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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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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 vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
35 to 45 mmHg
Immediate oxygenation with or without intubation

2. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Normal to increased FEV1%
Perfusion

3. expiratory reserve
Insufficient oxygenation of hemoglobin in the lungs
The amount of air that can be exhaled after expiration
80%
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

4. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Spirometry
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Difficulty breathing or shortness of breath

5. Central cyanosis results from
Mediastinum
A reduction in lung capacity - secondary to scarring or extraneous material
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Insufficient oxygenation of hemoglobin in the lungs

6. Inspiratory stridor becomes evident at about
Immediate oxygenation with or without intubation
70% occlusion of the airway
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
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

7. Chest Radiography: The most common chest X-ray series is the...
The amount of air that can be exhaled after 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
Diffusion
Postero-anterior (PA) and lateral view series

8. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Hypoventilation or modest changes in the PaO2
Dyspnea that awakens the patient several hours after going to sleep
Manubrio-sternal junction (angle of Louis)
Air-filled - fluid-filled - or solid

9. The upper airway accounts For what % of airway resistance?
The total amount of air that can be exhaled following a maximal inhalation
Wheezes - high-pitched - musical sounds - distinct whistling quality
The examiner can clearly distinguish the word that the pt speak or whispers
50%

10. PaO2
Partial pressure of O2 in the arterial blood
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
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
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

11. Patients with restrictive disease have low
Partial pressure of oxygen (PO2)
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Pressure required to drive air through the airways
Lung volumes - but no difficulty or delay in exhaling what volume they do have

12. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Narrowed nearly to the point of closure
Nitrogen
No respiration for > 20 seconds
Partial pressure of oxygen (PO2)

13. total lung capacity (TLC)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Increased minute volume ventilation - which results in a lowered carbon dioxide level
The total amount of air in the lungs at the end of a maximal inhalation
Either inspiration or expiration

14. Bronchiovesicular breath sounds
right and left mainstem bronchi
Increased Hb-O2 affinity
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Insufficient oxygenation of hemoglobin in the lungs

15. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Overcome some of the problems associated with low blood flow to the probe site
Insufficient oxygenation of hemoglobin in the lungs

16. Auscultation of the chest depends on...
Expiratory volume - and there is a prolonged expiratory time
The examiner can clearly distinguish the word that the pt speak or whispers
A reliable and consistent classification of auditory findings
Acinus

17. Continuous lung sounds
Diffusion
Wheezes - high-pitched - musical sounds - distinct whistling quality
Mouth as well as through the chest wall
Diaphragm and the intercostal muscles

18. FIO2
Portable antero-posterior (AP) view
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
80%
Fraction (%age) of inspired oxygen

19. Peripheral cyanosis results from
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

20. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Right
Partial pressure of carbon dioxide in the alveoli
Immediate oxygenation with or without intubation
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

21. PAO2
Partial pressure of oxygen in the alveoli
80%
The amount of air that can be inhaled after normal inspiration
'adventitious' breath sounds

22. Tachypnea is an
No
Increased rate of breathing and is commonly associated with a decrease in tidal volume
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
require supplemental oxygenation and possibly ABG analysis

23. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Functional residual capacity (FRC)
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Oxygen-Hemoglobin Dissociation Curve
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

24. FEV1/FVC
The amount of air that can be exhaled after expiration
Dullness replaces resonance
70% occlusion of the airway
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

25. Continuous lung sounds occur during...
500 to 800 mL
Inspiration
Either inspiration or expiration
Normal to increased FEV1%

26. Rhonchi frequently clear after
Cough
Either continuous or discontinuous
Alveoli to the blood
Pressure required to drive air through the airways

27. The normal FEV1 /FVC ratio is...
Louder - lower-pitched - and slightly longer in duration
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
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
70%

28. Examples of obstructive disease
Partial pressure of carbon dioxide in the alveoli
Diaphragm and the intercostal muscles
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
A reduction in lung capacity - secondary to scarring or extraneous material

29. The spirometry printout usually includes

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30. the lingula is analogous to...
Either continuous or discontinuous
The right middle lobe
Pulse oximetry
Blood to the alveoli

31. Obstructive disease refers to...
Cough
Blood to the alveoli
70%
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

32. forced expiratory volume in one second (FEV1)
Expiration
right & left
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
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

33. The trachea divides into
Increased amounts of unsaturated hemoglobin in capillary blood
right and left mainstem bronchi
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Obstruction below the vocal cords (subglottic or tracheal obstruction)

34. Examples of restrictive disease
Pressure required to drive air through the airways
The examiner can clearly distinguish the word that the pt speak or whispers
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
80%

35. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Either inspiration or expiration
Blue or bluish-gray discoloration of the skin or mucous membranes
Increase the intrathoracic space
500 to 800 mL

36. Which bronchus is wider - shorter - and more vertically placed?
The amount of air that can be exhaled after expiration
Right
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
There is an inverse relationship between pressure and volume

37. dead space ventilation
Partial pressure of oxygen in the alveoli
Diaphragm - External Intercostals
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The gas in the conducting airways does not participate in alveolar exchange

38. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
Mouth as well as through the chest wall
500 to 800 mL
Larger airways

39. Which lung has an oblique fissure?
Postero-anterior (PA) and lateral view series
right & left
The amount of air that can be exhaled after expiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

40. Rhonchi originate in the...
Larger airways
Tongue
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

41. What is the potential space between the visceral and parietal pleurae?
35 to 45 mmHg
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
Pleural space
Lowered carbon dioxide level - results from hyperventilation

42. Orthopnea is quantified by
Insufficient oxygenation of hemoglobin in the lungs
Mediastinum
The negative logarithm of hydrogen ions in the blood
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

43. The internal intercostals decrease the transverse diameter of the chest during
Partial pressure of CO2 in the arterial blood
right and left mainstem bronchi
Expiration
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

44. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Perfusion
Increased amounts of unsaturated hemoglobin in capillary blood
Inspiration
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

45. Spirometry: The result is stated as
The examiner can clearly distinguish the word that the pt speak or whispers
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The total amount of air in the lungs at the end of a maximal inhalation
Increase the intrathoracic space

46. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiration
Pulse oximetry
Narrowed nearly to the point of closure
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

47. Restrictive Disease: Expiratory volume is reduced more than
Either continuous or discontinuous
Bronchospasm - mucosal edema - or excessive secretions
Nitrogen
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

48. Spirometry plots
Outer surface of each lung
Ventilation
A tracing of the lung volume against time in seconds
Larger airways

49. The active movement of gases between the ambient air and the lungs
Total lung capacity (TLC)
Ventilation
Partial pressure of O2 in the arterial blood
There is an inverse relationship between pressure and volume

50. Rhonchi
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
right & left
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
respiration