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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. Orthopnea is quantified by
Blood to the alveoli
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Inspiration

2. Egophony

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3. What may prevent cyanosis from appearing?
Alveoli to the blood
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Bronchospasm - mucosal edema - or excessive secretions
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

4. Airway resistance refers to...
Pressure required to drive air through the airways
PaCO2
Right
10 to 11 cm long and about 2 cm in diameter

5. within limits - increased temperature =
Louder - lower-pitched - and slightly longer in duration
Overcome some of the problems associated with low blood flow to the probe site
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
release of O2 from Hb - as heat is a by-product of metabolism.

6. Continuous lung sounds occur during...
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Either inspiration or expiration
Alveoli to the blood
Hypoventilation or modest changes in the PaO2

7. At rest - the use of accessory muscles is a sign of...
2 - each wavelength is partially absorbed by hemoglobin
Significant pulmonary impairment
Expiration
Decreased pressure

8. Pulse Oximetry does not detect
Contracts
Hypoventilation or modest changes in the PaO2
Difficulty breathing or shortness of breath
release of O2 from Hb

9. Coarse crackles are heard in
require supplemental oxygenation and possibly ABG analysis
Larger airways
right
Pneumonia - obstructive lung disease - and late pulmonary edema

10. Restrictive Disease: Expiratory volume is reduced more than
Inspiration
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Partial pressure of CO2 in the arterial blood
right

11. FEV1/FVC
Expiration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Either inspiration or expiration

12. HCO3
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
Spirometry
Bicarbonate
Increased rate of breathing and is commonly associated with a decrease in tidal volume

13. Oxygen moves from the...
Perfusion
To assess response to treatment
Alveoli to the blood
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

14. Which lung has an oblique fissure?
Oxygen (O2)
The amount of air that can be inhaled after normal inspiration
right & left
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

15. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Diaphragm and the intercostal muscles
2 - each wavelength is partially absorbed by hemoglobin

16. tidal volume (Vt)
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
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Tongue

17. The trachea is how long/wide?
10 to 11 cm long and about 2 cm in diameter
70%
reduced in size - compared with a normal curve - due to lower lung volume
50%

18. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Spirometry
Interstitial diseases or early pulmonary edema
Partial pressure of oxygen in the alveoli
Either continuous or discontinuous

19. Which bronchus is more susceptible to aspiration of foreign bodies?
Right
Sternocleidomastoid - Scalene Muscles
Excessive secretions and abnormal airway collapsibility
The total amount of air that can be exhaled following a maximal inhalation

20. Discontinuous lung sounds are also called

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21. Central cyanosis results from
Insufficient oxygenation of hemoglobin in the lungs
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Bronchospasm - mucosal edema - or excessive secretions

22. Coarse crackles result from
Obstruction below the vocal cords (subglottic or tracheal obstruction)
10 to 11 cm long and about 2 cm in diameter
Air bubbles flowing through secretions or slightly closed airways during respiration
The examiner can clearly distinguish the word that the pt speak or whispers

23. PAO2
Significant pulmonary impairment
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Diffusion
Partial pressure of oxygen in the alveoli

24. Cyanosis is caused by
respiration
Increased amounts of unsaturated hemoglobin in capillary blood
Manubrio-sternal junction (angle of Louis)
Either inspiration or expiration

25. pH
Right
The negative logarithm of hydrogen ions in the blood
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
A reliable and consistent classification of auditory findings

26. Vesicular breath sounds
Either continuous or discontinuous
T4 or T5 - and just below the manubrio-sternal joint
10 to 11 cm long and about 2 cm in diameter
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

27. Abnormal lung sounds are classified as
Dullness replaces resonance
PaCO2
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Either continuous or discontinuous

28. Spirometry plots
Perfusion
70%
A tracing of the lung volume against time in seconds
Sternocleidomastoid - Scalene Muscles

29. What is the potential space between the visceral and parietal pleurae?
Pleural space
Mouth as well as through the chest wall
Diffusion
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

30. Which lobe has an inferior tongue-like projection called the lingula?
Interstitial diseases or early pulmonary edema
The amount of air that can be inhaled after normal inspiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Left upper lobe

31. Examples of obstructive disease
Partial pressure of O2 in the arterial blood
500 to 800 mL
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Perfusion

32. pain in lung conditions usually arises from
Increase the intrathoracic space
Inflammation of the adjacent parietal pleura
Carboxyhemoglobin
Oxygen (O2)

33. The muscles of expiration are the...
Nitrogen
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Mediastinum
right and left mainstem bronchi

34. Obstructive disease refers to...
Mediastinum
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
2 - each wavelength is partially absorbed by hemoglobin
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

35. Abnormal lung sounds AKA

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36. dead space ventilation
right
The gas in the conducting airways does not participate in alveolar exchange
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Lowered carbon dioxide level - results from hyperventilation

37. Spirometry is useful in distinguishing
There is an inverse relationship between pressure and volume
Obstructive lung disease from restrictive lung disease
Partial pressure of O2 in the arterial blood
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

38. Bohr Effect of pH is graphed as
Expiratory volume - and there is a prolonged expiratory time
Dullness replaces resonance
Either continuous or discontinuous
Oxygen-Hemoglobin Dissociation Curve

39. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Spirometry
Manubrio-sternal junction (angle of Louis)
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Lung volumes - but find it difficult to exhale rapidly

40. Factors that influence the oxygen carrying capacity of hemoglobin
Increased work of breathing
Air to move from the upper airway to the farthest alveolar reaches
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

41. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Pressure required to drive air through the airways
Manubrio-sternal junction (angle of Louis)
Pleural space

42. normal subjects expel approximately how much of the FVC in the 1st second?
Louder - lower-pitched - and slightly longer in duration
80%
Decreased Hb-O2 affinity
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

43. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Significant pulmonary impairment
T4 or T5 - and just below the manubrio-sternal joint
The atmospheric pressure
Dyspnea that awakens the patient several hours after going to sleep

44. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
Either continuous or discontinuous
Manubrio-sternal junction (angle of Louis)
Pulse oximetry

45. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Expiration
Either inspiration or expiration

46. The trachea divides into right and left mainstem bronchi At what level?
Dyspnea that awakens the patient several hours after going to sleep
Ventilation
quickly - usually reaching a plateau within 6.0 seconds
T4 or T5 - and just below the manubrio-sternal joint

47. The parietal pleura lines the...
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Partial pressure of oxygen (PO2)
reduced in size - compared with a normal curve - due to lower lung volume
Decreased Hb-O2 affinity

48. A normal volume-time curve rises
500 to 800 mL
quickly - usually reaching a plateau within 6.0 seconds
Mediastinum
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

49. Orthopnea is defined as
right
Oxygen (O2)
Soft - high-pitched and crisp
Dyspnea upon assuming a recumbent position

50. Hyperventilation is defined as
right & left
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Wheezes - high-pitched - musical sounds - distinct whistling quality
Diaphragm - External Intercostals