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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. The trachea divides into right and left mainstem bronchi At what level?
70%
Right
The gas in the conducting airways does not participate in alveolar exchange
T4 or T5 - and just below the manubrio-sternal joint

2. Nitroglycerin applied to the probe area has been reported to...
The atmospheric pressure
Acinus
Overcome some of the problems associated with low blood flow to the probe site
Mediastinum

3. PaCO2
35 to 45 mmHg
Blood to the alveoli
Inspiration
Partial pressure of CO2 in the arterial blood

4. the lingula is analogous to...
The right middle lobe
reduced in size - compared with a normal curve - due to lower lung volume
Inflammation of the adjacent parietal pleura
Dyspnea that awakens the patient several hours after going to sleep

5. Cyanosis appears when
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Observing the pattern of breathing
Diffusion
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

6. Spirometry is useful in distinguishing
'crackles' or 'rales'
Obstructive lung disease from restrictive lung disease
The examiner can clearly distinguish the word that the pt speak or whispers
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

7. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Narrowed nearly to the point of closure
Larger airways
Blue or bluish-gray discoloration of the skin or mucous membranes
A sensor placed over a translucent area of arterial pulsation

8. high CO2 = high acidity =
70%
right
Oxygen-Hemoglobin Dissociation Curve
release of O2 from Hb

9. Orthopnea is quantified by
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Increased rate of breathing and is commonly associated with a decrease in tidal volume
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
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

10. Oximetry readings of < 94%
Decreased Hb-O2 affinity
5 years - to detect obstruction and determine its reversibility
require supplemental oxygenation and possibly ABG analysis
Either inspiration or expiration

11. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Dullness replaces resonance
A reliable and consistent classification of auditory findings
Brief - discrete - non-musical sounds with a popping quality
Increase the intrathoracic space

12. forced vital capacity (FVC)
T4 or T5 - and just below the manubrio-sternal joint
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Bronchospasm - mucosal edema - or excessive secretions
Air to move from the upper airway to the farthest alveolar reaches

13. Abnormal lung sounds AKA

14. Spirometry plots
Partial pressure of oxygen (PO2)
Alveoli to the blood
A tracing of the lung volume against time in seconds
There is an inverse relationship between pressure and volume

15. Which lung has an oblique fissure?
Speed of airflow - the higher the flow - the greater the resistance
Diffusion
right & left
Inflammation of the adjacent parietal pleura

16. Cyanosis
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
The gas in the conducting airways does not participate in alveolar exchange
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Blue or bluish-gray discoloration of the skin or mucous membranes

17. Discontinuous lung sounds are also called

18. Apnea is defined as
Mediastinum
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Air bubbles flowing through secretions or slightly closed airways during respiration
No respiration for > 20 seconds

19. The purpose of respiration is to...
Lowered carbon dioxide level - results from hyperventilation
Decreased Hb-O2 affinity
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

20. Patients with restrictive disease have low
500 to 800 mL
Interstitial diseases or early pulmonary edema
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

21. Bronchial breath sounds
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Total lung capacity (TLC)
Excessive secretions and abnormal airway collapsibility
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

22. FEV1% in restrictive disease
Increased work of breathing
2 - each wavelength is partially absorbed by hemoglobin
Carboxyhemoglobin
Normal to increased FEV1%

23. gas exchange across the alveolar-pulmonary capillary membranes
'crackles' or 'rales'
Either inspiration or expiration
Diffusion
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

24. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
Portable antero-posterior (AP) view
Bicarbonate
Interstitial diseases or early pulmonary edema

25. Bronchiovesicular breath sounds
A reliable and consistent classification of auditory findings
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Diaphragm - External Intercostals

26. Resistance is dependent upon
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Hypoventilation or modest changes in the PaO2
Total lung capacity (TLC)
Speed of airflow - the higher the flow - the greater the resistance

