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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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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. The normal FEV1 /FVC ratio is...
Spirometry
Spirometry
70%
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

2. Inspiratory stridor indicates
Total lung capacity (TLC)
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Mediastinum

3. Which bronchus is more susceptible to aspiration of foreign bodies?
Right
35 to 45 mmHg
Lung volumes - but find it difficult to exhale rapidly
Partial pressure of oxygen (PO2)

4. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
release of O2 from Hb
results in a lower than normal FEV1%
Increase the intrathoracic space
Inspiration

5. Abnormal lung sounds AKA

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6. movement of blood through the capillaries in direct communication with the alveoli
Normal to increased FEV1%
Perfusion
Pleural space
right & left

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
Diaphragm and the intercostal muscles
Postero-anterior (PA) and lateral view series
Partial pressure of O2 in the arterial blood

8. total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
Ventilation - Diffusion - Perfusion
Overcome some of the problems associated with low blood flow to the probe site
The gas in the conducting airways does not participate in alveolar exchange

9. Orthopnea is quantified by
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
release of O2 from Hb
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

10. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Sternocleidomastoid - Scalene Muscles
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Portable antero-posterior (AP) view
Diffusion

11. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Decreased pressure
Either inspiration or expiration
Perfusion
respiration

12. Percussion helps you establish whether the underlying tissues are...
To assess response to treatment
Saturated with oxygen or unsaturated
Air-filled - fluid-filled - or solid
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

13. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Spirometry
Carboxyhemoglobin
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Obstruction below the vocal cords (subglottic or tracheal obstruction)

14. Examples of obstructive disease
Larger airways
A tracing of the lung volume against time in seconds
80%
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

15. expiratory reserve
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
The amount of air that can be exhaled after expiration
Alveoli to the blood
Spirometry

16. The pattern of breathing refers to...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
reduced in size - compared with a normal curve - due to lower lung volume
respiration
To assess response to treatment

17. Paroxysmal nocturnal dyspnea (PND) is...
Fraction (%age) of inspired oxygen
Dyspnea that awakens the patient several hours after going to sleep
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

18. forced expiratory volume in one second (FEV1)
Bicarbonate
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
'scooped out' or bowl-shaped
The atmospheric pressure

19. Vesicular breath sounds
Air bubbles flowing through secretions or slightly closed airways during respiration
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
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
Expiratory volume - and there is a prolonged expiratory time

20. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Dullness replaces resonance
Brief - discrete - non-musical sounds with a popping quality
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

21. Bronchial breath sounds
'crackles' or 'rales'
Cough
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

22. 78.08% Atmospheric Composition
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Partial pressure of CO2 in the arterial blood
Nitrogen
Functional residual capacity (FRC)

23. Spirometry: The result is stated as
The examiner can clearly distinguish the word that the pt speak or whispers
Overcome some of the problems associated with low blood flow to the probe site
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Oxygen (O2)

24. Patients with obstructive disease have normal
Partial pressure of carbon dioxide in the alveoli
Lung volumes - but find it difficult to exhale rapidly
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Wheezes - high-pitched - musical sounds - distinct whistling quality

25. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Functional residual capacity (FRC)
Spirometry
Either inspiration or expiration

26. Rhonchi originate in the...
Tongue
Larger airways
50%
Diffusion

27. Inspiratory stridor becomes evident at about
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
70% occlusion of the airway
Diffusion

28. Pectoriloquy
The examiner can clearly distinguish the word that the pt speak or whispers
Interstitial diseases or early pulmonary edema
quickly - usually reaching a plateau within 6.0 seconds
Air bubbles flowing through secretions or slightly closed airways during respiration

29. Which lung has a horizontal fissure?
Mediastinum
Postero-anterior (PA) and lateral view series
Air-filled - fluid-filled - or solid
right

30. The purpose of respiration is to...
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Altering the respiratory rate and/or the tidal volume
Perfusion
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

31. Continuous lung sounds
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Wheezes - high-pitched - musical sounds - distinct whistling quality
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
The amount of air that can be inhaled after normal inspiration

32. HCO3
Diaphragm - External Intercostals
2 - each wavelength is partially absorbed by hemoglobin
Bicarbonate
Spirometry

33. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Dyspnea upon assuming a recumbent position
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Tongue

34. The trachea is how long/wide?
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
10 to 11 cm long and about 2 cm in diameter
Diaphragm and the intercostal muscles
Lung volumes - but no difficulty or delay in exhaling what volume they do have

35. Pulmonary ventilation is varied by
Carboxyhemoglobin
Altering the respiratory rate and/or the tidal volume
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
respiration

36. Continuous lung sounds occur in the setting of...
Bronchospasm - mucosal edema - or excessive secretions
Spirometry
Dyspnea that awakens the patient several hours after going to sleep
Increased amounts of unsaturated hemoglobin in capillary blood

37. PaCO2
Alveoli to the blood
A reduction in lung capacity - secondary to scarring or extraneous material
Partial pressure of O2 in the arterial blood
Partial pressure of CO2 in the arterial blood

38. Carbon dioxide moves from the...
Partial pressure of oxygen in the alveoli
Inspiration
Blood to the alveoli
10 to 11 cm long and about 2 cm in diameter

39. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Expiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Soft - high-pitched and crisp
Narrowed nearly to the point of closure

40. The active movement of gases between the ambient air and the lungs
Outer surface of each lung
results in a lower than normal FEV1%
Acinus
Ventilation

41. dead space ventilation
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Air-filled - fluid-filled - or solid
The gas in the conducting airways does not participate in alveolar exchange
Mouth as well as through the chest wall

42. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Dyspnea upon assuming a recumbent position
Air to move from the upper airway to the farthest alveolar reaches
Increased work of breathing

43. The most reliable site for detecting central cyanosis is the...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Inflammation of the adjacent parietal pleura
Tongue
80 to 120% of predicted value

44. PaO2
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Partial pressure of O2 in the arterial blood
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Manubrio-sternal junction (angle of Louis)

45. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Contracts
Diffusion
Expiratory volume - and there is a prolonged expiratory time
results in a lower than normal FEV1%

46. Continuous lung sounds occur during...
Either inspiration or expiration
PaCO2
Increased amounts of unsaturated hemoglobin in capillary blood
Partial pressure of carbon dioxide in the alveoli

47. within limits - increased temperature =
Partial pressure of CO2 in the arterial blood
release of O2 from Hb - as heat is a by-product of metabolism.
Blue or bluish-gray discoloration of the skin or mucous membranes
Either inspiration or expiration

48. Spirometry plots
Partial pressure of oxygen in the alveoli
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
A tracing of the lung volume against time in seconds
Either continuous or discontinuous

49. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Total lung capacity (TLC)
70%
A tracing of the lung volume against time in seconds

50. Auscultation of the chest depends on...
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
A reliable and consistent classification of auditory findings
Normal to increased FEV1%