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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. Airway resistance refers to...
Ventilation - Diffusion - Perfusion
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The rib above it
Pressure required to drive air through the airways

2. tidal volume (Vt)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
The right middle lobe
Upper respiratory obstruction - usually in the trachea or larynx
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

3. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
A good effort
Wheezes - high-pitched - musical sounds - distinct whistling quality
Manubrio-sternal junction (angle of Louis)
Outer surface of each lung

4. Resistance is dependent upon
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Speed of airflow - the higher the flow - the greater the resistance
No

5. normal adult tidal volume
The rib above it
Carboxyhemoglobin
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
500 to 800 mL

6. Boyle's Gas Law
Oxygen (O2)
Immediate oxygenation with or without intubation
There is an inverse relationship between pressure and volume
70% occlusion of the airway

7. Pulse Oximetry is dependent on...
Oxygen (O2)
results in a lower than normal FEV1%
right and left mainstem bronchi
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

8. The trachea divides into right and left mainstem bronchi At what level?
T4 or T5 - and just below the manubrio-sternal joint
Outer surface of each lung
Normal to increased FEV1%
Nitrogen

9. Oxygen moves from the...
Alveoli to the blood
Diffusion
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Brief - discrete - non-musical sounds with a popping quality

10. The upper airway accounts For what % of airway resistance?
50%
Immediate oxygenation with or without intubation
Interstitial diseases or early pulmonary edema
Partial pressure of O2 in the arterial blood

11. vital capacity (VC)
Hypoventilation or modest changes in the PaO2
Air bubbles flowing through secretions or slightly closed airways during respiration
The total amount of air that can be exhaled following a maximal inhalation
Ventilation - Diffusion - Perfusion

12. Egophony

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13. A normal volume-time curve rises
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
'crackles' or 'rales'
quickly - usually reaching a plateau within 6.0 seconds
results in a lower than normal FEV1%

14. 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
Hypoventilation or modest changes in the PaO2
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Manubrio-sternal junction (angle of Louis)

15. During inspiration the diaphragm
Pleural space
Perfusion
Expiratory volume - and there is a prolonged expiratory time
Contracts

16. forced vital capacity (FVC)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Diaphragm and the intercostal muscles

17. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Larger airways
Decreased pressure

18. pH
A reliable and consistent classification of auditory findings
Obstructive lung disease from restrictive lung disease
The negative logarithm of hydrogen ions in the blood
A good effort

19. Inspiratory stridor indicates
Carboxyhemoglobin
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Dyspnea upon assuming a recumbent position
80%

20. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
A good effort
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Excessive secretions and abnormal airway collapsibility
'scooped out' or bowl-shaped

21. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Saturated with oxygen or unsaturated
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

22. Respiration involves
Ventilation - Diffusion - Perfusion
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Saturated with oxygen or unsaturated
Altering the respiratory rate and/or the tidal volume

23. Bohr Effect of pH: right shift
Decreased Hb-O2 affinity
A reduction in lung capacity - secondary to scarring or extraneous material
Dullness replaces resonance
release of O2 from Hb - as heat is a by-product of metabolism.

24. 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
Obstructive lung disease from restrictive lung disease
A reduction in lung capacity - secondary to scarring or extraneous material
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

25. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
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
Inspiration
Outer surface of each lung
release of O2 from Hb

26. Cyanosis appears when
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Expiration
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Narrowed nearly to the point of closure

27. Paroxysmal nocturnal dyspnea (PND) is...
Dyspnea that awakens the patient several hours after going to sleep
Contracts
PaCO2
Normal to increased FEV1%

28. Continuous lung sounds occur when air flows rapidly through bronchi that are...
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
Spirometry
Narrowed nearly to the point of closure
Speed of airflow - the higher the flow - the greater the resistance

29. Late inspiratory crackles result from
Altering the respiratory rate and/or the tidal volume
5 years - to detect obstruction and determine its reversibility
Speed of airflow - the higher the flow - the greater the resistance
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

30. Cyanosis is caused by
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Increased amounts of unsaturated hemoglobin in capillary blood
Blue or bluish-gray discoloration of the skin or mucous membranes
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

31. PaCO2
Ventilation
Mediastinum
Partial pressure of CO2 in the arterial blood
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

32. The muscles of expiration are the...
A reduction in lung capacity - secondary to scarring or extraneous material
Acinus
Pneumonia - obstructive lung disease - and late pulmonary edema
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

33. Oximetry readings of < 94%
require supplemental oxygenation and possibly ABG analysis
Right
Increased minute volume ventilation - which results in a lowered carbon dioxide level
'scooped out' or bowl-shaped

34. Continuous lung sounds occur in the setting of...
release of O2 from Hb - as heat is a by-product of metabolism.
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Bronchospasm - mucosal edema - or excessive secretions

35. With restrictive disease - the flow-volume curve is...
A sensor placed over a translucent area of arterial pulsation
To assess response to treatment
reduced in size - compared with a normal curve - due to lower lung volume
The gas in the conducting airways does not participate in alveolar exchange

36. 78.08% Atmospheric Composition
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Expiratory volume - and there is a prolonged expiratory time
Nitrogen
'adventitious' breath sounds

37. Which lung has an oblique fissure?
A tracing of the lung volume against time in seconds
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
right & left
Partial pressure of carbon dioxide in the alveoli

38. Spirometry is useful in distinguishing
A good effort
To assess response to treatment
Obstructive lung disease from restrictive lung disease
The rib above it

39. the lingula is analogous to...
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
The right middle lobe
Acinus
Outer surface of each lung

40. Cyanosis
Blue or bluish-gray discoloration of the skin or mucous membranes
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
release of O2 from Hb

41. PACO2
Pleural space
Expiration
Spirometry
Partial pressure of carbon dioxide in the alveoli

42. The purpose of respiration is to...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Decreased Hb-O2 affinity

43. The primary muscles of respiration are the...
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Immediate oxygenation with or without intubation
Fraction (%age) of inspired oxygen
Diaphragm and the intercostal muscles

44. The internal intercostals decrease the transverse diameter of the chest during
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Soft - high-pitched and crisp
results in a lower than normal FEV1%
Expiration

45. Orthopnea is defined as
Carboxyhemoglobin
reduced in size - compared with a normal curve - due to lower lung volume
Dyspnea upon assuming a recumbent position
Lowered carbon dioxide level - results from hyperventilation

46. FEV1% in restrictive disease
Normal to increased FEV1%
Total lung capacity (TLC)
Air-filled - fluid-filled - or solid
The atmospheric pressure

47. What may prevent cyanosis from appearing?
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Partial pressure of oxygen in the alveoli
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

48. Coarse crackles are...
A tracing of the lung volume against time in seconds
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Spirometry
Louder - lower-pitched - and slightly longer in duration

49. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
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
results in a lower than normal FEV1%
right & left
2 - each wavelength is partially absorbed by hemoglobin

50. Spirometry: The result is stated as
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
results in a lower than normal FEV1%
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

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Pulmonology

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