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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. Tachypnea is an
Excessive secretions and abnormal airway collapsibility
Ventilation
quickly - usually reaching a plateau within 6.0 seconds
Increased rate of breathing and is commonly associated with a decrease in tidal volume

2. 78.08% Atmospheric Composition
PaCO2
Bicarbonate
Contracts
Nitrogen

3. Bronchophony
The total amount of air in the lungs at the end of a maximal inhalation
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
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
Ventilation

4. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Cough
Oxygen-Hemoglobin Dissociation Curve
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Saturated with oxygen or unsaturated

5. Abnormal lung sounds AKA

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6. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

7. Pulmonary ventilation is varied by
Functional residual capacity (FRC)
Spirometry
Altering the respiratory rate and/or the tidal volume
Insufficient oxygenation of hemoglobin in the lungs

8. Rhonchi are due to...
Excessive secretions and abnormal airway collapsibility
Larger airways
Total lung capacity (TLC)
Fraction (%age) of inspired oxygen

9. Restrictive disease refers to...
The amount of air that can be inhaled after normal inspiration
A reduction in lung capacity - secondary to scarring or extraneous material
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Partial pressure of oxygen (PO2)

10. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
2 - each wavelength is partially absorbed by hemoglobin
release of O2 from Hb
Left upper lobe
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

11. Inspiratory stridor indicates
80 to 120% of predicted value
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Excessive secretions and abnormal airway collapsibility

12. Chest Radiography: The most common chest X-ray series is the...
5 years - to detect obstruction and determine its reversibility
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Total lung capacity (TLC)
Postero-anterior (PA) and lateral view series

13. The presence of pressure gradients causes respiratory gases to move from
A tracing of the lung volume against time in seconds
Pneumonia - obstructive lung disease - and late pulmonary edema
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Increased rate of breathing and is commonly associated with a decrease in tidal volume

14. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
A good effort
The gas in the conducting airways does not participate in alveolar exchange
Partial pressure of CO2 in the arterial blood

15. the lingula is analogous to...
The rib above it
The right middle lobe
Inspiration
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

16. Which lobe has an inferior tongue-like projection called the lingula?
Either continuous or discontinuous
Left upper lobe
A reliable and consistent classification of auditory findings
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

17. Percussion helps you establish whether the underlying tissues are...
Pleural space
respiration
Air-filled - fluid-filled - or solid
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

18. Continuous lung sounds occur in the setting of...
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Left upper lobe
Diffusion
Bronchospasm - mucosal edema - or excessive secretions

19. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
A good effort
No respiration for > 20 seconds
Inspiration

20. Which bronchus is more susceptible to aspiration of foreign bodies?
The negative logarithm of hydrogen ions in the blood
quickly - usually reaching a plateau within 6.0 seconds
Right
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

21. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
2 - each wavelength is partially absorbed by hemoglobin
Mediastinum
Blood to the alveoli
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

22. within limits - increased temperature =
respiration
The examiner can clearly distinguish the word that the pt speak or whispers
Expiration
release of O2 from Hb - as heat is a by-product of metabolism.

23. Spirometry plots
2 - each wavelength is partially absorbed by hemoglobin
A good effort
Nitrogen
A tracing of the lung volume against time in seconds

24. Respiration involves
Ventilation - Diffusion - Perfusion
No
Ventilation
Alveoli to the blood

25. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Partial pressure of oxygen in the alveoli
respiration
Left upper lobe
Binding of O2 to Hb

26. PaCO2
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%
The negative logarithm of hydrogen ions in the blood
Partial pressure of CO2 in the arterial blood

27. inspiratory reserve
Saturated with oxygen or unsaturated
No respiration for > 20 seconds
results in a lower than normal FEV1%
The amount of air that can be inhaled after normal inspiration

28. vital capacity (VC)
35 to 45 mmHg
right
Binding of O2 to Hb
The total amount of air that can be exhaled following a maximal inhalation

29. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Decreased pressure
Fraction (%age) of inspired oxygen
Increased work of breathing
Cough

30. The trachea bifurcates into its mainstem bronchi at the level of...
Increased minute volume ventilation - which results in a lowered carbon dioxide level
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

31. The trachea divides into right and left mainstem bronchi At what level?
Nitrogen
Air bubbles flowing through secretions or slightly closed airways during respiration
T4 or T5 - and just below the manubrio-sternal joint
Partial pressure of carbon dioxide in the alveoli

32. residual volume
Blood to the alveoli
Ventilation
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
release of O2 from Hb - as heat is a by-product of metabolism.

33. Continuous lung sounds
release of O2 from Hb - as heat is a by-product of metabolism.
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Wheezes - high-pitched - musical sounds - distinct whistling quality
Pleural space

34. Which lung has a horizontal fissure?
right
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Pulse oximetry
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

35. The most reliable site for detecting central cyanosis is the...
Saturated with oxygen or unsaturated
Tongue
Mediastinum
Pleural space

36. Coarse crackles are heard in
A sensor placed over a translucent area of arterial pulsation
Pneumonia - obstructive lung disease - and late pulmonary edema
The atmospheric pressure
quickly - usually reaching a plateau within 6.0 seconds

37. An efficient approach to examination of the patient begins with
A good effort
Air bubbles flowing through secretions or slightly closed airways during respiration
A reliable and consistent classification of auditory findings
Observing the pattern of breathing

38. The parietal pleura lines the...
Significant pulmonary impairment
release of O2 from Hb - as heat is a by-product of metabolism.
Inside of the thoracic cavity wall and the upper surface of the diaphragm
80 to 120% of predicted value

39. gas exchange across the alveolar-pulmonary capillary membranes
Diffusion
Decreased pressure
Pneumonia - obstructive lung disease - and late pulmonary edema
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

40. The normal FEV1 /FVC ratio is...
The negative logarithm of hydrogen ions in the blood
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
70%
Obstruction below the vocal cords (subglottic or tracheal obstruction)

41. Continuous lung sounds occur during...
results in a lower than normal FEV1%
Either inspiration or expiration
Diffusion
Pneumonia - obstructive lung disease - and late pulmonary edema

42. pH
Oxygen (O2)
The negative logarithm of hydrogen ions in the blood
Mediastinum
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

43. 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
Decreased Hb-O2 affinity
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Mediastinum

44. FEV1% in obstructive disease
Perfusion
quickly - usually reaching a plateau within 6.0 seconds
results in a lower than normal FEV1%
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

45. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Diaphragm - External Intercostals
Increased amounts of unsaturated hemoglobin in capillary blood
Bronchospasm - mucosal edema - or excessive secretions

46. Spirometry: The result is stated as
right and left mainstem bronchi
Diffusion
Either inspiration or expiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

47. The trachea divides into
The atmospheric pressure
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
T4 or T5 - and just below the manubrio-sternal joint
right and left mainstem bronchi

48. The active movement of gases between the ambient air and the lungs
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Spirometry
'adventitious' breath sounds
Ventilation

49. Late inspiratory crackles result from
Right
Insufficient oxygenation of hemoglobin in the lungs
Larger airways
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

50. FEV1/FVC
Total lung capacity (TLC)
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Increased amounts of unsaturated hemoglobin in capillary blood
Oxygen (O2)