in alveolar exchange

40. Oximetry readings of < 94%
require supplemental oxygenation and possibly ABG analysis
Insufficient oxygenation of hemoglobin in the lungs
10 to 11 cm long and about 2 cm in diameter
release of O2 from Hb - as heat is a by-product of metabolism.

41. Pulse Oximetry does not detect
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Hypoventilation or modest changes in the PaO2
Dullness replaces resonance
Dyspnea that awakens the patient several hours after going to sleep

42. residual volume
Right
Either inspiration or expiration
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
Expiratory volume - and there is a prolonged expiratory time

43. PAO2
A reliable and consistent classification of auditory findings
Manubrio-sternal junction (angle of Louis)
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Partial pressure of oxygen in the alveoli

44. Spirometry can be used to determine the severity of functional impairment as well as
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Louder - lower-pitched - and slightly longer in duration
Upper respiratory obstruction - usually in the trachea or larynx
To assess response to treatment

45. Cyanosis
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Blue or bluish-gray discoloration of the skin or mucous membranes
Inspiration

46. What may prevent cyanosis from appearing?
Significant pulmonary impairment
T4 or T5 - and just below the manubrio-sternal joint
Inspiration
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

47. Vesicular breath sounds
Louder - lower-pitched - and slightly longer in duration
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
Diffusion
The examiner can clearly distinguish the word that the pt speak or whispers

48. movement of blood through the capillaries in direct communication with the alveoli
500 to 800 mL
Perfusion
Pulse oximetry
80%

49. Pectoriloquy
release of O2 from Hb
Excessive secretions and abnormal airway collapsibility
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
The examiner can clearly distinguish the word that the pt speak or whispers

50. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Spirometry
Speed of airflow - the higher the flow - the greater the resistance
Partial pressure of carbon dioxide in the alveoli
Hypoventilation or modest changes in the PaO2