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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. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Increased work of breathing
Upper respiratory obstruction - usually in the trachea or larynx
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

2. PaCO2
'adventitious' breath sounds
Oxygen-Hemoglobin Dissociation Curve
Partial pressure of CO2 in the arterial blood
Pleural space

3. The trachea bifurcates into its mainstem bronchi at the level of...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
'crackles' or 'rales'
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

4. Obstructive disease refers to...
Observing the pattern of breathing
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
The atmospheric pressure

5. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Total lung capacity (TLC)
Functional residual capacity (FRC)
Lung volumes - but find it difficult to exhale rapidly
Obstruction below the vocal cords (subglottic or tracheal obstruction)

6. hypocapnia
50%
Wheezes - high-pitched - musical sounds - distinct whistling quality
Lowered carbon dioxide level - results from hyperventilation
quickly - usually reaching a plateau within 6.0 seconds

7. Examples of restrictive disease
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Pneumonia - obstructive lung disease - and late pulmonary edema
To assess response to treatment
Inflammation of the adjacent parietal pleura

8. The external intercostal muscles increase the antero-posterior chest diameter during
Normal to increased FEV1%
70%
Inspiration
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

9. Rhonchi are due to...
Wheezes - high-pitched - musical sounds - distinct whistling quality
Excessive secretions and abnormal airway collapsibility
The total amount of air in the lungs at the end of a maximal inhalation
Inspiration

10. The presence of pressure gradients causes respiratory gases to move from
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
'scooped out' or bowl-shaped
Oxygen (O2)

11. Coarse crackles are heard in
Pneumonia - obstructive lung disease - and late pulmonary edema
release of O2 from Hb - as heat is a by-product of metabolism.
right
Increased rate of breathing and is commonly associated with a decrease in tidal volume

12. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
The amount of air that can be inhaled after normal inspiration
Interstitial diseases or early pulmonary edema
Perfusion

13. high CO2 = high acidity =
The amount of air that can be exhaled after expiration
release of O2 from Hb
Carboxyhemoglobin
Decreased pressure

14. Which lung has an oblique fissure?
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
70%
Larger airways
right & left

15. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
The examiner can clearly distinguish the word that the pt speak or whispers
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Binding of O2 to Hb

16. Fine crackles are...
Nitrogen
Soft - high-pitched and crisp
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
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

17. normal adult tidal volume
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Speed of airflow - the higher the flow - the greater the resistance
80%
500 to 800 mL

18. The primary muscles of respiration are the...
Pulse oximetry
Bronchospasm - mucosal edema - or excessive secretions
Diaphragm and the intercostal muscles
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

19. Spirometry can be used to determine the severity of functional impairment as well as
To assess response to treatment
Left upper lobe
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Altering the respiratory rate and/or the tidal volume

20. Examples of obstructive disease
A tracing of the lung volume against time in seconds
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Lung volumes - but no difficulty or delay in exhaling what volume they do have

21. movement of blood through the capillaries in direct communication with the alveoli
Normal to increased FEV1%
The total amount of air in the lungs at the end of a maximal inhalation
Partial pressure of CO2 in the arterial blood
Perfusion

22. Which lobe has an inferior tongue-like projection called the lingula?
Left upper lobe
Postero-anterior (PA) and lateral view series
Inspiration
Significant pulmonary impairment

23. expiratory reserve
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The amount of air that can be exhaled after expiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Expiration

24. pain in lung conditions usually arises from
A reduction in lung capacity - secondary to scarring or extraneous material
No
Inflammation of the adjacent parietal pleura
respiration

25. Pectoriloquy
Oxygen-Hemoglobin Dissociation Curve
The examiner can clearly distinguish the word that the pt speak or whispers
'adventitious' breath sounds
Immediate oxygenation with or without intubation

26. 78.08% Atmospheric Composition
Nitrogen
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
'scooped out' or bowl-shaped
Expiration

27. Paroxysmal nocturnal dyspnea (PND) is...
Blue or bluish-gray discoloration of the skin or mucous membranes
T4 or T5 - and just below the manubrio-sternal joint
Dyspnea that awakens the patient several hours after going to sleep
release of O2 from Hb - as heat is a by-product of metabolism.

28. Late inspiratory crackles result from
Pleural space
Wheezes - high-pitched - musical sounds - distinct whistling quality
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

29. The normal FEV1 /FVC ratio is...
There is an inverse relationship between pressure and volume
70%
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Either continuous or discontinuous

30. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Immediate oxygenation with or without intubation
Decreased Hb-O2 affinity
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
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

31. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Partial pressure of carbon dioxide in the alveoli
Either inspiration or expiration
Increase the intrathoracic space
A good effort

32. Expiratory stridor indicates
Ventilation - Diffusion - Perfusion
Partial pressure of oxygen in the alveoli
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Increase the intrathoracic space

33. total lung capacity (TLC)
Pneumonia - obstructive lung disease - and late pulmonary edema
80%
The total amount of air in the lungs at the end of a maximal inhalation
No respiration for > 20 seconds

34. Rhonchi
'adventitious' breath sounds
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Inside of the thoracic cavity wall and the upper surface of the diaphragm
release of O2 from Hb - as heat is a by-product of metabolism.

35. Bohr Effect of pH is graphed as
Partial pressure of carbon dioxide in the alveoli
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
50%
Oxygen-Hemoglobin Dissociation Curve

36. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
Partial pressure of CO2 in the arterial blood
release of O2 from Hb - as heat is a by-product of metabolism.
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

37. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Inspiration
The negative logarithm of hydrogen ions in the blood
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

38. With restrictive disease - the flow-volume curve is...
Increased Hb-O2 affinity
Portable antero-posterior (AP) view
Pneumonia - obstructive lung disease - and late pulmonary edema
reduced in size - compared with a normal curve - due to lower lung volume

39. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
Increased amounts of unsaturated hemoglobin in capillary blood
70%
Spirometry

40. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Mediastinum
Spirometry
Lung volumes - but no difficulty or delay in exhaling what volume they do have

41. terminal respiratory unit
Acinus
Bronchospasm - mucosal edema - or excessive secretions
50%
Significant pulmonary impairment

42. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Obstructive lung disease from restrictive lung disease
Contracts
Spirometry
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

43. The muscles of inspiration are the...
Diaphragm - External Intercostals
Speed of airflow - the higher the flow - the greater the resistance
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Contracts

44. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Upper respiratory obstruction - usually in the trachea or larynx
Partial pressure of O2 in the arterial blood
Total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation

45. HCO3
Bicarbonate
80 to 120% of predicted value
Soft - high-pitched and crisp
Diffusion

46. Cyanosis
Blue or bluish-gray discoloration of the skin or mucous membranes
Manubrio-sternal junction (angle of Louis)
No
right

47. The acini consist of the...
A tracing of the lung volume against time in seconds
Outer surface of each lung
Partial pressure of oxygen (PO2)
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

48. The visceral pleura lines the...
Perfusion
T4 or T5 - and just below the manubrio-sternal joint
Outer surface of each lung
No respiration for > 20 seconds

49. Patients with restrictive disease have low
Increased amounts of unsaturated hemoglobin in capillary blood
Interstitial diseases or early pulmonary edema
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Acinus

50. Orthopnea is defined as
Significant pulmonary impairment
Oxygen-Hemoglobin Dissociation Curve
10 to 11 cm long and about 2 cm in diameter
Dyspnea upon assuming a recumbent position