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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. An efficient approach to examination of the patient begins with
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Observing the pattern of breathing
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

2. Obstructive Disease: Expiratory airflow is reduced more than
No respiration for > 20 seconds
Right
Expiratory volume - and there is a prolonged expiratory time
Outer surface of each lung

3. Pulse Oximetry does not detect
Either inspiration or expiration
Either continuous or discontinuous
Hypoventilation or modest changes in the PaO2
Blue or bluish-gray discoloration of the skin or mucous membranes

4. FEV1% in restrictive disease
Normal to increased FEV1%
Pneumonia - obstructive lung disease - and late pulmonary edema
Increased amounts of unsaturated hemoglobin in capillary blood
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

5. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
The amount of air that can be inhaled after normal inspiration
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Saturated with oxygen or unsaturated

6. The trachea is how long/wide?
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Overcome some of the problems associated with low blood flow to the probe site
10 to 11 cm long and about 2 cm in diameter

7. The volume of gas remaining in the lungs at the end of normal expiration is called the...
5 years - to detect obstruction and determine its reversibility
Partial pressure of carbon dioxide in the alveoli
Functional residual capacity (FRC)
The rib above it

8. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
2 - each wavelength is partially absorbed by hemoglobin
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

9. Spirometry: The result is stated as
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
require supplemental oxygenation and possibly ABG analysis
right & left
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

10. The parietal pleura lines the...
Fraction (%age) of inspired oxygen
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Ventilation
Portable antero-posterior (AP) view

11. Restrictive disease refers to...
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
A reduction in lung capacity - secondary to scarring or extraneous material
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
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

12. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
A sensor placed over a translucent area of arterial pulsation
right & left
Perfusion
Air bubbles flowing through secretions or slightly closed airways during respiration

13. FIO2
Fraction (%age) of inspired oxygen
reduced in size - compared with a normal curve - due to lower lung volume
70%
Dyspnea upon assuming a recumbent position

14. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Decreased Hb-O2 affinity
The negative logarithm of hydrogen ions in the blood
Increased work of breathing
Louder - lower-pitched - and slightly longer in duration

15. inspiratory reserve
Dyspnea that awakens the patient several hours after going to sleep
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Blue or bluish-gray discoloration of the skin or mucous membranes
The amount of air that can be inhaled after normal inspiration

16. What may prevent cyanosis from appearing?
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
Normal to increased FEV1%
The amount of air that can be inhaled after normal inspiration

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

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18. terminal respiratory unit
Fraction (%age) of inspired oxygen
A reliable and consistent classification of auditory findings
Acinus
Pressure required to drive air through the airways

19. The trachea divides into
right and left mainstem bronchi
The amount of air that can be inhaled after normal inspiration
Excessive secretions and abnormal airway collapsibility
Ventilation - Diffusion - Perfusion

20. FEV1/FVC
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Immediate oxygenation with or without intubation
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
Bronchospasm - mucosal edema - or excessive secretions

21. Carbon dioxide moves from the...
Alveoli to the blood
Blood to the alveoli
To assess response to treatment
Obstructive lung disease from restrictive lung disease

22. increased volume results in
A tracing of the lung volume against time in seconds
Decreased pressure
release of O2 from Hb - as heat is a by-product of metabolism.
Total lung capacity (TLC)

23. Fine crackles are heard in
Interstitial diseases or early pulmonary edema
quickly - usually reaching a plateau within 6.0 seconds
Louder - lower-pitched - and slightly longer in duration
Increased Hb-O2 affinity

24. Which lobe has an inferior tongue-like projection called the lingula?
Dullness replaces resonance
Left upper lobe
right
Diaphragm - External Intercostals

25. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Manubrio-sternal junction (angle of Louis)
Increased amounts of unsaturated hemoglobin in capillary blood
Either inspiration or expiration
'scooped out' or bowl-shaped

26. The main bronchi are divided into smaller branches that begin to subdivide into
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Bicarbonate
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
There is an inverse relationship between pressure and volume

27. 20.95% Atmospheric Composition
reduced in size - compared with a normal curve - due to lower lung volume
Soft - high-pitched and crisp
Oxygen (O2)
Nitrogen

28. forced expiratory volume in one second (FEV1)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
5 years - to detect obstruction and determine its reversibility
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
release of O2 from Hb

29. The interspace between two ribs (intercostal space) is numbered by
right & left
The rib above it
Right
70% occlusion of the airway

30. office-based spirometry is recommended for patients as young as
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
5 years - to detect obstruction and determine its reversibility
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

31. Which bronchus is more susceptible to aspiration of foreign bodies?
Right
Fraction (%age) of inspired oxygen
Excessive secretions and abnormal airway collapsibility
500 to 800 mL

32. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Increased Hb-O2 affinity
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Spirometry
right and left mainstem bronchi

33. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Louder - lower-pitched - and slightly longer in duration
Spirometry
Outer surface of each lung
Air bubbles flowing through secretions or slightly closed airways during respiration

34. Coarse crackles are heard in
Manubrio-sternal junction (angle of Louis)
Speed of airflow - the higher the flow - the greater the resistance
Air bubbles flowing through secretions or slightly closed airways during respiration
Pneumonia - obstructive lung disease - and late pulmonary edema

35. Continuous lung sounds
Spirometry
Wheezes - high-pitched - musical sounds - distinct whistling quality
Increase the intrathoracic space
Bronchospasm - mucosal edema - or excessive secretions

36. The most reliable site for detecting central cyanosis is the...
Diaphragm - External Intercostals
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Tongue
Inside of the thoracic cavity wall and the upper surface of the diaphragm

37. The acini consist of the...
Soft - high-pitched and crisp
No respiration for > 20 seconds
50%
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

38. Late inspiratory crackles result from
Increased work of breathing
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Ventilation
right & left

39. 78.08% Atmospheric Composition
A reduction in lung capacity - secondary to scarring or extraneous material
The examiner can clearly distinguish the word that the pt speak or whispers
Diaphragm - External Intercostals
Nitrogen

40. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Carboxyhemoglobin
quickly - usually reaching a plateau within 6.0 seconds
Perfusion
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

41. Examples of obstructive disease
The total amount of air in the lungs at the end of a maximal inhalation
Portable antero-posterior (AP) view
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Lung volumes - but find it difficult to exhale rapidly

42. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
The total amount of air that can be exhaled following a maximal inhalation
Insufficient oxygenation of hemoglobin in the lungs
Mediastinum
Functional residual capacity (FRC)

43. Nitroglycerin applied to the probe area has been reported to...
Overcome some of the problems associated with low blood flow to the probe site
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
There is an inverse relationship between pressure and volume

44. The best indicator of adequate ventilation is the...
Increased Hb-O2 affinity
PaCO2
The negative logarithm of hydrogen ions in the blood
Right

45. The purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
A reduction in lung capacity - secondary to scarring or extraneous material
Inspiration
results in a lower than normal FEV1%

46. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Obstructive lung disease from restrictive lung disease
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
5 years - to detect obstruction and determine its reversibility
Upper respiratory obstruction - usually in the trachea or larynx

47. Apnea is defined as
T4 or T5 - and just below the manubrio-sternal joint
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
The total amount of air that can be exhaled following a maximal inhalation
No respiration for > 20 seconds

48. The spirometry printout usually includes

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49. Spirometry plots
A tracing of the lung volume against time in seconds
Partial pressure of carbon dioxide in the alveoli
80 to 120% of predicted value
respiration

50. Coarse crackles are...
Tongue
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
quickly - usually reaching a plateau within 6.0 seconds
Louder - lower-pitched - and slightly longer in duration