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Pulmonology

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Answer 50 questions in 15 minutes.
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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. Boyle's Gas Law
Increased amounts of unsaturated hemoglobin in capillary blood
There is an inverse relationship between pressure and volume
'scooped out' or bowl-shaped
quickly - usually reaching a plateau within 6.0 seconds

2. The active movement of gases between the ambient air and the lungs
Ventilation
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

3. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
The atmospheric pressure
Carboxyhemoglobin
'adventitious' breath sounds

4. Tachypnea is an
Nitrogen
Postero-anterior (PA) and lateral view series
Wheezes - high-pitched - musical sounds - distinct whistling quality
Increased rate of breathing and is commonly associated with a decrease in tidal volume

5. Abnormal lung sounds AKA

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6. The visceral pleura lines the...
Outer surface of each lung
Saturated with oxygen or unsaturated
'adventitious' breath sounds
A tracing of the lung volume against time in seconds

7. Normal lung sounds
The gas in the conducting airways does not participate in alveolar exchange
release of O2 from Hb
Oxygen (O2)
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

8. Coarse crackles are heard in
Pneumonia - obstructive lung disease - and late pulmonary edema
Total lung capacity (TLC)
No
Difficulty breathing or shortness of breath

9. Which lung has a horizontal fissure?
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Partial pressure of oxygen (PO2)
right
Blue or bluish-gray discoloration of the skin or mucous membranes

10. increased volume results in
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Significant pulmonary impairment
Decreased pressure
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

11. gas exchange across the alveolar-pulmonary capillary membranes
Outer surface of each lung
Diffusion
Increased amounts of unsaturated hemoglobin in capillary blood
Lung volumes - but no difficulty or delay in exhaling what volume they do have

12. The interspace between two ribs (intercostal space) is numbered by
The rib above it
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Inspiration
right and left mainstem bronchi

13. Orthopnea is defined as
Expiration
Blood to the alveoli
Dyspnea upon assuming a recumbent position
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

14. Bronchial breath sounds
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Total lung capacity (TLC)
Insufficient oxygenation of hemoglobin in the lungs
release of O2 from Hb - as heat is a by-product of metabolism.

15. Restrictive disease refers to...
A reduction in lung capacity - secondary to scarring or extraneous material
T4 or T5 - and just below the manubrio-sternal joint
Acinus
Perfusion

16. The internal intercostals decrease the transverse diameter of the chest during
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
Expiration
Pneumonia - obstructive lung disease - and late pulmonary edema
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

17. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
right
A reduction in lung capacity - secondary to scarring or extraneous material
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Immediate oxygenation with or without intubation

18. Obstructive disease refers to...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
80 to 120% of predicted value
Nitrogen
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

19. The presence of pressure gradients causes respiratory gases to move from
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
Lowered carbon dioxide level - results from hyperventilation
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Mouth as well as through the chest wall

20. vital capacity (VC)
The total amount of air that can be exhaled following a maximal inhalation
70% occlusion of the airway
Sternocleidomastoid - Scalene Muscles
Hypoventilation or modest changes in the PaO2

21. Continuous lung sounds often audible at the...
Larger airways
Either continuous or discontinuous
Soft - high-pitched and crisp
Mouth as well as through the chest wall

22. Patients with restrictive disease have low
Bronchospasm - mucosal edema - or excessive secretions
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Pressure required to drive air through the airways

23. Patients with obstructive disease have normal
Left upper lobe
Partial pressure of oxygen (PO2)
Lung volumes - but find it difficult to exhale rapidly
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

24. At rest - the use of accessory muscles is a sign of...
Significant pulmonary impairment
Speed of airflow - the higher the flow - the greater the resistance
70%
Left upper lobe

25. Bohr Effect of pH is graphed as
Wheezes - high-pitched - musical sounds - distinct whistling quality
To assess response to treatment
Acinus
Oxygen-Hemoglobin Dissociation Curve

26. The trachea is how long/wide?
Narrowed nearly to the point of closure
80%
Air bubbles flowing through secretions or slightly closed airways during respiration
10 to 11 cm long and about 2 cm in diameter

27. total lung capacity (TLC)
Inspiration
Speed of airflow - the higher the flow - the greater the resistance
The total amount of air in the lungs at the end of a maximal inhalation
5 years - to detect obstruction and determine its reversibility

28. The vital capacity and the residual volume together constitute the...
Decreased pressure
'adventitious' breath sounds
Total lung capacity (TLC)
70%

29. An efficient approach to examination of the patient begins with
Interstitial diseases or early pulmonary edema
Observing the pattern of breathing
Obstruction below the vocal cords (subglottic or tracheal obstruction)
5 years - to detect obstruction and determine its reversibility

30. Rhonchi originate in the...
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
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
Larger airways

31. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Perfusion
Air to move from the upper airway to the farthest alveolar reaches
The examiner can clearly distinguish the word that the pt speak or whispers
Manubrio-sternal junction (angle of Louis)

32. Pulse Oximetry is dependent on...
Carboxyhemoglobin
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
The amount of air that can be exhaled after expiration
10 to 11 cm long and about 2 cm in diameter

33. hypocapnia
Difficulty breathing or shortness of breath
Either inspiration or expiration
Lung volumes - but find it difficult to exhale rapidly
Lowered carbon dioxide level - results from hyperventilation

34. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Spirometry
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
Expiration
Dyspnea that awakens the patient several hours after going to sleep

35. Factors that influence the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Outer surface of each lung
right
Diaphragm and the intercostal muscles

36. Continuous lung sounds
Dullness replaces resonance
Wheezes - high-pitched - musical sounds - distinct whistling quality
Binding of O2 to Hb
Interstitial diseases or early pulmonary edema

37. Spirometry plots
Portable antero-posterior (AP) view
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
A tracing of the lung volume against time in seconds
Air-filled - fluid-filled - or solid

38. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Narrowed nearly to the point of closure
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Mediastinum

39. expiratory reserve
The amount of air that can be exhaled after expiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Air bubbles flowing through secretions or slightly closed airways during respiration
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

40. FEV1/FVC
Inspiration
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Normal to increased FEV1%

41. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Increased work of breathing
35 to 45 mmHg
The amount of air that can be exhaled after expiration
Dullness replaces resonance

42. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Ventilation - Diffusion - Perfusion
Upper respiratory obstruction - usually in the trachea or larynx
Saturated with oxygen or unsaturated

43. Spirometry can be used to determine the severity of functional impairment as well as
The amount of air that can be inhaled after normal inspiration
Decreased pressure
T4 or T5 - and just below the manubrio-sternal joint
To assess response to treatment

44. Rhonchi are due to...
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Expiratory volume - and there is a prolonged expiratory time
Cough
Excessive secretions and abnormal airway collapsibility

45. low CO2 = low acidity =
Binding of O2 to Hb
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
require supplemental oxygenation and possibly ABG analysis
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

46. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Postero-anterior (PA) and lateral view series
Tongue
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

47. Spirometry: The result is stated as
Partial pressure of CO2 in the arterial blood
Dyspnea upon assuming a recumbent position
Insufficient oxygenation of hemoglobin in the lungs
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

48. Expiratory stridor indicates
Normal to increased FEV1%
Immediate oxygenation with or without intubation
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Blue or bluish-gray discoloration of the skin or mucous membranes

49. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
The negative logarithm of hydrogen ions in the blood
70% occlusion of the airway
The total amount of air in the lungs at the end of a maximal inhalation

50. forced vital capacity (FVC)
Manubrio-sternal junction (angle of Louis)
500 to 800 mL
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

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Pulmonology

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