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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. The muscles of expiration are the...
Mediastinum
Total lung capacity (TLC)
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Right

2. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dyspnea upon assuming a recumbent position
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Dullness replaces resonance
The examiner can clearly distinguish the word that the pt speak or whispers

3. The external intercostal muscles increase the antero-posterior chest diameter during
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Upper respiratory obstruction - usually in the trachea or larynx
Diffusion
Inspiration

4. Fine crackles are heard in
Nitrogen
Brief - discrete - non-musical sounds with a popping quality
Interstitial diseases or early pulmonary edema
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

5. Which lung has a horizontal fissure?
right
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Obstructive lung disease from restrictive lung disease
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

6. Spirometry normal range
80 to 120% of predicted value
Alveoli to the blood
35 to 45 mmHg
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

7. Egophony

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8. The trachea is how long/wide?
Difficulty breathing or shortness of breath
10 to 11 cm long and about 2 cm in diameter
Upper respiratory obstruction - usually in the trachea or larynx
A sensor placed over a translucent area of arterial pulsation

9. The vital capacity and the residual volume together constitute the...
Insufficient oxygenation of hemoglobin in the lungs
A tracing of the lung volume against time in seconds
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Total lung capacity (TLC)

10. Oxygen moves from the...
Alveoli to the blood
Immediate oxygenation with or without intubation
Binding of O2 to Hb
80%

11. tidal volume (Vt)
Larger airways
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Partial pressure of oxygen (PO2)

12. Does lung tissue have pain fibers?
Normal to increased FEV1%
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
No
quickly - usually reaching a plateau within 6.0 seconds

13. The muscles of inspiration are the...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Diaphragm - External Intercostals
Dullness replaces resonance
Obstruction below the vocal cords (subglottic or tracheal obstruction)

14. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Mediastinum
Right
Perfusion
Expiration

15. The trachea divides into right and left mainstem bronchi At what level?
T4 or T5 - and just below the manubrio-sternal joint
Bronchospasm - mucosal edema - or excessive secretions
Decreased Hb-O2 affinity
Right

16. normal adult tidal volume
Significant pulmonary impairment
Dyspnea upon assuming a recumbent position
Left upper lobe
500 to 800 mL

17. pain in lung conditions usually arises from
To assess response to treatment
results in a lower than normal FEV1%
Pneumonia - obstructive lung disease - and late pulmonary edema
Inflammation of the adjacent parietal pleura

18. Patients with obstructive disease have normal
Lung volumes - but find it difficult to exhale rapidly
quickly - usually reaching a plateau within 6.0 seconds
Perfusion
Pleural space

19. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
A sensor placed over a translucent area of arterial pulsation
500 to 800 mL
Observing the pattern of breathing
Oxygen-Hemoglobin Dissociation Curve

20. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Interstitial diseases or early pulmonary edema
Spirometry
Pulse oximetry

21. The normal FEV1 /FVC ratio is...
Spirometry
Lowered carbon dioxide level - results from hyperventilation
Binding of O2 to Hb
70%

22. most important factor that influences the oxygen carrying capacity of hemoglobin
results in a lower than normal FEV1%
Pleural space
Partial pressure of oxygen (PO2)
Obstruction below the vocal cords (subglottic or tracheal obstruction)

23. The primary muscles of respiration are the...
The right middle lobe
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Diaphragm and the intercostal muscles

24. pH
The negative logarithm of hydrogen ions in the blood
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Partial pressure of oxygen in the alveoli

25. Examples of obstructive disease
'scooped out' or bowl-shaped
50%
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Bronchospasm - mucosal edema - or excessive secretions

26. FIO2
Portable antero-posterior (AP) view
Either inspiration or expiration
Fraction (%age) of inspired oxygen
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

27. Bronchial breath sounds
80 to 120% of predicted value
70% occlusion of the airway
Inspiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

28. The spirometry printout usually includes

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29. office-based spirometry is recommended for patients as young as
Ventilation - Diffusion - Perfusion
80 to 120% of predicted value
5 years - to detect obstruction and determine its reversibility
right

30. The upper airway accounts For what % of airway resistance?
Total lung capacity (TLC)
The total amount of air that can be exhaled following a maximal inhalation
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
50%

31. Vesicular breath sounds
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The amount of air that can be exhaled after expiration
A reduction in lung capacity - secondary to scarring or extraneous material
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

32. The interspace between two ribs (intercostal space) is numbered by
There is an inverse relationship between pressure and volume
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
PaCO2
The rib above it

33. hypocapnia
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Air to move from the upper airway to the farthest alveolar reaches
'adventitious' breath sounds
Lowered carbon dioxide level - results from hyperventilation

34. Restrictive disease refers to...
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
The total amount of air in the lungs at the end of a maximal inhalation
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
A reduction in lung capacity - secondary to scarring or extraneous material

35. The visceral pleura lines the...
Narrowed nearly to the point of closure
Outer surface of each lung
Dyspnea that awakens the patient several hours after going to sleep
Blue or bluish-gray discoloration of the skin or mucous membranes

36. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Either inspiration or expiration
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Increase the intrathoracic space
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

37. 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
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Spirometry
Acinus

38. 20.95% Atmospheric Composition
Oxygen (O2)
Wheezes - high-pitched - musical sounds - distinct whistling quality
Right
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

39. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
release of O2 from Hb
release of O2 from Hb - as heat is a by-product of metabolism.
Increase the intrathoracic space

40. Inspiratory stridor indicates
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)
70%
The amount of air that can be inhaled after normal inspiration

41. Abnormal lung sounds are classified as
Either continuous or discontinuous
Partial pressure of oxygen in the alveoli
Expiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

42. Continuous lung sounds occur during...
Either inspiration or expiration
Obstruction below the vocal cords (subglottic or tracheal obstruction)
A reduction in lung capacity - secondary to scarring or extraneous material
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

43. The trachea divides into
The examiner can clearly distinguish the word that the pt speak or whispers
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
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
right and left mainstem bronchi

44. An efficient approach to examination of the patient begins with
Partial pressure of oxygen (PO2)
Observing the pattern of breathing
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

45. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Pleural space
Cough
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
A good effort

46. Boyle's Gas Law
Dyspnea upon assuming a recumbent position
Tongue
Binding of O2 to Hb
There is an inverse relationship between pressure and volume

47. What occurs passively as muscles relax?
Functional residual capacity (FRC)
Spirometry
Expiration
Overcome some of the problems associated with low blood flow to the probe site

48. Rhonchi
Perfusion
Decreased Hb-O2 affinity
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

49. Expiratory stridor indicates
No
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Perfusion

50. The best indicator of adequate ventilation is the...
PaCO2
70%
Acinus
Normal to increased FEV1%