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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. The acini consist of the...
Overcome some of the problems associated with low blood flow to the probe site
release of O2 from Hb - as heat is a by-product of metabolism.
quickly - usually reaching a plateau within 6.0 seconds
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

2. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Inflammation of the adjacent parietal pleura
Binding of O2 to Hb
2 - each wavelength is partially absorbed by hemoglobin
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

3. Which lung has a horizontal fissure?
Partial pressure of O2 in the arterial blood
right
Postero-anterior (PA) and lateral view series
Expiratory volume - and there is a prolonged expiratory time

4. office-based spirometry is recommended for patients as young as
reduced in size - compared with a normal curve - due to lower lung volume
5 years - to detect obstruction and determine its reversibility
Total lung capacity (TLC)
Pulse oximetry

5. hypocapnia
PaCO2
Normal to increased FEV1%
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Lowered carbon dioxide level - results from hyperventilation

6. Spirometry is useful in distinguishing
Normal to increased FEV1%
Increased work of breathing
Obstructive lung disease from restrictive lung disease
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

7. Oximetry readings of < 94%
The negative logarithm of hydrogen ions in the blood
require supplemental oxygenation and possibly ABG analysis
Bicarbonate
'adventitious' breath sounds

8. Bronchiovesicular breath sounds
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Mediastinum
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Partial pressure of oxygen in the alveoli

9. Discontinuous lung sounds are...
Blue or bluish-gray discoloration of the skin or mucous membranes
500 to 800 mL
Ventilation - Diffusion - Perfusion
Brief - discrete - non-musical sounds with a popping quality

10. A state-of-the-art - inexpensive - non-invasive - simple method to monitor a patient's percent hemoglobin saturation with oxygen (SaO2) - without having to obtain an arterial blood specimen
right
The negative logarithm of hydrogen ions in the blood
Pulse oximetry
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

11. forced vital capacity (FVC)
The total amount of air that can be exhaled following a maximal inhalation
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

12. The active movement of gases between the ambient air and the lungs
reduced in size - compared with a normal curve - due to lower lung volume
Ventilation
Dyspnea that awakens the patient several hours after going to sleep
Dyspnea upon assuming a recumbent position

13. normal subjects expel approximately how much of the FVC in the 1st second?
80%
quickly - usually reaching a plateau within 6.0 seconds
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Obstructive lung disease from restrictive lung disease

14. Rhonchi occur during
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Partial pressure of carbon dioxide in the alveoli
Partial pressure of CO2 in the arterial blood
Either inspiration or expiration

15. Does lung tissue have pain fibers?
Manubrio-sternal junction (angle of Louis)
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Difficulty breathing or shortness of breath
No

16. 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
release of O2 from Hb
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
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

17. Continuous lung sounds occur in the setting of...
5 years - to detect obstruction and determine its reversibility
Either continuous or discontinuous
Partial pressure of oxygen in the alveoli
Bronchospasm - mucosal edema - or excessive secretions

18. Central cyanosis results from
Altering the respiratory rate and/or the tidal volume
Increased Hb-O2 affinity
Portable antero-posterior (AP) view
Insufficient oxygenation of hemoglobin in the lungs

19. The internal intercostals decrease the transverse diameter of the chest during
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Expiration
Functional residual capacity (FRC)
Lung volumes - but no difficulty or delay in exhaling what volume they do have

20. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Insufficient oxygenation of hemoglobin in the lungs
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Oxygen (O2)
Immediate oxygenation with or without intubation

21. Resistance is dependent upon
right
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
Speed of airflow - the higher the flow - the greater the resistance
Lowered carbon dioxide level - results from hyperventilation

22. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
Expiratory volume - and there is a prolonged expiratory time
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Partial pressure of O2 in the arterial blood

23. At rest - the use of accessory muscles is a sign of...
Contracts
Outer surface of each lung
Significant pulmonary impairment
Lung volumes - but no difficulty or delay in exhaling what volume they do have

24. pain in lung conditions usually arises from
Upper respiratory obstruction - usually in the trachea or larynx
Immediate oxygenation with or without intubation
Significant pulmonary impairment
Inflammation of the adjacent parietal pleura

25. The muscles of expiration are the...
Pulse oximetry
Excessive secretions and abnormal airway collapsibility
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Mouth as well as through the chest wall

26. Bohr Effect of pH: right shift
Portable antero-posterior (AP) view
Inflammation of the adjacent parietal pleura
Decreased Hb-O2 affinity
50%

27. The presence of pressure gradients causes respiratory gases to move from
80 to 120% of predicted value
A good effort
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Inspiration

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

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29. Abnormal lung sounds are classified as
Either continuous or discontinuous
Dyspnea upon assuming a recumbent position
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
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

30. Patients with obstructive disease have normal
Lung volumes - but find it difficult to exhale rapidly
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Either inspiration or expiration
Hypoventilation or modest changes in the PaO2

31. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Functional residual capacity (FRC)
5 years - to detect obstruction and determine its reversibility
Oxygen (O2)
Air bubbles flowing through secretions or slightly closed airways during respiration

32. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Partial pressure of oxygen (PO2)
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Spirometry
Right

33. Factors that influence the oxygen carrying capacity of hemoglobin
500 to 800 mL
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
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
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

34. Chest Radiography: The most common chest X-ray series is the...
Acinus
Postero-anterior (PA) and lateral view series
Speed of airflow - the higher the flow - the greater the resistance
A good effort

35. The purpose of respiration is to...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
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
Bronchospasm - mucosal edema - or excessive secretions

36. Inspiratory stridor indicates
Increased Hb-O2 affinity
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Observing the pattern of breathing

37. Pulse Oximetry is dependent on...
Left upper lobe
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
results in a lower than normal FEV1%

38. Inspiratory stridor becomes evident at about
'adventitious' breath sounds
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
70% occlusion of the airway
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

39. The accessory muscles are the...
Perfusion
right
Dyspnea that awakens the patient several hours after going to sleep
Sternocleidomastoid - Scalene Muscles

40. Orthopnea is quantified by
'crackles' or 'rales'
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Decreased pressure
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

41. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
Spirometry
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
The total amount of air that can be exhaled following a maximal inhalation

42. PaO2
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Either inspiration or expiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Partial pressure of O2 in the arterial blood

43. Which lobe has an inferior tongue-like projection called the lingula?
Lowered carbon dioxide level - results from hyperventilation
Pulse oximetry
Left upper lobe
Pressure required to drive air through the airways

44. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiration
Air to move from the upper airway to the farthest alveolar reaches
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Either inspiration or expiration

45. The trachea divides into right and left mainstem bronchi At what level?
right
T4 or T5 - and just below the manubrio-sternal joint
right & left
Either inspiration or expiration

46. Coarse crackles result from
Pressure required to drive air through the airways
Wheezes - high-pitched - musical sounds - distinct whistling quality
Air bubbles flowing through secretions or slightly closed airways during respiration
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

47. Patients with restrictive disease have low
Binding of O2 to Hb
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Lung volumes - but no difficulty or delay in exhaling what volume they do have
PaCO2

48. Discontinuous lung sounds are also called

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49. 20.95% Atmospheric Composition
release of O2 from Hb
Oxygen (O2)
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Alveoli to the blood

50. 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
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
quickly - usually reaching a plateau within 6.0 seconds
Tongue

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Pulmonology

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