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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. Expiratory stridor indicates
A tracing of the lung volume against time in seconds
Brief - discrete - non-musical sounds with a popping quality
Normal to increased FEV1%
Obstruction below the vocal cords (subglottic or tracheal obstruction)

2. What occurs passively as muscles relax?
Expiration
Postero-anterior (PA) and lateral view series
Dullness replaces resonance
Partial pressure of O2 in the arterial blood

3. Nitroglycerin applied to the probe area has been reported to...
Overcome some of the problems associated with low blood flow to the probe site
Partial pressure of carbon dioxide in the alveoli
Upper respiratory obstruction - usually in the trachea or larynx
Increased rate of breathing and is commonly associated with a decrease in tidal volume

4. Obstructive Disease: Expiratory airflow is reduced more than
Expiratory volume - and there is a prolonged expiratory time
Carboxyhemoglobin
Either inspiration or expiration
Partial pressure of carbon dioxide in the alveoli

5. PaCO2
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Contracts
Manubrio-sternal junction (angle of Louis)
Partial pressure of CO2 in the arterial blood

6. The pattern of breathing refers to...
Insufficient oxygenation of hemoglobin in the lungs
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Lung volumes - but find it difficult to exhale rapidly
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

7. Egophony

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8. Spirometry: The result is stated as
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Interstitial diseases or early pulmonary edema
Inflammation of the adjacent parietal pleura
Carboxyhemoglobin

9. Compliance
Obstructive lung disease from restrictive lung disease
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 maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Normal to increased FEV1%

10. At rest - the use of accessory muscles is a sign of...
Bicarbonate
Significant pulmonary impairment
Right
Pneumonia - obstructive lung disease - and late pulmonary edema

11. Cyanosis
Pulse oximetry
Overcome some of the problems associated with low blood flow to the probe site
Inflammation of the adjacent parietal pleura
Blue or bluish-gray discoloration of the skin or mucous membranes

12. movement of blood through the capillaries in direct communication with the alveoli
Inspiration
Pneumonia - obstructive lung disease - and late pulmonary edema
Perfusion
require supplemental oxygenation and possibly ABG analysis

13. Carbon dioxide moves from the...
Blood to the alveoli
Inspiration
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Either inspiration or expiration

14. office-based spirometry is recommended for patients as young as
5 years - to detect obstruction and determine its reversibility
Fraction (%age) of inspired oxygen
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
Bronchospasm - mucosal edema - or excessive secretions

15. Continuous lung sounds occur in the setting of...
Ventilation
Increased Hb-O2 affinity
Bronchospasm - mucosal edema - or excessive secretions
5 years - to detect obstruction and determine its reversibility

16. Spirometry is useful in distinguishing
Diaphragm - External Intercostals
Increased amounts of unsaturated hemoglobin in capillary blood
Obstructive lung disease from restrictive lung disease
Obstruction below the vocal cords (subglottic or tracheal obstruction)

17. PaO2
Dullness replaces resonance
Partial pressure of O2 in the arterial blood
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
2 - each wavelength is partially absorbed by hemoglobin

18. The interspace between two ribs (intercostal space) is numbered by
Brief - discrete - non-musical sounds with a popping quality
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
The rib above it
Inside of the thoracic cavity wall and the upper surface of the diaphragm

19. most important factor that influences the oxygen carrying capacity of hemoglobin
Lowered carbon dioxide level - results from hyperventilation
Outer surface of each lung
Partial pressure of oxygen (PO2)
Larger airways

20. 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
Pulse oximetry
Postero-anterior (PA) and lateral view series
Portable antero-posterior (AP) view
Inflammation of the adjacent parietal pleura

21. Obstructive disease refers to...
50%
Partial pressure of CO2 in the arterial blood
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

22. Oxygen moves from the...
Lowered carbon dioxide level - results from hyperventilation
10 to 11 cm long and about 2 cm in diameter
There is an inverse relationship between pressure and volume
Alveoli to the blood

23. The primary muscles of respiration are the...
Mouth as well as through the chest wall
respiration
Diaphragm and the intercostal muscles
Altering the respiratory rate and/or the tidal volume

