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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. pain in lung conditions usually arises from
Air bubbles flowing through secretions or slightly closed airways during respiration
A good effort
Contracts
Inflammation of the adjacent parietal pleura

2. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Nitrogen
Inspiration
Increased work of breathing
Spirometry

3. The visceral pleura lines the...
results in a lower than normal FEV1%
Increased work of breathing
Outer surface of each lung
There is an inverse relationship between pressure and volume

4. Bronchiovesicular breath sounds
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
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
A good effort
Sternocleidomastoid - Scalene Muscles

5. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
5 years - to detect obstruction and determine its reversibility
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

6. Coarse crackles result from
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
70% occlusion of the airway
Air bubbles flowing through secretions or slightly closed airways during respiration
Lung volumes - but find it difficult to exhale rapidly

7. Apnea is defined as
Mediastinum
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Right
No respiration for > 20 seconds

8. gas exchange across the alveolar-pulmonary capillary membranes
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Diffusion
Lowered carbon dioxide level - results from hyperventilation
Bicarbonate

9. most important factor that influences the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2)
Partial pressure of oxygen in the alveoli
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Lowered carbon dioxide level - results from hyperventilation

10. terminal respiratory unit
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
Dyspnea that awakens the patient several hours after going to sleep
Acinus
Tongue

11. The vital capacity and the residual volume together constitute the...
Increase the intrathoracic space
Total lung capacity (TLC)
Spirometry
Obstructive lung disease from restrictive lung disease

12. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Pneumonia - obstructive lung disease - and late pulmonary edema
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
2 - each wavelength is partially absorbed by hemoglobin
Left upper lobe

13. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
Immediate oxygenation with or without intubation
Louder - lower-pitched - and slightly longer in duration
Speed of airflow - the higher the flow - the greater the resistance

14. Fine crackles are...
Functional residual capacity (FRC)
Expiratory volume - and there is a prolonged expiratory time
Soft - high-pitched and crisp
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

15. The trachea is how long/wide?
500 to 800 mL
10 to 11 cm long and about 2 cm in diameter
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
Oxygen-Hemoglobin Dissociation Curve

16. The normal FEV1 /FVC ratio is...
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
70%
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Total lung capacity (TLC)

17. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Outer surface of each lung
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Pressure required to drive air through the airways

18. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
80 to 120% of predicted value
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Increased amounts of unsaturated hemoglobin in capillary blood

19. Respiration involves
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Functional residual capacity (FRC)
Ventilation - Diffusion - Perfusion
reduced in size - compared with a normal curve - due to lower lung volume

20. The best indicator of adequate ventilation is the...
PaCO2
Immediate oxygenation with or without intubation
'crackles' or 'rales'
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

21. HCO3
Lowered carbon dioxide level - results from hyperventilation
Dullness replaces resonance
Sternocleidomastoid - Scalene Muscles
Bicarbonate

22. The pattern of breathing refers to...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Narrowed nearly to the point of closure
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Air bubbles flowing through secretions or slightly closed airways during respiration

23. The spirometry printout usually includes

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24. Abnormal lung sounds AKA

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25. Patients with restrictive disease have low
A reliable and consistent classification of auditory findings
Decreased Hb-O2 affinity
Lung volumes - but no difficulty or delay in exhaling what volume they do have
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

26. vital capacity (VC)
Ventilation - Diffusion - Perfusion
Cough
The total amount of air that can be exhaled following a maximal inhalation
Upper respiratory obstruction - usually in the trachea or larynx

27. Stridor is a high-pitched - noisy respiration - Which is indicative of...
A reduction in lung capacity - secondary to scarring or extraneous material
Upper respiratory obstruction - usually in the trachea or larynx
The amount of air that can be exhaled after expiration
release of O2 from Hb

28. PACO2
Partial pressure of O2 in the arterial blood
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
Partial pressure of carbon dioxide in the alveoli
The total amount of air that can be exhaled following a maximal inhalation

29. Coarse crackles are heard in
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
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Pneumonia - obstructive lung disease - and late pulmonary edema
Either inspiration or expiration

30. the lingula is analogous to...
The right middle lobe
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
The atmospheric pressure
Binding of O2 to Hb

31. normal subjects expel approximately how much of the FVC in the 1st second?
Increased amounts of unsaturated hemoglobin in capillary blood
Louder - lower-pitched - and slightly longer in duration
80%
Upper respiratory obstruction - usually in the trachea or larynx

32. office-based spirometry is recommended for patients as young as
5 years - to detect obstruction and determine its reversibility
Excessive secretions and abnormal airway collapsibility
Right
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

33. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Expiratory volume - and there is a prolonged expiratory time
A tracing of the lung volume against time in seconds
reduced in size - compared with a normal curve - due to lower lung volume

34. Which bronchus is wider - shorter - and more vertically placed?
Right
Diffusion
Pressure required to drive air through the airways
Insufficient oxygenation of hemoglobin in the lungs

35. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
2 - each wavelength is partially absorbed by hemoglobin
Partial pressure of CO2 in the arterial blood
Manubrio-sternal junction (angle of Louis)
Portable antero-posterior (AP) view

36. Vesicular breath sounds
The amount of air that can be exhaled after expiration
Inside of the thoracic cavity wall and the upper surface of the diaphragm
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
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

37. An efficient approach to examination of the patient begins with
To assess response to treatment
Functional residual capacity (FRC)
Either inspiration or expiration
Observing the pattern of breathing

38. Continuous lung sounds often audible at the...
Mouth as well as through the chest wall
right
2 - each wavelength is partially absorbed by hemoglobin
80%

39. A state-of-the-art - inexpensive - non-invasive - simple method to monitor a patient's percent hemoglobin saturation with oxygen (SaO2) - without having to obtain an arterial blood specimen
Pulse oximetry
'scooped out' or bowl-shaped
70% occlusion of the airway
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

40. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
The amount of air that can be exhaled after expiration
Carboxyhemoglobin
Dullness replaces resonance
respiration

41. Which lung has a horizontal fissure?
right
50%
Tongue
release of O2 from Hb - as heat is a by-product of metabolism.

42. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
Either continuous or discontinuous
Decreased pressure
respiration

43. What occurs passively as muscles relax?
Expiration
A good effort
No respiration for > 20 seconds
To assess response to treatment

44. Which bronchus is more susceptible to aspiration of foreign bodies?
Expiration
Right
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Spirometry

45. Cyanosis
Immediate oxygenation with or without intubation
Significant pulmonary impairment
Blue or bluish-gray discoloration of the skin or mucous membranes
Diffusion

46. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
A reliable and consistent classification of auditory findings
release of O2 from Hb - as heat is a by-product of metabolism.
Diffusion
Sternocleidomastoid - Scalene Muscles

47. Continuous lung sounds occur in the setting of...
Bronchospasm - mucosal edema - or excessive secretions
Dyspnea that awakens the patient several hours after going to sleep
Manubrio-sternal junction (angle of Louis)
Oxygen-Hemoglobin Dissociation Curve

48. Rhonchi
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Partial pressure of O2 in the arterial blood
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

49. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Dyspnea that awakens the patient several hours after going to sleep
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Cough

50. Coarse crackles are...
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Louder - lower-pitched - and slightly longer in duration
Expiratory volume - and there is a prolonged expiratory time
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up