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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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1. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Either continuous or discontinuous
'scooped out' or bowl-shaped
Increase the intrathoracic space
Perfusion

2. During inspiration the diaphragm
Contracts
Dullness replaces resonance
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
right & left

3. PACO2
Partial pressure of carbon dioxide in the alveoli
Insufficient oxygenation of hemoglobin in the lungs
Dyspnea upon assuming a recumbent position
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

4. 78.08% Atmospheric Composition
No
Nitrogen
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
Increased rate of breathing and is commonly associated with a decrease in tidal volume

5. At rest - the use of accessory muscles is a sign of...
Alveoli to the blood
Significant pulmonary impairment
70% occlusion of the airway
80 to 120% of predicted value

6. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Increase the intrathoracic space
Speed of airflow - the higher the flow - the greater the resistance
Obstructive lung disease from restrictive lung disease

7. Peripheral cyanosis results from
Alveoli to the blood
results in a lower than normal FEV1%
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Acinus

8. An efficient approach to examination of the patient begins with
Observing the pattern of breathing
Either inspiration or expiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

9. Rhonchi
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Oxygen-Hemoglobin Dissociation Curve
Perfusion
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

10. normal subjects expel approximately how much of the FVC in the 1st second?
Expiratory volume - and there is a prolonged expiratory time
Postero-anterior (PA) and lateral view series
80%
Pneumonia - obstructive lung disease - and late pulmonary edema

11. Late inspiratory crackles result from
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Increased minute volume ventilation - which results in a lowered carbon dioxide level
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

12. Which lung has a horizontal fissure?
results in a lower than normal FEV1%
right
respiration
Binding of O2 to Hb

13. PaCO2
Partial pressure of CO2 in the arterial blood
500 to 800 mL
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
The total amount of air in the lungs at the end of a maximal inhalation

14. Hyperventilation is defined as
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Nitrogen
Left upper lobe

15. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
35 to 45 mmHg
Nitrogen

16. inspiratory reserve
Dyspnea that awakens the patient several hours after going to sleep
Insufficient oxygenation of hemoglobin in the lungs
The amount of air that can be inhaled after normal inspiration
Obstruction below the vocal cords (subglottic or tracheal obstruction)

17. Restrictive Disease: Expiratory volume is reduced more than
The amount of air that can be inhaled after normal inspiration
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Pulse oximetry
80%

18. Expiratory stridor indicates
T4 or T5 - and just below the manubrio-sternal joint
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Postero-anterior (PA) and lateral view series
A tracing of the lung volume against time in seconds

19. FIO2
80 to 120% of predicted value
Significant pulmonary impairment
Fraction (%age) of inspired oxygen
right & left

20. The trachea divides into
right and left mainstem bronchi
Either continuous or discontinuous
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

21. Paroxysmal nocturnal dyspnea (PND) is...
Lung volumes - but find it difficult to exhale rapidly
Overcome some of the problems associated with low blood flow to the probe site
Dyspnea that awakens the patient several hours after going to sleep
Partial pressure of CO2 in the arterial blood

22. dead space ventilation
Expiratory volume - and there is a prolonged expiratory time
The gas in the conducting airways does not participate in alveolar exchange
Increased minute volume ventilation - which results in a lowered carbon dioxide level
quickly - usually reaching a plateau within 6.0 seconds

23. Pulse Oximetry does not detect
Air to move from the upper airway to the farthest alveolar reaches
Pleural space
Hypoventilation or modest changes in the PaO2
10 to 11 cm long and about 2 cm in diameter

24. Pulse Oximetry is dependent on...
'adventitious' breath sounds
Immediate oxygenation with or without intubation
T4 or T5 - and just below the manubrio-sternal joint
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

25. Oximetry readings of < 94%
Hypoventilation or modest changes in the PaO2
Either inspiration or expiration
Dyspnea that awakens the patient several hours after going to sleep
require supplemental oxygenation and possibly ABG analysis

