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Pulmonology

Instructions:

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. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Partial pressure of carbon dioxide in the alveoli
Increased Hb-O2 affinity
There is an inverse relationship between pressure and volume

2. Boyle's Gas Law
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
reduced in size - compared with a normal curve - due to lower lung volume
Sternocleidomastoid - Scalene Muscles
There is an inverse relationship between pressure and volume

3. Does lung tissue have pain fibers?
reduced in size - compared with a normal curve - due to lower lung volume
Perfusion
No
right and left mainstem bronchi

4. the lingula is analogous to...
Pneumonia - obstructive lung disease - and late pulmonary edema
The total amount of air in the lungs at the end of a maximal inhalation
The right middle lobe
release of O2 from Hb - as heat is a by-product of metabolism.

5. normal adult tidal volume
500 to 800 mL
Obstructive lung disease from restrictive lung disease
Binding of O2 to Hb
Inspiration

6. The most reliable site for detecting central cyanosis is the...
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Tongue
Overcome some of the problems associated with low blood flow to the probe site

7. Tachypnea is an
Overcome some of the problems associated with low blood flow to the probe site
Mouth as well as through the chest wall
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
Increased rate of breathing and is commonly associated with a decrease in tidal volume

8. Patients with obstructive disease have normal
reduced in size - compared with a normal curve - due to lower lung volume
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
To assess response to treatment
Lung volumes - but find it difficult to exhale rapidly

9. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Either inspiration or expiration
Dyspnea that awakens the patient several hours after going to sleep
Manubrio-sternal junction (angle of Louis)

10. forced vital capacity (FVC)
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
'crackles' or 'rales'
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

11. The purpose of respiration is to...
Air-filled - fluid-filled - or solid
Inspiration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

12. Discontinuous lung sounds are also called

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13. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A reliable and consistent classification of auditory findings
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Partial pressure of oxygen in the alveoli

14. Bronchophony
Increase the intrathoracic space
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
right and left mainstem bronchi
Dyspnea that awakens the patient several hours after going to sleep

15. movement of blood through the capillaries in direct communication with the alveoli
Carboxyhemoglobin
Expiration
Perfusion
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. Inspiratory stridor indicates
Right
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Functional residual capacity (FRC)
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

17. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
80%
Immediate oxygenation with or without intubation
Increased rate of breathing and is commonly associated with a decrease in tidal volume

18. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
The right middle lobe
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
No

19. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
Partial pressure of CO2 in the arterial blood
right & left
Nitrogen

20. Examples of obstructive disease
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Ventilation - Diffusion - Perfusion
Portable antero-posterior (AP) view
Either inspiration or expiration

21. inspiratory reserve
Sternocleidomastoid - Scalene Muscles
The amount of air that can be inhaled after normal inspiration
Pleural space
The gas in the conducting airways does not participate in alveolar exchange

22. Factors that influence the oxygen carrying capacity of hemoglobin
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Partial pressure of oxygen (PO2)
Hypoventilation or modest changes in the PaO2

23. Cyanosis
T4 or T5 - and just below the manubrio-sternal joint
Diffusion
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
Blue or bluish-gray discoloration of the skin or mucous membranes

24. Oximetry readings of < 94%
Diaphragm and the intercostal muscles
require supplemental oxygenation and possibly ABG analysis
80%
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

25. Compliance
Contracts
Perfusion
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
Perfusion

26. Resistance is dependent upon
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Speed of airflow - the higher the flow - the greater the resistance
The gas in the conducting airways does not participate in alveolar exchange
right & left

27. PACO2
Pleural space
Fraction (%age) of inspired oxygen
Partial pressure of carbon dioxide in the alveoli
Lung volumes - but find it difficult to exhale rapidly

28. Respiration involves
Significant pulmonary impairment
Ventilation - Diffusion - Perfusion
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Increased minute volume ventilation - which results in a lowered carbon dioxide level

29. high CO2 = high acidity =
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 maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Contracts
release of O2 from Hb

30. Pulse Oximetry is dependent on...
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
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
Pressure required to drive air through the airways
Pleural space

31. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Air-filled - fluid-filled - or solid
Left upper lobe
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

32. Which bronchus is wider - shorter - and more vertically placed?
2 - each wavelength is partially absorbed by hemoglobin
Right
Narrowed nearly to the point of closure
70% occlusion of the airway

33. The spirometry printout usually includes

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34. FIO2
Right
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Speed of airflow - the higher the flow - the greater the resistance
Fraction (%age) of inspired oxygen

35. The primary muscles of respiration are the...
70% occlusion of the airway
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Diaphragm and the intercostal muscles

36. PAO2
Diffusion
Increased work of breathing
Partial pressure of oxygen in the alveoli
A good effort

37. Spirometry plots
Bicarbonate
Pneumonia - obstructive lung disease - and late pulmonary edema
A tracing of the lung volume against time in seconds
Left upper lobe

38. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
A reduction in lung capacity - secondary to scarring or extraneous material
Cough
Soft - high-pitched and crisp

39. Dyspnea is defined as
To assess response to treatment
500 to 800 mL
Difficulty breathing or shortness of breath
Hypoventilation or modest changes in the PaO2

40. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
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
Blood to the alveoli
Diaphragm and the intercostal muscles

41. Coarse crackles are heard in
Pneumonia - obstructive lung disease - and late pulmonary edema
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Perfusion

42. The internal intercostals decrease the transverse diameter of the chest during
Observing the pattern of breathing
Inflammation of the adjacent parietal pleura
Expiration
release of O2 from Hb - as heat is a by-product of metabolism.

43. normal subjects expel approximately how much of the FVC in the 1st second?
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
Diffusion
80%
Partial pressure of CO2 in the arterial blood

44. increased volume results in
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Decreased pressure
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

45. Normal range of PaCO2
release of O2 from Hb
Acinus
35 to 45 mmHg
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

46. Rhonchi are due to...
Diaphragm and the intercostal muscles
Excessive secretions and abnormal airway collapsibility
Hypoventilation or modest changes in the PaO2
Increased minute volume ventilation - which results in a lowered carbon dioxide level

47. Obstructive Disease: Expiratory airflow is reduced more than
Air to move from the upper airway to the farthest alveolar reaches
Partial pressure of oxygen (PO2)
Expiratory volume - and there is a prolonged expiratory time
Increase the intrathoracic space

48. The muscles of inspiration are the...
Postero-anterior (PA) and lateral view series
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Diaphragm - External Intercostals
The amount of air that can be exhaled after expiration

49. Hyperventilation is defined as
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Difficulty breathing or shortness of breath
Sternocleidomastoid - Scalene Muscles

50. The trachea divides into
Brief - discrete - non-musical sounds with a popping quality
right and left mainstem bronchi
Partial pressure of CO2 in the arterial blood
Decreased Hb-O2 affinity