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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. Bronchiovesicular breath sounds
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Obstructive lung disease from restrictive lung disease
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
Acinus

2. Coarse crackles result from
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
Cough
Air bubbles flowing through secretions or slightly closed airways during respiration

3. Normal range of PaCO2
35 to 45 mmHg
Air bubbles flowing through secretions or slightly closed airways during respiration
Lowered carbon dioxide level - results from hyperventilation
Diffusion

4. inspiratory reserve
Mouth as well as through the chest wall
The amount of air that can be inhaled after normal inspiration
Soft - high-pitched and crisp
Blood to the alveoli

5. At rest - the use of accessory muscles is a sign of...
70%
Significant pulmonary impairment
release of O2 from Hb - as heat is a by-product of metabolism.
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

6. Expiratory stridor indicates
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The negative logarithm of hydrogen ions in the blood
Immediate oxygenation with or without intubation
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

7. the lingula is analogous to...
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Air-filled - fluid-filled - or solid
The right middle lobe
Pneumonia - obstructive lung disease - and late pulmonary edema

8. Rhonchi frequently clear after
Tongue
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Cough
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. Resistance is dependent upon
Partial pressure of oxygen in the alveoli
'crackles' or 'rales'
Speed of airflow - the higher the flow - the greater the resistance
Decreased Hb-O2 affinity

10. movement of blood through the capillaries in direct communication with the alveoli
Partial pressure of carbon dioxide in the alveoli
Perfusion
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
Lowered carbon dioxide level - results from hyperventilation

11. Cyanosis appears when
Perfusion
Obstruction below the vocal cords (subglottic or tracheal obstruction)
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Either inspiration or expiration

12. pain in lung conditions usually arises from
2 - each wavelength is partially absorbed by hemoglobin
70% occlusion of the airway
Inflammation of the adjacent parietal pleura
5 years - to detect obstruction and determine its reversibility

13. The purpose of respiration is to...
The total amount of air in the lungs at the end of a maximal inhalation
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
Dyspnea upon assuming a recumbent position
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

14. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
respiration
Diffusion
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

15. total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
Pulse oximetry
10 to 11 cm long and about 2 cm in diameter
Right

16. Which bronchus is more susceptible to aspiration of foreign bodies?
A reduction in lung capacity - secondary to scarring or extraneous material
Lung volumes - but find it difficult to exhale rapidly
Right
To assess response to treatment

17. normal adult tidal volume
There is an inverse relationship between pressure and volume
500 to 800 mL
Total lung capacity (TLC)
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

18. Inspiratory stridor becomes evident at about
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
70% occlusion of the airway
The total amount of air in the lungs at the end of a maximal inhalation

19. FEV1/FVC
35 to 45 mmHg
require supplemental oxygenation and possibly ABG analysis
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Lung volumes - but find it difficult to exhale rapidly

20. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Either continuous or discontinuous
Spirometry
The rib above it
To assess response to treatment

21. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Right
The total amount of air in the lungs at the end of a maximal inhalation
Dullness replaces resonance
Increased rate of breathing and is commonly associated with a decrease in tidal volume

22. The parietal pleura lines the...
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Significant pulmonary impairment
Dyspnea upon assuming a recumbent position
Binding of O2 to Hb

23. Pulse Oximetry is dependent on...
Sternocleidomastoid - Scalene Muscles
Bicarbonate
Spirometry
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

24. Examples of obstructive disease
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
A tracing of the lung volume against time in seconds

25. The spirometry printout usually includes

26. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
Ventilation
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Partial pressure of O2 in the arterial blood

27. Pulse Oximetry does not detect
Air-filled - fluid-filled - or solid
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
Hypoventilation or modest changes in the PaO2
Increased Hb-O2 affinity

28. Spirometry plots
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
A tracing of the lung volume against time in seconds
'crackles' or 'rales'
Partial pressure of O2 in the arterial blood

29. tidal volume (Vt)
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Expiratory volume - and there is a prolonged expiratory time
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

30. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
require supplemental oxygenation and possibly ABG analysis
Either inspiration or expiration
70%
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

31. Factors that influence the oxygen carrying capacity of hemoglobin
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
Partial pressure of O2 in the arterial blood
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Increased work of breathing

32. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Bicarbonate
Mediastinum

33. Spirometry: The result is stated as
right and left mainstem bronchi
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Total lung capacity (TLC)

34. FEV1% in restrictive disease
Decreased Hb-O2 affinity
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Normal to increased FEV1%
Altering the respiratory rate and/or the tidal volume

35. Fine crackles are heard in
Perfusion
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
Interstitial diseases or early pulmonary edema
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

36. Vesicular breath sounds
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
right
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Perfusion

37. Restrictive Disease: Expiratory volume is reduced more than
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Cough
PaCO2

38. office-based spirometry is recommended for patients as young as
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
'scooped out' or bowl-shaped
5 years - to detect obstruction and determine its reversibility

39. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Carboxyhemoglobin
A reliable and consistent classification of auditory findings
Ventilation - Diffusion - Perfusion
Increased Hb-O2 affinity

40. most important factor that influences the oxygen carrying capacity of hemoglobin
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Partial pressure of oxygen (PO2)
Acinus
Excessive secretions and abnormal airway collapsibility

41. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Ventilation
Spirometry
Increased work of breathing
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

42. Obstructive disease refers to...
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
500 to 800 mL
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Air to move from the upper airway to the farthest alveolar reaches

43. A normal volume-time curve rises
Observing the pattern of breathing
Expiration
80%
quickly - usually reaching a plateau within 6.0 seconds

44. hypocapnia
Postero-anterior (PA) and lateral view series
The atmospheric pressure
Decreased Hb-O2 affinity
Lowered carbon dioxide level - results from hyperventilation

45. 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
Blood to the alveoli
Inflammation of the adjacent parietal pleura
Decreased Hb-O2 affinity

46. FEV1% in obstructive disease
results in a lower than normal FEV1%
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
A good effort
Lowered carbon dioxide level - results from hyperventilation

47. An efficient approach to examination of the patient begins with
The amount of air that can be exhaled after expiration
results in a lower than normal FEV1%
Observing the pattern of breathing
Inspiration

48. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
Increase the intrathoracic space
Pleural space
Sternocleidomastoid - Scalene Muscles

49. Continuous lung sounds occur in the setting of...
Diffusion
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Speed of airflow - the higher the flow - the greater the resistance
Bronchospasm - mucosal edema - or excessive secretions

50. The interspace between two ribs (intercostal space) is numbered by
Ventilation
Increased work of breathing
The rib above it
Upper respiratory obstruction - usually in the trachea or larynx