27. What is the potential space between the visceral and parietal pleurae?
Decreased Hb-O2 affinity
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Pleural space
Ventilation - Diffusion - Perfusion

28. total lung capacity (TLC)
A tracing of the lung volume against time in seconds
The total amount of air in the lungs at the end of a maximal inhalation
Blue or bluish-gray discoloration of the skin or mucous membranes
Air-filled - fluid-filled - or solid

29. The visceral pleura lines the...
Interstitial diseases or early pulmonary edema
Carboxyhemoglobin
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Outer surface of each lung

30. pH
The negative logarithm of hydrogen ions in the blood
require supplemental oxygenation and possibly ABG analysis
Either inspiration or expiration
Increased amounts of unsaturated hemoglobin in capillary blood

31. Coarse crackles result from
T4 or T5 - and just below the manubrio-sternal joint
right
Air bubbles flowing through secretions or slightly closed airways during respiration
The amount of air that can be exhaled after expiration

32. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
A good effort
Partial pressure of carbon dioxide in the alveoli
Right
The total amount of air in the lungs at the end of a maximal inhalation

33. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Acinus
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
Inspiration
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

34. The volume of gas remaining in the lungs at the end of normal expiration is called the...
There is an inverse relationship between pressure and volume
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
A tracing of the lung volume against time in seconds
Functional residual capacity (FRC)

35. Which bronchus is more susceptible to aspiration of foreign bodies?
Perfusion
Overcome some of the problems associated with low blood flow to the probe site
Right
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

36. 20.95% Atmospheric Composition
Significant pulmonary impairment
Nitrogen
5 years - to detect obstruction and determine its reversibility
Oxygen (O2)

37. Factors that influence the oxygen carrying capacity of hemoglobin
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
70%
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

38. expiratory reserve
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Expiration
The amount of air that can be inhaled after normal inspiration
The amount of air that can be exhaled after expiration

39. The trachea divides into
Decreased Hb-O2 affinity
Spirometry
right and left mainstem bronchi
Ventilation - Diffusion - Perfusion

40. Vesicular breath sounds
Altering the respiratory rate and/or the tidal volume
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
release of O2 from Hb
require supplemental oxygenation and possibly ABG analysis

41. The best indicator of adequate ventilation is the...
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
A sensor placed over a translucent area of arterial pulsation
Nitrogen
PaCO2

42. At rest - the use of accessory muscles is a sign of...
Significant pulmonary impairment
The examiner can clearly distinguish the word that the pt speak or whispers
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
'adventitious' breath sounds

43. low CO2 = low acidity =
quickly - usually reaching a plateau within 6.0 seconds
Binding of O2 to Hb
Lowered carbon dioxide level - results from hyperventilation
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

44. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
Contracts
Total lung capacity (TLC)
There is an inverse relationship between pressure and volume

45. Percussion helps you establish whether the underlying tissues are...
results in a lower than normal FEV1%
Diaphragm - External Intercostals
Air-filled - fluid-filled - or solid
5 years - to detect obstruction and determine its reversibility

46. The interspace between two ribs (intercostal space) is numbered by
The rib above it
Bronchospasm - mucosal edema - or excessive secretions
Alveoli to the blood
reduced in size - compared with a normal curve - due to lower lung volume

47. 78.08% Atmospheric Composition
Pleural space
Increased amounts of unsaturated hemoglobin in capillary blood
Blue or bluish-gray discoloration of the skin or mucous membranes
Nitrogen

48. What occurs passively as muscles relax?
Left upper lobe
Obstructive lung disease from restrictive lung disease
Expiration
No respiration for > 20 seconds

49. Rhonchi frequently clear after
Saturated with oxygen or unsaturated
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
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Cough

50. Cyanosis is caused by
Acinus
Increased amounts of unsaturated hemoglobin in capillary blood
70% occlusion of the airway
Pneumonia - obstructive lung disease - and late pulmonary edema