26. Pulmonary ventilation is varied by
Altering the respiratory rate and/or the tidal volume
Inspiration
Bronchospasm - mucosal edema - or excessive secretions
Normal to increased FEV1%

27. Normal range of PaCO2
35 to 45 mmHg
Binding of O2 to Hb
Mouth as well as through the chest wall
Increased minute volume ventilation - which results in a lowered carbon dioxide level

28. Does lung tissue have pain fibers?
Dyspnea upon assuming a recumbent position
Difficulty breathing or shortness of breath
No
Either inspiration or expiration

29. forced vital capacity (FVC)
Dyspnea that awakens the patient several hours after going to sleep
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Fraction (%age) of inspired oxygen
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

30. Airway resistance refers to...
Immediate oxygenation with or without intubation
Pressure required to drive air through the airways
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Interstitial diseases or early pulmonary edema

31. The normal FEV1 /FVC ratio is...
70%
The examiner can clearly distinguish the word that the pt speak or whispers
Spirometry
Speed of airflow - the higher the flow - the greater the resistance

32. The muscles of inspiration are the...
Blood to the alveoli
70% occlusion of the airway
Fraction (%age) of inspired oxygen
Diaphragm - External Intercostals

33. pH
80%
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
The negative logarithm of hydrogen ions in the blood
The examiner can clearly distinguish the word that the pt speak or whispers

34. The spirometry printout usually includes

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35. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
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
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Portable antero-posterior (AP) view

36. The accessory muscles are the...
Bicarbonate
Sternocleidomastoid - Scalene Muscles
80%
'adventitious' breath sounds

37. office-based spirometry is recommended for patients as young as
Expiratory volume - and there is a prolonged expiratory time
Excessive secretions and abnormal airway collapsibility
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
5 years - to detect obstruction and determine its reversibility

38. Central cyanosis results from
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
70% occlusion of the airway
Expiratory volume - and there is a prolonged expiratory time
Insufficient oxygenation of hemoglobin in the lungs

39. low CO2 = low acidity =
There is an inverse relationship between pressure and volume
Expiration
Binding of O2 to Hb
Bicarbonate

40. Auscultation of the chest depends on...
Oxygen-Hemoglobin Dissociation Curve
Portable antero-posterior (AP) view
Inflammation of the adjacent parietal pleura
A reliable and consistent classification of auditory findings

41. The tracheo-bronchial tree is a tubular system that provides a pathway for
A tracing of the lung volume against time in seconds
PaCO2
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Air to move from the upper airway to the farthest alveolar reaches

42. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The rib above it
Interstitial diseases or early pulmonary edema
Right
The atmospheric pressure

43. Rhonchi originate in the...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Larger airways
Soft - high-pitched and crisp
Right

44. normal adult tidal volume
Brief - discrete - non-musical sounds with a popping quality
The total amount of air in the lungs at the end of a maximal inhalation
500 to 800 mL
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

45. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Wheezes - high-pitched - musical sounds - distinct whistling quality
Diffusion
Larger airways

46. increased volume results in
Decreased pressure
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Tongue
Difficulty breathing or shortness of breath

47. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Oxygen (O2)
Partial pressure of carbon dioxide in the alveoli
To assess response to treatment
Narrowed nearly to the point of closure

48. The upper airway accounts For what % of airway resistance?
Insufficient oxygenation of hemoglobin in the lungs
Significant pulmonary impairment
50%
T4 or T5 - and just below the manubrio-sternal joint

49. With restrictive disease - the flow-volume curve is...
Expiratory volume - and there is a prolonged expiratory time
reduced in size - compared with a normal curve - due to lower lung volume
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Blood to the alveoli

50. FEV1% in restrictive disease
Wheezes - high-pitched - musical sounds - distinct whistling quality
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
release of O2 from Hb
Normal to increased FEV1%

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Pulmonology

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