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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. Coarse crackles are heard in
'crackles' or 'rales'
Pneumonia - obstructive lung disease - and late pulmonary edema
release of O2 from Hb
80%

2. Orthopnea is defined as
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Either inspiration or expiration
Dyspnea upon assuming a recumbent position
Increase the intrathoracic space

3. The purpose of respiration is to...
The negative logarithm of hydrogen ions in the blood
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Blue or bluish-gray discoloration of the skin or mucous membranes
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

4. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
50%
The rib above it
The negative logarithm of hydrogen ions in the blood

5. Bohr Effect of pH: left shift
The negative logarithm of hydrogen ions in the blood
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Increased Hb-O2 affinity
Significant pulmonary impairment

6. Continuous lung sounds occur during...
Immediate oxygenation with or without intubation
Either inspiration or expiration
'adventitious' breath sounds
Excessive secretions and abnormal airway collapsibility

7. office-based spirometry is recommended for patients as young as
A sensor placed over a translucent area of arterial pulsation
Fraction (%age) of inspired oxygen
Immediate oxygenation with or without intubation
5 years - to detect obstruction and determine its reversibility

8. Bronchophony
Increased amounts of unsaturated hemoglobin in capillary blood
Postero-anterior (PA) and lateral view series
Increased minute volume ventilation - which results in a lowered carbon dioxide level
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

9. Coarse crackles result from
Significant pulmonary impairment
T4 or T5 - and just below the manubrio-sternal joint
Air bubbles flowing through secretions or slightly closed airways during respiration
Lowered carbon dioxide level - results from hyperventilation

10. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
The examiner can clearly distinguish the word that the pt speak or whispers
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
PaCO2
A good effort

11. Carbon dioxide moves from the...
Cough
Right
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Blood to the alveoli

12. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Immediate oxygenation with or without intubation
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Increase the intrathoracic space
The examiner can clearly distinguish the word that the pt speak or whispers

13. Abnormal lung sounds are classified as
Either continuous or discontinuous
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Bicarbonate
Tongue

14. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Contracts
Saturated with oxygen or unsaturated
Inspiration
Lung volumes - but no difficulty or delay in exhaling what volume they do have

15. PaCO2
Partial pressure of CO2 in the arterial blood
Inside of the thoracic cavity wall and the upper surface of the diaphragm
5 years - to detect obstruction and determine its reversibility
Narrowed nearly to the point of closure

16. The spirometry printout usually includes

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17. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Tongue
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Perfusion
Spirometry

18. tidal volume (Vt)
Air-filled - fluid-filled - or solid
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Manubrio-sternal junction (angle of Louis)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

19. Pulse Oximetry does not detect
Hypoventilation or modest changes in the PaO2
Lowered carbon dioxide level - results from hyperventilation
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

20. Rhonchi are due to...
The examiner can clearly distinguish the word that the pt speak or whispers
Excessive secretions and abnormal airway collapsibility
PaCO2
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

21. Orthopnea is quantified by
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Pressure required to drive air through the airways
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

22. 78.08% Atmospheric Composition
Spirometry
Pulse oximetry
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Nitrogen

23. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Portable antero-posterior (AP) view
quickly - usually reaching a plateau within 6.0 seconds

24. Examples of restrictive disease
Ventilation - Diffusion - Perfusion
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Lowered carbon dioxide level - results from hyperventilation
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

25. The trachea bifurcates into its mainstem bronchi at the level of...
Hypoventilation or modest changes in the PaO2
Excessive secretions and abnormal airway collapsibility
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
The amount of air that can be exhaled after expiration

26. Peripheral cyanosis results from
Alveoli to the blood
Lung volumes - but find it difficult to exhale rapidly
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
500 to 800 mL

27. The presence of pressure gradients causes respiratory gases to move from
Dyspnea that awakens the patient several hours after going to sleep
500 to 800 mL
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
10 to 11 cm long and about 2 cm in diameter

28. 20.95% Atmospheric Composition
Oxygen (O2)
Brief - discrete - non-musical sounds with a popping quality
The rib above it
Wheezes - high-pitched - musical sounds - distinct whistling quality

29. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Tongue
Hypoventilation or modest changes in the PaO2
Diffusion
500 to 800 mL

30. Rhonchi
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
500 to 800 mL
reduced in size - compared with a normal curve - due to lower lung volume
Diaphragm - External Intercostals

31. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
respiration
80%
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
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

32. 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
right and left mainstem bronchi
Pulse oximetry
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Wheezes - high-pitched - musical sounds - distinct whistling quality

33. Which lung has a horizontal fissure?
quickly - usually reaching a plateau within 6.0 seconds
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
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
right

34. Spirometry can be used to determine the severity of functional impairment as well as
T4 or T5 - and just below the manubrio-sternal joint
To assess response to treatment
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Increase the intrathoracic space

35. The primary muscles of respiration are the...
Decreased pressure
Diaphragm and the intercostal muscles
Increased work of breathing
Pneumonia - obstructive lung disease - and late pulmonary edema

36. Cyanosis appears when
Diaphragm and the intercostal muscles
The amount of air that can be inhaled after normal inspiration
2 - each wavelength is partially absorbed by hemoglobin
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

37. The upper airway accounts For what % of airway resistance?
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
The total amount of air in the lungs at the end of a maximal inhalation
50%
Outer surface of each lung

38. increased volume results in
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Decreased pressure
Lowered carbon dioxide level - results from hyperventilation
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

39. The most reliable site for detecting central cyanosis is the...
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Oxygen (O2)
right
Tongue

40. Restrictive Disease: Expiratory volume is reduced more than
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The amount of air that can be exhaled after expiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

41. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Pleural space
Upper respiratory obstruction - usually in the trachea or larynx
The negative logarithm of hydrogen ions in the blood
The amount of air that can be inhaled after normal inspiration

42. What is the potential space between the visceral and parietal pleurae?
80%
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Expiratory volume - and there is a prolonged expiratory time
Pleural space

43. Bronchiovesicular breath sounds
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
The negative logarithm of hydrogen ions in the blood
The gas in the conducting airways does not participate in alveolar exchange
Left upper lobe

44. normal subjects expel approximately how much of the FVC in the 1st second?
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
80%
Speed of airflow - the higher the flow - the greater the resistance
Lung volumes - but find it difficult to exhale rapidly

45. FEV1% in restrictive disease
Normal to increased FEV1%
Tongue
Alveoli to the blood
PaCO2

46. Examples of obstructive disease
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
The atmospheric pressure
'adventitious' breath sounds
Observing the pattern of breathing

47. Fine crackles are heard in
Fraction (%age) of inspired oxygen
Interstitial diseases or early pulmonary edema
PaCO2
Expiration

48. pain in lung conditions usually arises from
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
Inspiration
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

49. A normal volume-time curve rises
The total amount of air that can be exhaled following a maximal inhalation
Soft - high-pitched and crisp
quickly - usually reaching a plateau within 6.0 seconds
Sternocleidomastoid - Scalene Muscles

50. Pulse Oximetry is dependent on...
Partial pressure of oxygen (PO2)
Spirometry
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction