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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

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. office-based spirometry is recommended for patients as young as
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
PaCO2
5 years - to detect obstruction and determine its reversibility
Cough

2. Carbon dioxide moves from the...
Blood to the alveoli
A reduction in lung capacity - secondary to scarring or extraneous material
Manubrio-sternal junction (angle of Louis)
Increased minute volume ventilation - which results in a lowered carbon dioxide level

3. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
The rib above it
Increased amounts of unsaturated hemoglobin in capillary blood
80%
Mediastinum

4. high CO2 = high acidity =
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
reduced in size - compared with a normal curve - due to lower lung volume
release of O2 from Hb
Pressure required to drive air through the airways

5. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Either inspiration or expiration
Narrowed nearly to the point of closure
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
Ventilation - Diffusion - Perfusion

6. Peripheral cyanosis results from
Tongue
Pressure required to drive air through the airways
Left upper lobe
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

7. most important factor that influences the oxygen carrying capacity of hemoglobin
require supplemental oxygenation and possibly ABG analysis
Narrowed nearly to the point of closure
Partial pressure of oxygen (PO2)
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

8. Chest Radiography: The most common chest X-ray series is the...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
70%
Immediate oxygenation with or without intubation
Postero-anterior (PA) and lateral view series

9. The purpose of respiration is to...
Increase the intrathoracic space
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Observing the pattern of breathing

10. Stridor is a high-pitched - noisy respiration - Which is indicative of...
The amount of air that can be inhaled after normal inspiration
Upper respiratory obstruction - usually in the trachea or larynx
Oxygen-Hemoglobin Dissociation Curve
Alveoli to the blood

11. The internal intercostals decrease the transverse diameter of the chest during
Either inspiration or expiration
The gas in the conducting airways does not participate in alveolar exchange
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Expiration

12. The accessory muscles are the...
Immediate oxygenation with or without intubation
Larger airways
Sternocleidomastoid - Scalene Muscles
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

13. During inspiration the diaphragm
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
Larger airways
Contracts
Saturated with oxygen or unsaturated

14. Which lobe has an inferior tongue-like projection called the lingula?
Cough
T4 or T5 - and just below the manubrio-sternal joint
Expiration
Left upper lobe

15. vital capacity (VC)
Perfusion
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
The total amount of air that can be exhaled following a maximal inhalation
Excessive secretions and abnormal airway collapsibility

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

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17. Resistance is dependent upon
Speed of airflow - the higher the flow - the greater the resistance
Oxygen-Hemoglobin Dissociation Curve
Mouth as well as through the chest wall
Either inspiration or expiration

18. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiration
Spirometry
The total amount of air in the lungs at the end of a maximal inhalation
The examiner can clearly distinguish the word that the pt speak or whispers

19. Does lung tissue have pain fibers?
Bronchospasm - mucosal edema - or excessive secretions
No
Inspiration
Sternocleidomastoid - Scalene Muscles

20. Percussion helps you establish whether the underlying tissues are...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Inflammation of the adjacent parietal pleura
5 years - to detect obstruction and determine its reversibility
Air-filled - fluid-filled - or solid

21. Bohr Effect of pH: left shift
Right
Diffusion
Increased Hb-O2 affinity
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

22. The main bronchi are divided into smaller branches that begin to subdivide into
A reliable and consistent classification of auditory findings
Postero-anterior (PA) and lateral view series
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
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

23. The primary muscles of respiration are the...
Blood to the alveoli
Blue or bluish-gray discoloration of the skin or mucous membranes
Diaphragm and the intercostal muscles
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

24. Nitroglycerin applied to the probe area has been reported to...
Diffusion
Overcome some of the problems associated with low blood flow to the probe site
Soft - high-pitched and crisp
Diaphragm - External Intercostals

25. PaCO2
Inspiration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Dullness replaces resonance
Partial pressure of CO2 in the arterial blood

26. Restrictive Disease: Expiratory volume is reduced more than
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Difficulty breathing or shortness of breath
Altering the respiratory rate and/or the tidal volume

27. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Expiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Diffusion
The amount of air that can be inhaled after normal inspiration

28. The muscles of inspiration are the...
50%
Diaphragm - External Intercostals
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

29. Pulmonary ventilation is varied by
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
Increased Hb-O2 affinity
Altering the respiratory rate and/or the tidal volume
'crackles' or 'rales'

30. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
The atmospheric pressure
Acinus
Increase the intrathoracic space
Fraction (%age) of inspired oxygen

31. Which bronchus is wider - shorter - and more vertically placed?
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Soft - high-pitched and crisp
Right

32. Apnea is defined as
The atmospheric pressure
No respiration for > 20 seconds
Obstructive lung disease from restrictive lung disease
Bicarbonate

33. Orthopnea is quantified by
Blood to the alveoli
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Hypoventilation or modest changes in the PaO2
Carboxyhemoglobin

34. Rhonchi originate in the...
Diffusion
Contracts
T4 or T5 - and just below the manubrio-sternal joint
Larger airways

35. Bronchiovesicular breath sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Air-filled - fluid-filled - or solid
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

36. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
80%
Air-filled - fluid-filled - or solid
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
80 to 120% of predicted value

37. Rhonchi occur during
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Either inspiration or expiration
Oxygen (O2)
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

38. Compliance
Binding of O2 to Hb
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Insufficient oxygenation of hemoglobin in the lungs
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

39. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
'scooped out' or bowl-shaped

40. Spirometry plots
Air to move from the upper airway to the farthest alveolar reaches
A tracing of the lung volume against time in seconds
80%
Significant pulmonary impairment

41. Expiratory stridor indicates
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Sternocleidomastoid - Scalene Muscles
Obstruction below the vocal cords (subglottic or tracheal obstruction)

42. The interspace between two ribs (intercostal space) is numbered by
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Air bubbles flowing through secretions or slightly closed airways during respiration
The rib above it
5 years - to detect obstruction and determine its reversibility

43. Auscultation of the chest depends on...
A reliable and consistent classification of auditory findings
Dullness replaces resonance
The examiner can clearly distinguish the word that the pt speak or whispers
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

44. Obstructive disease refers to...
Partial pressure of oxygen in the alveoli
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Decreased Hb-O2 affinity
Fraction (%age) of inspired oxygen

45. 20.95% Atmospheric Composition
right and left mainstem bronchi
Oxygen (O2)
Diaphragm and the intercostal muscles
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

46. Which lung has a horizontal fissure?
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Either inspiration or expiration
right
Either inspiration or expiration

47. Oxygen moves from the...
35 to 45 mmHg
Altering the respiratory rate and/or the tidal volume
release of O2 from Hb - as heat is a by-product of metabolism.
Alveoli to the blood

48. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Obstructive lung disease from restrictive lung disease
A sensor placed over a translucent area of arterial pulsation
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

49. Discontinuous lung sounds are also called

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50. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
10 to 11 cm long and about 2 cm in diameter
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
Diffusion