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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
No
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Functional residual capacity (FRC)

2. Pulse Oximetry is dependent on...
Pulse oximetry
Hypoventilation or modest changes in the PaO2
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Difficulty breathing or shortness of breath

3. Chest Radiography: The most common chest X-ray series is the...
Postero-anterior (PA) and lateral view series
require supplemental oxygenation and possibly ABG analysis
Inspiration
50%

4. The accessory muscles are the...
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
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
Sternocleidomastoid - Scalene Muscles
Manubrio-sternal junction (angle of Louis)

5. At rest - the use of accessory muscles is a sign of...
500 to 800 mL
Difficulty breathing or shortness of breath
Significant pulmonary impairment
Expiratory volume - and there is a prolonged expiratory time

6. expiratory reserve
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Increased amounts of unsaturated hemoglobin in capillary blood
Decreased Hb-O2 affinity
The amount of air that can be exhaled after expiration

7. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Inspiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Decreased Hb-O2 affinity

8. 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
Increased Hb-O2 affinity
Either inspiration or expiration
50%

9. Discontinuous lung sounds are also called

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10. Normal lung sounds
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Larger airways
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

11. Pectoriloquy
Insufficient oxygenation of hemoglobin in the lungs
Functional residual capacity (FRC)
The examiner can clearly distinguish the word that the pt speak or whispers
Right

12. FEV1% in restrictive disease
PaCO2
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Normal to increased FEV1%
A tracing of the lung volume against time in seconds

13. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Difficulty breathing or shortness of breath
respiration
Alveoli to the blood
Dyspnea upon assuming a recumbent position

14. Airway resistance refers to...
Spirometry
Pleural space
Pressure required to drive air through the airways
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

15. Bronchiovesicular breath sounds
require supplemental oxygenation and possibly ABG analysis
Expiration
Ventilation
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

16. Carbon dioxide moves from the...
Blood to the alveoli
results in a lower than normal FEV1%
The gas in the conducting airways does not participate in alveolar exchange
Expiration

17. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Brief - discrete - non-musical sounds with a popping quality
Partial pressure of carbon dioxide in the alveoli
Excessive secretions and abnormal airway collapsibility
A good effort

18. Central cyanosis results from
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Insufficient oxygenation of hemoglobin in the lungs
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
A sensor placed over a translucent area of arterial pulsation

19. Spirometry plots
Altering the respiratory rate and/or the tidal volume
A tracing of the lung volume against time in seconds
70%
Expiration

20. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Pressure required to drive air through the airways
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The examiner can clearly distinguish the word that the pt speak or whispers
Decreased pressure

21. The trachea divides into
right
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
right and left mainstem bronchi
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

22. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
A sensor placed over a translucent area of arterial pulsation
Portable antero-posterior (AP) view
Diaphragm - External Intercostals
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

23. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
The rib above it
Perfusion
Inflammation of the adjacent parietal pleura
'adventitious' breath sounds

24. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dullness replaces resonance
'crackles' or 'rales'
The total amount of air in the lungs at the end of a maximal inhalation
80%

25. low CO2 = low acidity =
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Binding of O2 to Hb
The total amount of air in the lungs at the end of a maximal inhalation

26. FIO2
Sternocleidomastoid - Scalene Muscles
Fraction (%age) of inspired oxygen
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Bicarbonate

27. PACO2
Partial pressure of carbon dioxide in the alveoli
Dyspnea upon assuming a recumbent position
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Narrowed nearly to the point of closure

28. Which bronchus is wider - shorter - and more vertically placed?
Pneumonia - obstructive lung disease - and late pulmonary edema
results in a lower than normal FEV1%
release of O2 from Hb
Right

29. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
A sensor placed over a translucent area of arterial pulsation
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
A reduction in lung capacity - secondary to scarring or extraneous material
Right

30. Pulmonary ventilation is varied by
Cough
Partial pressure of oxygen (PO2)
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
Altering the respiratory rate and/or the tidal volume

31. Normal range of PaCO2
80%
35 to 45 mmHg
Increased minute volume ventilation - which results in a lowered carbon dioxide level
'crackles' or 'rales'

32. Rhonchi occur during
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Either inspiration or expiration
The amount of air that can be inhaled after normal inspiration

33. Orthopnea is defined as
Dyspnea upon assuming a recumbent position
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Normal to increased FEV1%
Blood to the alveoli

34. office-based spirometry is recommended for patients as young as
5 years - to detect obstruction and determine its reversibility
Fraction (%age) of inspired oxygen
right and left mainstem bronchi
Increase the intrathoracic space

35. The parietal pleura lines the...
500 to 800 mL
10 to 11 cm long and about 2 cm in diameter
Inside of the thoracic cavity wall and the upper surface of the diaphragm
The gas in the conducting airways does not participate in alveolar exchange

36. The visceral pleura lines the...
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Outer surface of each lung
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
70% occlusion of the airway

37. 20.95% Atmospheric Composition
The amount of air that can be exhaled after expiration
Binding of O2 to Hb
Functional residual capacity (FRC)
Oxygen (O2)

38. Compliance
Significant pulmonary impairment
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
Binding of O2 to Hb
The gas in the conducting airways does not participate in alveolar exchange

39. The main bronchi are divided into smaller branches that begin to subdivide into
Alveoli to the blood
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
There is an inverse relationship between pressure and volume
Increased work of breathing

40. Rhonchi are due to...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
2 - each wavelength is partially absorbed by hemoglobin
Excessive secretions and abnormal airway collapsibility
Pneumonia - obstructive lung disease - and late pulmonary edema

41. The acini consist of the...
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Functional residual capacity (FRC)
Portable antero-posterior (AP) view
Mouth as well as through the chest wall

42. hypocapnia
Lowered carbon dioxide level - results from hyperventilation
Portable antero-posterior (AP) view
Diaphragm - External Intercostals
Diffusion

43. Continuous lung sounds occur during...
The right middle lobe
right & left
Either continuous or discontinuous
Either inspiration or expiration

44. Cyanosis appears when
Ventilation - Diffusion - Perfusion
Dullness replaces resonance
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Increase the intrathoracic space

45. total lung capacity (TLC)
Either inspiration or expiration
The total amount of air in the lungs at the end of a maximal inhalation
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

46. Spirometry is useful in distinguishing
Sternocleidomastoid - Scalene Muscles
A tracing of the lung volume against time in seconds
Obstructive lung disease from restrictive lung disease
Upper respiratory obstruction - usually in the trachea or larynx

47. FEV1% in obstructive disease
Fraction (%age) of inspired oxygen
Wheezes - high-pitched - musical sounds - distinct whistling quality
results in a lower than normal FEV1%
Inflammation of the adjacent parietal pleura

48. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Air bubbles flowing through secretions or slightly closed airways during respiration
Saturated with oxygen or unsaturated
Inspiration
2 - each wavelength is partially absorbed by hemoglobin

49. Bohr Effect of pH: left shift
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Fraction (%age) of inspired oxygen
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Increased Hb-O2 affinity

50. The presence of pressure gradients causes respiratory gases to move from
Partial pressure of O2 in the arterial blood
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Blue or bluish-gray discoloration of the skin or mucous membranes
To assess response to treatment