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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. Pectoriloquy
Sternocleidomastoid - Scalene Muscles
The examiner can clearly distinguish the word that the pt speak or whispers
Soft - high-pitched and crisp
Observing the pattern of breathing

2. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Total lung capacity (TLC)
results in a lower than normal FEV1%
'adventitious' breath sounds

3. The volume of gas remaining in the lungs at the end of normal expiration is called the...
right
Blood to the alveoli
A reliable and consistent classification of auditory findings
Functional residual capacity (FRC)

4. Rhonchi
Diaphragm - External Intercostals
70%
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
right

5. PAO2
'crackles' or 'rales'
Manubrio-sternal junction (angle of Louis)
Partial pressure of oxygen in the alveoli
Louder - lower-pitched - and slightly longer in duration

6. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Total lung capacity (TLC)
Interstitial diseases or early pulmonary edema
Ventilation - Diffusion - Perfusion
Immediate oxygenation with or without intubation

7. pain in lung conditions usually arises from
Soft - high-pitched and crisp
Inflammation of the adjacent parietal pleura
Overcome some of the problems associated with low blood flow to the probe site
The total amount of air in the lungs at the end of a maximal inhalation

8. What is the potential space between the visceral and parietal pleurae?
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Pleural space
reduced in size - compared with a normal curve - due to lower lung volume
Dyspnea that awakens the patient several hours after going to sleep

9. Fine crackles are heard in
Fraction (%age) of inspired oxygen
Interstitial diseases or early pulmonary edema
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
Diaphragm and the intercostal muscles

10. Expiratory stridor indicates
Obstruction below the vocal cords (subglottic or tracheal obstruction)
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
'adventitious' breath sounds
release of O2 from Hb - as heat is a by-product of metabolism.

11. forced vital capacity (FVC)
Perfusion
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
The atmospheric pressure
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

12. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Observing the pattern of breathing
Air-filled - fluid-filled - or solid

13. Chest Radiography: The most common chest X-ray series is the...
Decreased pressure
The gas in the conducting airways does not participate in alveolar exchange
Postero-anterior (PA) and lateral view series
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

14. 78.08% Atmospheric Composition
Pneumonia - obstructive lung disease - and late pulmonary edema
The right middle lobe
Nitrogen
Diaphragm and the intercostal muscles

15. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
The negative logarithm of hydrogen ions in the blood
Inspiration
35 to 45 mmHg
Increase the intrathoracic space

16. Rhonchi occur during
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Diffusion
'adventitious' breath sounds
Either inspiration or expiration

17. At rest - the use of accessory muscles is a sign of...
Significant pulmonary impairment
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Alveoli to the blood
Expiration

18. Continuous lung sounds
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Wheezes - high-pitched - musical sounds - distinct whistling quality

19. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
respiration
Acinus
Inflammation of the adjacent parietal pleura
No

20. Rhonchi are due to...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Excessive secretions and abnormal airway collapsibility
Increased minute volume ventilation - which results in a lowered carbon dioxide level

21. Continuous lung sounds often audible at the...
35 to 45 mmHg
Mouth as well as through the chest wall
Carboxyhemoglobin
Blue or bluish-gray discoloration of the skin or mucous membranes

22. Patients with obstructive disease have normal
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Lung volumes - but find it difficult to exhale rapidly
release of O2 from Hb - as heat is a by-product of metabolism.
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

23. inspiratory reserve
Air to move from the upper airway to the farthest alveolar reaches
The amount of air that can be inhaled after normal inspiration
Pneumonia - obstructive lung disease - and late pulmonary edema
T4 or T5 - and just below the manubrio-sternal joint

24. Dyspnea is defined as
5 years - to detect obstruction and determine its reversibility
Difficulty breathing or shortness of breath
respiration
A tracing of the lung volume against time in seconds

25. PACO2
Carboxyhemoglobin
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Partial pressure of carbon dioxide in the alveoli
Mouth as well as through the chest wall

26. Rhonchi frequently clear after
Pulse oximetry
'adventitious' breath sounds
Cough
Upper respiratory obstruction - usually in the trachea or larynx

27. Coarse crackles result from
Brief - discrete - non-musical sounds with a popping quality
Manubrio-sternal junction (angle of Louis)
Air bubbles flowing through secretions or slightly closed airways during respiration
No respiration for > 20 seconds

28. Pulse Oximetry does not detect
70%
Bicarbonate
Hypoventilation or modest changes in the PaO2
Soft - high-pitched and crisp

29. FEV1/FVC
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Brief - discrete - non-musical sounds with a popping quality

30. Inspiratory stridor becomes evident at about
70% occlusion of the airway
Decreased pressure
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
2 - each wavelength is partially absorbed by hemoglobin

31. Fine crackles are...
Soft - high-pitched and crisp
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Dyspnea that awakens the patient several hours after going to sleep
Pleural space

32. Spirometry can be used to determine the severity of functional impairment as well as
70%
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Interstitial diseases or early pulmonary edema
To assess response to treatment

33. pH
Right
Pressure required to drive air through the airways
The negative logarithm of hydrogen ions in the blood
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

34. Airway resistance refers to...
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Oxygen-Hemoglobin Dissociation Curve
Inflammation of the adjacent parietal pleura
Pressure required to drive air through the airways

35. the lingula is analogous to...
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Perfusion
The right middle lobe
Total lung capacity (TLC)

36. Bronchiovesicular breath sounds
Either inspiration or expiration
Decreased Hb-O2 affinity
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
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

37. During inspiration the diaphragm
Oxygen (O2)
Inspiration
Right
Contracts

38. Which lobe has an inferior tongue-like projection called the lingula?
Nitrogen
Left upper lobe
Increased work of breathing
2 - each wavelength is partially absorbed by hemoglobin

39. What may prevent cyanosis from appearing?
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
'crackles' or 'rales'
PaCO2
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

40. Which bronchus is more susceptible to aspiration of foreign bodies?
'crackles' or 'rales'
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Right
Upper respiratory obstruction - usually in the trachea or larynx

41. 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
Tongue
Partial pressure of O2 in the arterial blood
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

42. Spirometry plots
A tracing of the lung volume against time in seconds
To assess response to treatment
Narrowed nearly to the point of closure
The amount of air that can be inhaled after normal inspiration

43. Compliance
500 to 800 mL
Ventilation
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
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

44. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
'crackles' or 'rales'
Diffusion
Nitrogen
respiration

45. Apnea is defined as
No respiration for > 20 seconds
Spirometry
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A reduction in lung capacity - secondary to scarring or extraneous material

46. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Blue or bluish-gray discoloration of the skin or mucous membranes
Portable antero-posterior (AP) view
2 - each wavelength is partially absorbed by hemoglobin
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

47. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
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
The amount of air that can be exhaled after expiration
Spirometry

48. tidal volume (Vt)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Manubrio-sternal junction (angle of Louis)
Bronchospasm - mucosal edema - or excessive secretions
The total amount of air that can be exhaled following a maximal inhalation

49. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
Fraction (%age) of inspired oxygen
Inside of the thoracic cavity wall and the upper surface of the diaphragm
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

50. hypocapnia
Increased work of breathing
Bicarbonate
Partial pressure of carbon dioxide in the alveoli
Lowered carbon dioxide level - results from hyperventilation