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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. Fine crackles are...
Soft - high-pitched and crisp
The amount of air that can be inhaled after normal inspiration
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
A reduction in lung capacity - secondary to scarring or extraneous material

2. Bohr Effect of pH: right shift
Decreased Hb-O2 affinity
Pressure required to drive air through the airways
release of O2 from Hb
Expiration

3. 78.08% Atmospheric Composition
'scooped out' or bowl-shaped
Nitrogen
right and left mainstem bronchi
5 years - to detect obstruction and determine its reversibility

4. FEV1% in restrictive disease
Inspiration
Mouth as well as through the chest wall
Normal to increased FEV1%
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

5. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Portable antero-posterior (AP) view
Partial pressure of oxygen (PO2)
2 - each wavelength is partially absorbed by hemoglobin
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

6. PACO2
Interstitial diseases or early pulmonary edema
Alveoli to the blood
Partial pressure of carbon dioxide in the alveoli
The negative logarithm of hydrogen ions in the blood

7. forced expiratory volume in one second (FEV1)
Partial pressure of O2 in the arterial blood
Either continuous or discontinuous
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
Right

8. Dyspnea is defined as
Difficulty breathing or shortness of breath
Blue or bluish-gray discoloration of the skin or mucous membranes
The total amount of air that can be exhaled following a maximal inhalation
right

9. Continuous lung sounds occur in the setting of...
Alveoli to the blood
Inside of the thoracic cavity wall and the upper surface of the diaphragm
right & left
Bronchospasm - mucosal edema - or excessive secretions

10. The muscles of inspiration are the...
Blood to the alveoli
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Mouth as well as through the chest wall
Diaphragm - External Intercostals

11. During inspiration the diaphragm
Increased work of breathing
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Pulse oximetry
Contracts

12. FIO2
Functional residual capacity (FRC)
Fraction (%age) of inspired oxygen
Partial pressure of carbon dioxide in the alveoli
right and left mainstem bronchi

13. Nitroglycerin applied to the probe area has been reported to...
Normal to increased FEV1%
Contracts
Overcome some of the problems associated with low blood flow to the probe site
reduced in size - compared with a normal curve - due to lower lung volume

14. Bronchial breath sounds
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Expiration
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

15. hypocapnia
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Diaphragm and the intercostal muscles
Lowered carbon dioxide level - results from hyperventilation
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

16. Coarse crackles are heard in
Expiration
Mediastinum
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
Pneumonia - obstructive lung disease - and late pulmonary edema

17. Restrictive disease refers to...
Inspiration
A reduction in lung capacity - secondary to scarring or extraneous material
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

18. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
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
respiration
Partial pressure of O2 in the arterial blood
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

19. Peripheral cyanosis results from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Diffusion
Normal to increased FEV1%
Dyspnea upon assuming a recumbent position

20. Examples of obstructive disease
Soft - high-pitched and crisp
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
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

21. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
A sensor placed over a translucent area of arterial pulsation
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Increased Hb-O2 affinity
Louder - lower-pitched - and slightly longer in duration

22. The muscles of expiration are the...
Either inspiration or expiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Contracts
T4 or T5 - and just below the manubrio-sternal joint

23. Patients with obstructive disease have normal
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Diffusion
Lung volumes - but find it difficult to exhale rapidly
Interstitial diseases or early pulmonary edema

24. Spirometry: The result is stated as
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
right & left
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
70% occlusion of the airway

25. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
70%
Lung volumes - but find it difficult to exhale rapidly
release of O2 from Hb - as heat is a by-product of metabolism.

26. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
Manubrio-sternal junction (angle of Louis)
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
results in a lower than normal FEV1%

27. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Expiration
Mediastinum
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Bronchospasm - mucosal edema - or excessive secretions

28. Spirometry is useful in distinguishing
Diaphragm - External Intercostals
Perfusion
Obstructive lung disease from restrictive lung disease
Cough

29. Patients with restrictive disease have low
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Spirometry
Perfusion
Tongue

30. Cyanosis appears when
Increased amounts of unsaturated hemoglobin in capillary blood
There is an inverse relationship between pressure and volume
Upper respiratory obstruction - usually in the trachea or larynx
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

31. PaO2
Partial pressure of O2 in the arterial blood
Expiratory volume - and there is a prolonged expiratory time
Expiration
Perfusion

32. Discontinuous lung sounds are also called

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33. The trachea divides into right and left mainstem bronchi At what level?
Oxygen (O2)
Upper respiratory obstruction - usually in the trachea or larynx
Tongue
T4 or T5 - and just below the manubrio-sternal joint

34. A normal volume-time curve rises
Pressure required to drive air through the airways
Lung volumes - but find it difficult to exhale rapidly
quickly - usually reaching a plateau within 6.0 seconds
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

35. The upper airway accounts For what % of airway resistance?
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%
Increased amounts of unsaturated hemoglobin in capillary blood
Total lung capacity (TLC)

36. Rhonchi originate in the...
Left upper lobe
Larger airways
Contracts
Inspiration

37. FEV1/FVC
Inspiration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
right
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

38. The normal FEV1 /FVC ratio is...
10 to 11 cm long and about 2 cm in diameter
70%
Bicarbonate
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

39. Percussion helps you establish whether the underlying tissues are...
There is an inverse relationship between pressure and volume
10 to 11 cm long and about 2 cm in diameter
Air-filled - fluid-filled - or solid
Ventilation

40. The visceral pleura lines the...
The examiner can clearly distinguish the word that the pt speak or whispers
500 to 800 mL
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Outer surface of each lung

41. The most reliable site for detecting central cyanosis is the...
No
Partial pressure of CO2 in the arterial blood
Decreased Hb-O2 affinity
Tongue

42. Auscultation of the chest depends on...
Fraction (%age) of inspired oxygen
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Expiratory volume - and there is a prolonged expiratory time
A reliable and consistent classification of auditory findings

43. The spirometry printout usually includes

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44. PaCO2
Increased amounts of unsaturated hemoglobin in capillary blood
Either inspiration or expiration
Partial pressure of CO2 in the arterial blood
A sensor placed over a translucent area of arterial pulsation

45. vital capacity (VC)
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
The total amount of air that can be exhaled following a maximal inhalation
Louder - lower-pitched - and slightly longer in duration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

46. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Excessive secretions and abnormal airway collapsibility
No respiration for > 20 seconds

47. low CO2 = low acidity =
Pulse oximetry
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Binding of O2 to Hb

48. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Nitrogen
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Manubrio-sternal junction (angle of Louis)

49. Which bronchus is more susceptible to aspiration of foreign bodies?
80 to 120% of predicted value
reduced in size - compared with a normal curve - due to lower lung volume
Soft - high-pitched and crisp
Right

50. The active movement of gases between the ambient air and the lungs
Ventilation
Postero-anterior (PA) and lateral view series
'adventitious' breath sounds
Acinus

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Pulmonology

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