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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. Stridor is a high-pitched - noisy respiration - Which is indicative of...
There is an inverse relationship between pressure and volume
Upper respiratory obstruction - usually in the trachea or larynx
35 to 45 mmHg
The right middle lobe

2. within limits - increased temperature =
70%
Inflammation of the adjacent parietal pleura
release of O2 from Hb - as heat is a by-product of metabolism.
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

3. The acini consist of the...
Immediate oxygenation with or without intubation
Ventilation
A tracing of the lung volume against time in seconds
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

4. Chest Radiography: The most common chest X-ray series is the...
The total amount of air that can be exhaled following a maximal inhalation
Postero-anterior (PA) and lateral view series
Either inspiration or expiration
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

5. Cyanosis appears when
right and left mainstem bronchi
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Hypoventilation or modest changes in the PaO2

6. What is the potential space between the visceral and parietal pleurae?
The right middle lobe
require supplemental oxygenation and possibly ABG analysis
Pleural space
70% occlusion of the airway

7. Pulse Oximetry is dependent on...
respiration
Normal to increased FEV1%
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
right

8. Rhonchi occur during
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Either inspiration or expiration
Air bubbles flowing through secretions or slightly closed airways during respiration

9. Percussion helps you establish whether the underlying tissues are...
Air-filled - fluid-filled - or solid
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Either continuous or discontinuous
Decreased Hb-O2 affinity

10. The trachea bifurcates into its mainstem bronchi at the level of...
Carboxyhemoglobin
Interstitial diseases or early pulmonary edema
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Saturated with oxygen or unsaturated

11. Which bronchus is more susceptible to aspiration of foreign bodies?
Right
80%
Inflammation of the adjacent parietal pleura
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

12. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Pressure required to drive air through the airways
Portable antero-posterior (AP) view
Upper respiratory obstruction - usually in the trachea or larynx
release of O2 from Hb - as heat is a by-product of metabolism.

13. An efficient approach to examination of the patient begins with
The right middle lobe
Perfusion
Observing the pattern of breathing
Blood to the alveoli

14. dead space ventilation
respiration
The gas in the conducting airways does not participate in alveolar exchange
right
The total amount of air in the lungs at the end of a maximal inhalation

15. PACO2
Partial pressure of carbon dioxide in the alveoli
500 to 800 mL
Insufficient oxygenation of hemoglobin in the lungs
Decreased Hb-O2 affinity

16. Spirometry: The result is stated as
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
The right middle lobe
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

17. terminal respiratory unit
Partial pressure of oxygen in the alveoli
50%
Acinus
Cough

18. Which lobe has an inferior tongue-like projection called the lingula?
Cough
Spirometry
Left upper lobe
Speed of airflow - the higher the flow - the greater the resistance

19. Coarse crackles result from
Expiration
Air bubbles flowing through secretions or slightly closed airways during respiration
Mediastinum
reduced in size - compared with a normal curve - due to lower lung volume

20. Peripheral cyanosis results from
The right middle lobe
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
There is an inverse relationship between pressure and volume

21. gas exchange across the alveolar-pulmonary capillary membranes
A reliable and consistent classification of auditory findings
No respiration for > 20 seconds
Diffusion
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

22. HCO3
Portable antero-posterior (AP) view
Increase the intrathoracic space
right
Bicarbonate

23. Restrictive Disease: Expiratory volume is reduced more than
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Ventilation - Diffusion - Perfusion
Blood to the alveoli
Functional residual capacity (FRC)

24. Bronchophony
Diffusion
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
Pleural space
Increased work of breathing

25. The visceral pleura lines the...
Pleural space
PaCO2
reduced in size - compared with a normal curve - due to lower lung volume
Outer surface of each lung

26. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Functional residual capacity (FRC)
Decreased Hb-O2 affinity
Insufficient oxygenation of hemoglobin in the lungs
A good effort

27. The trachea divides into
Ventilation
right and left mainstem bronchi
Air-filled - fluid-filled - or solid
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

28. Auscultation of the chest depends on...
Difficulty breathing or shortness of breath
Increase the intrathoracic space
A reliable and consistent classification of auditory findings
'adventitious' breath sounds

29. vital capacity (VC)
Dullness replaces resonance
The total amount of air that can be exhaled following a maximal inhalation
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

30. Carbon dioxide moves from the...
Partial pressure of oxygen (PO2)
Tongue
Blood to the alveoli
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

31. Normal range of PaCO2
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
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Functional residual capacity (FRC)
35 to 45 mmHg

32. Cyanosis is caused by
The amount of air that can be inhaled after normal inspiration
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Increased amounts of unsaturated hemoglobin in capillary blood
Pneumonia - obstructive lung disease - and late pulmonary edema

33. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Pneumonia - obstructive lung disease - and late pulmonary edema
A reduction in lung capacity - secondary to scarring or extraneous material
right
Perfusion

34. Patients with obstructive disease have normal
Difficulty breathing or shortness of breath
Lung volumes - but find it difficult to exhale rapidly
release of O2 from Hb
Excessive secretions and abnormal airway collapsibility

35. forced expiratory volume in one second (FEV1)
Excessive secretions and abnormal airway collapsibility
There is an inverse relationship between pressure and volume
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

36. FEV1% in obstructive disease
Inspiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
results in a lower than normal FEV1%
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

37. Rhonchi
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
The total amount of air that can be exhaled following a maximal inhalation
Diffusion
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

38. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Oxygen-Hemoglobin Dissociation Curve
The rib above it
Spirometry

39. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
Right
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Lung volumes - but no difficulty or delay in exhaling what volume they do have

40. Bohr Effect of pH: left shift
Expiration
Interstitial diseases or early pulmonary edema
Increased Hb-O2 affinity
Partial pressure of O2 in the arterial blood

41. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
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
The atmospheric pressure
Perfusion
Either continuous or discontinuous

42. normal subjects expel approximately how much of the FVC in the 1st second?
'adventitious' breath sounds
Excessive secretions and abnormal airway collapsibility
Upper respiratory obstruction - usually in the trachea or larynx
80%

43. Expiratory stridor indicates
Altering the respiratory rate and/or the tidal volume
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Right
Obstruction below the vocal cords (subglottic or tracheal obstruction)

44. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Spirometry
Air-filled - fluid-filled - or solid
The amount of air that can be inhaled after normal inspiration
Oxygen-Hemoglobin Dissociation Curve

45. At rest - the use of accessory muscles is a sign of...
Speed of airflow - the higher the flow - the greater the resistance
Significant pulmonary impairment
Upper respiratory obstruction - usually in the trachea or larynx
Increased rate of breathing and is commonly associated with a decrease in tidal volume

46. Spirometry plots
Expiration
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
A tracing of the lung volume against time in seconds
Soft - high-pitched and crisp

47. forced vital capacity (FVC)
Dyspnea upon assuming a recumbent position
A sensor placed over a translucent area of arterial pulsation
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
2 - each wavelength is partially absorbed by hemoglobin

48. pain in lung conditions usually arises from
Air bubbles flowing through secretions or slightly closed airways during respiration
Brief - discrete - non-musical sounds with a popping quality
A good effort
Inflammation of the adjacent parietal pleura

49. Egophony

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50. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Normal to increased FEV1%
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Inspiration
The right middle lobe