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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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. Spirometry: The result is stated as
Inspiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Larger airways
Soft - high-pitched and crisp

2. within limits - increased temperature =
Binding of O2 to Hb
release of O2 from Hb - as heat is a by-product of metabolism.
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Diaphragm - External Intercostals

3. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
respiration
Oxygen (O2)
Portable antero-posterior (AP) view
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

4. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
Diffusion
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Pulse oximetry

5. Nitroglycerin applied to the probe area has been reported to...
Overcome some of the problems associated with low blood flow to the probe site
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
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
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

6. Oximetry readings of < 94%
require supplemental oxygenation and possibly ABG analysis
Difficulty breathing or shortness of breath
Increased Hb-O2 affinity
A tracing of the lung volume against time in seconds

7. 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
release of O2 from Hb
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Upper respiratory obstruction - usually in the trachea or larynx

8. Carbon dioxide moves from the...
Perfusion
Blood to the alveoli
Dyspnea upon assuming a recumbent position
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

9. Chest Radiography: The most common chest X-ray series is the...
Air-filled - fluid-filled - or solid
80 to 120% of predicted value
Postero-anterior (PA) and lateral view series
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

10. hypocapnia
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Left upper lobe
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Lowered carbon dioxide level - results from hyperventilation

11. Inspiratory stridor indicates
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
70%
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
35 to 45 mmHg

12. Continuous lung sounds occur during...
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Either inspiration or expiration
Spirometry
Pneumonia - obstructive lung disease - and late pulmonary edema

13. Abnormal lung sounds AKA

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14. Auscultation of the chest depends on...
Narrowed nearly to the point of closure
reduced in size - compared with a normal curve - due to lower lung volume
A reliable and consistent classification of auditory findings
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

15. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
A tracing of the lung volume against time in seconds
Tongue
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Manubrio-sternal junction (angle of Louis)

16. Restrictive disease refers to...
Increased work of breathing
Obstruction below the vocal cords (subglottic or tracheal obstruction)
A reduction in lung capacity - secondary to scarring or extraneous material
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

17. The vital capacity and the residual volume together constitute the...
Oxygen (O2)
Total lung capacity (TLC)
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
The amount of air that can be inhaled after normal inspiration

18. The trachea divides into
right and left mainstem bronchi
70% occlusion of the airway
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
35 to 45 mmHg

19. The accessory muscles are the...
Bronchospasm - mucosal edema - or excessive secretions
Sternocleidomastoid - Scalene Muscles
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Expiratory volume - and there is a prolonged expiratory time

20. The pattern of breathing refers to...
Expiration
Manubrio-sternal junction (angle of Louis)
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

21. forced vital capacity (FVC)
right
Speed of airflow - the higher the flow - the greater the resistance
'crackles' or 'rales'
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

22. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
respiration
No respiration for > 20 seconds
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

23. Bohr Effect of pH is graphed as
A reduction in lung capacity - secondary to scarring or extraneous material
Decreased Hb-O2 affinity
The amount of air that can be exhaled after expiration
Oxygen-Hemoglobin Dissociation Curve

24. FEV1% in restrictive disease
Inspiration
Wheezes - high-pitched - musical sounds - distinct whistling quality
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Normal to increased FEV1%

25. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Dullness replaces resonance
right and left mainstem bronchi
Partial pressure of CO2 in the arterial blood

26. Continuous lung sounds
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Wheezes - high-pitched - musical sounds - distinct whistling quality
The amount of air that can be inhaled after normal inspiration
Interstitial diseases or early pulmonary edema

27. Factors that influence the oxygen carrying capacity of hemoglobin
Increased work of breathing
80%
Right
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

28. most important factor that influences the oxygen carrying capacity of hemoglobin
Oxygen (O2)
Excessive secretions and abnormal airway collapsibility
The gas in the conducting airways does not participate in alveolar exchange
Partial pressure of oxygen (PO2)

29. The muscles of inspiration are the...
Partial pressure of CO2 in the arterial blood
Diaphragm - External Intercostals
Inflammation of the adjacent parietal pleura
Mouth as well as through the chest wall

30. The external intercostal muscles increase the antero-posterior chest diameter during
Wheezes - high-pitched - musical sounds - distinct whistling quality
Inspiration
Excessive secretions and abnormal airway collapsibility
Partial pressure of O2 in the arterial blood

31. Coarse crackles are...
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Mediastinum
Alveoli to the blood
Louder - lower-pitched - and slightly longer in duration

32. Expiratory stridor indicates
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
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Either inspiration or expiration

33. Pulse Oximetry is dependent on...
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Normal to increased FEV1%
'crackles' or 'rales'
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

34. 78.08% Atmospheric Composition
Nitrogen
Diaphragm and the intercostal muscles
A sensor placed over a translucent area of arterial pulsation
Outer surface of each lung

35. PaCO2
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Oxygen-Hemoglobin Dissociation Curve
Partial pressure of CO2 in the arterial blood

36. 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
Excessive secretions and abnormal airway collapsibility
Mouth as well as through the chest wall
Saturated with oxygen or unsaturated

37. vital capacity (VC)
right and left mainstem bronchi
The amount of air that can be inhaled after normal inspiration
The total amount of air that can be exhaled following a maximal inhalation
Carboxyhemoglobin

38. The main bronchi are divided into smaller branches that begin to subdivide into
The rib above it
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
A tracing of the lung volume against time in seconds
The right middle lobe

39. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
Oxygen (O2)
The rib above it
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

40. The normal FEV1 /FVC ratio is...
70%
Air bubbles flowing through secretions or slightly closed airways during respiration
No respiration for > 20 seconds
Left upper lobe

41. Typically - in the presence of obstructive disease - the flow-volume curve looks

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42. Examples of obstructive disease
Narrowed nearly to the point of closure
Diaphragm and the intercostal muscles
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

43. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Binding of O2 to Hb
The atmospheric pressure
Difficulty breathing or shortness of breath
Lung volumes - but find it difficult to exhale rapidly

44. Fine crackles are heard in
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Contracts
Interstitial diseases or early pulmonary edema
Partial pressure of oxygen (PO2)

45. 20.95% Atmospheric Composition
Oxygen (O2)
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Bicarbonate
Interstitial diseases or early pulmonary edema

46. The upper airway accounts For what % of airway resistance?
Narrowed nearly to the point of closure
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
right and left mainstem bronchi
50%

47. increased volume results in
Decreased pressure
Air-filled - fluid-filled - or solid
Left upper lobe
Perfusion

48. inspiratory reserve
Increase the intrathoracic space
The amount of air that can be inhaled after normal inspiration
Increased Hb-O2 affinity
80%

49. Respiration involves
The total amount of air that can be exhaled following a maximal inhalation
Interstitial diseases or early pulmonary edema
Ventilation - Diffusion - Perfusion
Blood to the alveoli

50. Spirometry plots
Difficulty breathing or shortness of breath
Interstitial diseases or early pulmonary edema
Soft - high-pitched and crisp
A tracing of the lung volume against time in seconds