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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Peripheral cyanosis results from
Dyspnea that awakens the patient several hours after going to sleep
'crackles' or 'rales'
Pneumonia - obstructive lung disease - and late pulmonary edema
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

2. Paroxysmal nocturnal dyspnea (PND) is...
Expiration
Contracts
Soft - high-pitched and crisp
Dyspnea that awakens the patient several hours after going to sleep

3. Obstructive disease refers to...
Interstitial diseases or early pulmonary edema
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
Increased Hb-O2 affinity
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

4. Expiratory stridor indicates
Overcome some of the problems associated with low blood flow to the probe site
Observing the pattern of breathing
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Air-filled - fluid-filled - or solid

5. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
500 to 800 mL
Dullness replaces resonance
Louder - lower-pitched - and slightly longer in duration
right

6. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Dyspnea that awakens the patient several hours after going to sleep
80%
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

7. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
70%
Ventilation - Diffusion - Perfusion

8. forced expiratory volume in one second (FEV1)
Tongue
Inspiration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
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

9. Patients with restrictive disease have low
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Binding of O2 to Hb
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

10. Nitroglycerin applied to the probe area has been reported to...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Overcome some of the problems associated with low blood flow to the probe site
The total amount of air that can be exhaled following a maximal inhalation
Sternocleidomastoid - Scalene Muscles

11. During inspiration the diaphragm
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
release of O2 from Hb
Contracts
'crackles' or 'rales'

12. Which lung has a horizontal fissure?
Bicarbonate
right
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

13. Dyspnea is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Difficulty breathing or shortness of breath
Diaphragm and the intercostal muscles
The rib above it

14. increased volume results in
right and left mainstem bronchi
Insufficient oxygenation of hemoglobin in the lungs
Decreased pressure
The right middle lobe

15. Abnormal lung sounds AKA

16. Fine crackles are heard in
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
70%
'adventitious' breath sounds
Interstitial diseases or early pulmonary edema

17. FEV1/FVC
Tongue
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Left upper lobe
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

18. The parietal pleura lines the...
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Insufficient oxygenation of hemoglobin in the lungs
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Wheezes - high-pitched - musical sounds - distinct whistling quality

19. Bohr Effect of pH is graphed as
80 to 120% of predicted value
No
Increased Hb-O2 affinity
Oxygen-Hemoglobin Dissociation Curve

20. The tracheo-bronchial tree is a tubular system that provides a pathway for
Air to move from the upper airway to the farthest alveolar reaches
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
release of O2 from Hb

21. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
A tracing of the lung volume against time in seconds
Mediastinum
A reduction in lung capacity - secondary to scarring or extraneous material
The atmospheric pressure

22. Restrictive Disease: Expiratory volume is reduced more than
Speed of airflow - the higher the flow - the greater the resistance
Interstitial diseases or early pulmonary edema
Ventilation - Diffusion - Perfusion
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

23. The spirometry printout usually includes

24. Pulse Oximetry does not detect
PaCO2
Fraction (%age) of inspired oxygen
Hypoventilation or modest changes in the PaO2
Soft - high-pitched and crisp

25. Cyanosis appears when
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
The atmospheric pressure
Tongue

26. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Binding of O2 to Hb
The amount of air that can be exhaled after expiration
Spirometry
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

27. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
Decreased Hb-O2 affinity
Inside of the thoracic cavity wall and the upper surface of the diaphragm
right and left mainstem bronchi

28. FEV1% in restrictive disease
Normal to increased FEV1%
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
The amount of air that can be inhaled after normal inspiration
Oxygen-Hemoglobin Dissociation Curve

29. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Lung volumes - but find it difficult to exhale rapidly
Either inspiration or expiration
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

30. The trachea divides into
Perfusion
10 to 11 cm long and about 2 cm in diameter
right and left mainstem bronchi
The total amount of air that can be exhaled following a maximal inhalation

31. Discontinuous lung sounds are also called

32. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
right & left
Pulse oximetry
Bicarbonate
A good effort

33. The interspace between two ribs (intercostal space) is numbered by
Outer surface of each lung
Decreased pressure
Perfusion
The rib above it

34. Which lung has an oblique fissure?
right & left
Lowered carbon dioxide level - results from hyperventilation
Diffusion
Larger airways

35. Auscultation of the chest depends on...
Increased Hb-O2 affinity
A good effort
A reliable and consistent classification of auditory findings
Excessive secretions and abnormal airway collapsibility

36. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
Either inspiration or expiration
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Partial pressure of CO2 in the arterial blood

37. What may prevent cyanosis from appearing?
Larger airways
Sternocleidomastoid - Scalene Muscles
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

38. Percussion helps you establish whether the underlying tissues are...
Increase the intrathoracic space
Air-filled - fluid-filled - or solid
The right middle lobe
80 to 120% of predicted value

39. pain in lung conditions usually arises from
right
No
Ventilation
Inflammation of the adjacent parietal pleura

40. The trachea divides into right and left mainstem bronchi At what level?
Decreased Hb-O2 affinity
Carboxyhemoglobin
Mouth as well as through the chest wall
T4 or T5 - and just below the manubrio-sternal joint

41. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
Excessive secretions and abnormal airway collapsibility
Increase the intrathoracic space
2 - each wavelength is partially absorbed by hemoglobin

42. Patients with obstructive disease have normal
Lung volumes - but find it difficult to exhale rapidly
50%
Narrowed nearly to the point of closure
No

43. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A reliable and consistent classification of auditory findings
The negative logarithm of hydrogen ions in the blood
Increased work of breathing

44. The trachea is how long/wide?
Inspiration
10 to 11 cm long and about 2 cm in diameter
Hypoventilation or modest changes in the PaO2
right and left mainstem bronchi

45. most important factor that influences the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2)
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Interstitial diseases or early pulmonary edema
Louder - lower-pitched - and slightly longer in duration

46. Spirometry normal range
PaCO2
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
80 to 120% of predicted value
Air bubbles flowing through secretions or slightly closed airways during respiration

47. The presence of pressure gradients causes respiratory gases to move from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Louder - lower-pitched - and slightly longer in duration
80 to 120% of predicted value
Significant pulmonary impairment

48. Egophony

49. Airway resistance refers to...
Pleural space
Alveoli to the blood
Dyspnea upon assuming a recumbent position
Pressure required to drive air through the airways

50. Spirometry can be used to determine the severity of functional impairment as well as
There is an inverse relationship between pressure and volume
To assess response to treatment
Diaphragm - External Intercostals
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up