24. Which lung has an oblique fissure?
Oxygen-Hemoglobin Dissociation Curve
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Soft - high-pitched and crisp
right & left

25. high CO2 = high acidity =
release of O2 from Hb
A tracing of the lung volume against time in seconds
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

26. What is the potential space between the visceral and parietal pleurae?
Pleural space
Wheezes - high-pitched - musical sounds - distinct whistling quality
Hypoventilation or modest changes in the PaO2
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

27. Factors that influence the oxygen carrying capacity of hemoglobin
The rib above it
The total amount of air that can be exhaled following a maximal inhalation
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

28. Tachypnea is an
Diffusion
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Diaphragm and the intercostal muscles
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

29. Cyanosis is caused by
A reliable and consistent classification of auditory findings
Increased amounts of unsaturated hemoglobin in capillary blood
Decreased Hb-O2 affinity
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

30. Continuous lung sounds occur during...
Decreased Hb-O2 affinity
A good effort
right and left mainstem bronchi
Either inspiration or expiration

31. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Wheezes - high-pitched - musical sounds - distinct whistling quality
Saturated with oxygen or unsaturated
Ventilation - Diffusion - Perfusion
Lung volumes - but no difficulty or delay in exhaling what volume they do have

32. The presence of pressure gradients causes respiratory gases to move from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Interstitial diseases or early pulmonary edema
Larger airways
right & left

33. Vesicular breath sounds
Overcome some of the problems associated with low blood flow to the probe site
Carboxyhemoglobin
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
Speed of airflow - the higher the flow - the greater the resistance

34. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
70% occlusion of the airway
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Inspiration

35. gas exchange across the alveolar-pulmonary capillary membranes
Diffusion
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
require supplemental oxygenation and possibly ABG analysis
reduced in size - compared with a normal curve - due to lower lung volume

36. The upper airway accounts For what % of airway resistance?
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
50%
Obstructive lung disease from restrictive lung disease
Cough

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

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38. vital capacity (VC)
The amount of air that can be inhaled after normal inspiration
right
The total amount of air that can be exhaled following a maximal inhalation
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

39. terminal respiratory unit
Increased Hb-O2 affinity
Increase the intrathoracic space
Acinus
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

40. total lung capacity (TLC)
right
Alveoli to the blood
The total amount of air in the lungs at the end of a maximal inhalation
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

41. Bronchiovesicular breath sounds
Alveoli to the blood
80 to 120% of predicted value
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

42. Pectoriloquy
Increased amounts of unsaturated hemoglobin in capillary blood
The examiner can clearly distinguish the word that the pt speak or whispers
PaCO2
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

43. The active movement of gases between the ambient air and the lungs
Increased amounts of unsaturated hemoglobin in capillary blood
The amount of air that can be exhaled after expiration
Ventilation
Saturated with oxygen or unsaturated

44. Spirometry normal range
Tongue
Oxygen (O2)
80 to 120% of predicted value
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

45. FEV1% in obstructive disease
Partial pressure of O2 in the arterial blood
There is an inverse relationship between pressure and volume
A reliable and consistent classification of auditory findings
results in a lower than normal FEV1%

46. Orthopnea is quantified by
500 to 800 mL
Pressure required to drive air through the airways
The negative logarithm of hydrogen ions in the blood
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

47. normal subjects expel approximately how much of the FVC in the 1st second?
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
A tracing of the lung volume against time in seconds
Oxygen (O2)
80%

48. Spirometry can be used to determine the severity of functional impairment as well as
A tracing of the lung volume against time in seconds
To assess response to treatment
Perfusion
Expiration

49. low CO2 = low acidity =
Partial pressure of oxygen (PO2)
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Partial pressure of CO2 in the arterial blood
Binding of O2 to Hb

50. FIO2
Partial pressure of oxygen in the alveoli
Expiratory volume - and there is a prolonged expiratory time
Dyspnea upon assuming a recumbent position
Fraction (%age) of inspired oxygen

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Pulmonology

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