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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. Late inspiratory crackles result from
Dullness replaces resonance
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Immediate oxygenation with or without intubation

2. Patients with restrictive disease have low
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
No respiration for > 20 seconds
Lung volumes - but no difficulty or delay in exhaling what volume they do have

3. FEV1% in obstructive disease
Difficulty breathing or shortness of breath
Right
results in a lower than normal FEV1%
Diaphragm - External Intercostals

4. high CO2 = high acidity =
Dyspnea upon assuming a recumbent position
No respiration for > 20 seconds
release of O2 from Hb
Air bubbles flowing through secretions or slightly closed airways during respiration

5. Cyanosis appears when
A reduction in lung capacity - secondary to scarring or extraneous material
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
80%
70%

6. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Immediate oxygenation with or without intubation
Increased amounts of unsaturated hemoglobin in capillary blood
Mediastinum
There is an inverse relationship between pressure and volume

7. The trachea is how long/wide?
Brief - discrete - non-musical sounds with a popping quality
10 to 11 cm long and about 2 cm in diameter
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The amount of air that can be inhaled after normal inspiration

8. 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
Mediastinum
Spirometry
right and left mainstem bronchi

9. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Spirometry
Increased work of breathing

10. residual volume
Wheezes - high-pitched - musical sounds - distinct whistling quality
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
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

11. Oxygen moves from the...
release of O2 from Hb
respiration
Carboxyhemoglobin
Alveoli to the blood

12. FEV1/FVC
Excessive secretions and abnormal airway collapsibility
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
require supplemental oxygenation and possibly ABG analysis

13. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
Insufficient oxygenation of hemoglobin in the lungs
Either inspiration or expiration
Bicarbonate

14. The parietal pleura lines the...
Bicarbonate
The examiner can clearly distinguish the word that the pt speak or whispers
right
Inside of the thoracic cavity wall and the upper surface of the diaphragm

15. The tracheo-bronchial tree is a tubular system that provides a pathway for
Air to move from the upper airway to the farthest alveolar reaches
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Mouth as well as through the chest wall
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

16. Continuous lung sounds occur in the setting of...
Inspiration
Dyspnea upon assuming a recumbent position
'crackles' or 'rales'
Bronchospasm - mucosal edema - or excessive secretions

17. The active movement of gases between the ambient air and the lungs
Inflammation of the adjacent parietal pleura
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
right and left mainstem bronchi
Ventilation

18. Respiration involves
Ventilation - Diffusion - Perfusion
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Alveoli to the blood
Lowered carbon dioxide level - results from hyperventilation

19. Peripheral cyanosis results from
Louder - lower-pitched - and slightly longer in duration
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
There is an inverse relationship between pressure and volume
Immediate oxygenation with or without intubation

20. FIO2
70%
Pneumonia - obstructive lung disease - and late pulmonary edema
Fraction (%age) of inspired oxygen
Diaphragm - External Intercostals

21. The purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Acinus
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
10 to 11 cm long and about 2 cm in diameter

22. FEV1% in restrictive disease
Sternocleidomastoid - Scalene Muscles
Partial pressure of oxygen in the alveoli
Normal to increased FEV1%
Immediate oxygenation with or without intubation

23. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Pneumonia - obstructive lung disease - and late pulmonary edema
The examiner can clearly distinguish the word that the pt speak or whispers

24. Spirometry normal range
Oxygen (O2)
80 to 120% of predicted value
Air to move from the upper airway to the farthest alveolar reaches
The gas in the conducting airways does not participate in alveolar exchange

25. Which bronchus is wider - shorter - and more vertically placed?
Perfusion
Right
Hypoventilation or modest changes in the PaO2
The total amount of air that can be exhaled following a maximal inhalation

26. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Wheezes - high-pitched - musical sounds - distinct whistling quality
Saturated with oxygen or unsaturated
Blood to the alveoli
Interstitial diseases or early pulmonary edema

27. Fine crackles are heard in
Interstitial diseases or early pulmonary edema
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Inspiration
No

28. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Inflammation of the adjacent parietal pleura
quickly - usually reaching a plateau within 6.0 seconds
Decreased Hb-O2 affinity
respiration

29. PaO2
Partial pressure of O2 in the arterial blood
PaCO2
Interstitial diseases or early pulmonary edema
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

30. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Fraction (%age) of inspired oxygen
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

31. Oximetry readings of < 94%
No respiration for > 20 seconds
require supplemental oxygenation and possibly ABG analysis
Postero-anterior (PA) and lateral view series
Soft - high-pitched and crisp

32. Chest Radiography: The most common chest X-ray series is the...
'adventitious' breath sounds
Hypoventilation or modest changes in the PaO2
Postero-anterior (PA) and lateral view series
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

33. The pattern of breathing refers to...
Diffusion
Air-filled - fluid-filled - or solid
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

34. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Diaphragm - External Intercostals
Blue or bluish-gray discoloration of the skin or mucous membranes
Spirometry

35. Examples of restrictive disease
Pleural space
Brief - discrete - non-musical sounds with a popping quality
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Wheezes - high-pitched - musical sounds - distinct whistling quality

36. Spirometry: The result is stated as
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 total amount of air that can be exhaled following a maximal inhalation
'scooped out' or bowl-shaped
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

37. Tachypnea is an
Portable antero-posterior (AP) view
Carboxyhemoglobin
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Binding of O2 to Hb

38. The vital capacity and the residual volume together constitute the...
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
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Total lung capacity (TLC)
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

39. Inspiratory stridor becomes evident at about
Nitrogen
70% occlusion of the airway
Soft - high-pitched and crisp
release of O2 from Hb - as heat is a by-product of metabolism.

40. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
70% occlusion of the airway
Speed of airflow - the higher the flow - the greater the resistance
Perfusion

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

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42. The trachea bifurcates into its mainstem bronchi at the level of...
Left upper lobe
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Increased minute volume ventilation - which results in a lowered carbon dioxide level

43. Restrictive Disease: Expiratory volume is reduced more than
Cough
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
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
'crackles' or 'rales'

44. Restrictive disease refers to...
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The amount of air that can be exhaled after expiration
A reduction in lung capacity - secondary to scarring or extraneous material

45. Factors that influence the oxygen carrying capacity of hemoglobin
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
'crackles' or 'rales'
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Excessive secretions and abnormal airway collapsibility

46. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
reduced in size - compared with a normal curve - due to lower lung volume
Inspiration
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
right & left

47. Which lung has a horizontal fissure?
Functional residual capacity (FRC)
The total amount of air that can be exhaled following a maximal inhalation
The total amount of air in the lungs at the end of a maximal inhalation
right

48. The spirometry printout usually includes

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49. terminal respiratory unit
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
A reduction in lung capacity - secondary to scarring or extraneous material
Cough
Acinus

50. The presence of pressure gradients causes respiratory gases to move from
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
The total amount of air that can be exhaled following a maximal inhalation
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
80 to 120% of predicted value