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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. With restrictive disease - the flow-volume curve is...
Cough
reduced in size - compared with a normal curve - due to lower lung volume
No respiration for > 20 seconds
Either inspiration or expiration

2. Normal range of PaCO2
35 to 45 mmHg
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Increased amounts of unsaturated hemoglobin in capillary blood
right

3. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
A good effort
Carboxyhemoglobin
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
70%

4. 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
Mouth as well as through the chest wall
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Manubrio-sternal junction (angle of Louis)
Pulse oximetry

5. Central cyanosis results from
T4 or T5 - and just below the manubrio-sternal joint
Immediate oxygenation with or without intubation
Insufficient oxygenation of hemoglobin in the lungs
right

6. terminal respiratory unit
Immediate oxygenation with or without intubation
Acinus
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
70% occlusion of the airway

7. expiratory reserve
Difficulty breathing or shortness of breath
Partial pressure of carbon dioxide in the alveoli
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
The amount of air that can be exhaled after expiration

8. The upper airway accounts For what % of airway resistance?
Excessive secretions and abnormal airway collapsibility
Increased Hb-O2 affinity
50%
500 to 800 mL

9. forced vital capacity (FVC)
Pressure required to drive air through the airways
Diaphragm and the intercostal muscles
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Increased amounts of unsaturated hemoglobin in capillary blood

10. gas exchange across the alveolar-pulmonary capillary membranes
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
quickly - usually reaching a plateau within 6.0 seconds
Diffusion
To assess response to treatment

11. residual volume
Insufficient oxygenation of hemoglobin in the lungs
Contracts
Oxygen (O2)
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

12. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
The amount of air that can be inhaled after normal inspiration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

13. FIO2
Inspiration
The rib above it
require supplemental oxygenation and possibly ABG analysis
Fraction (%age) of inspired oxygen

14. The visceral pleura lines the...
Mouth as well as through the chest wall
right and left mainstem bronchi
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Outer surface of each lung

15. 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
A reliable and consistent classification of auditory findings
Postero-anterior (PA) and lateral view series
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

16. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
The examiner can clearly distinguish the word that the pt speak or whispers
Right
A sensor placed over a translucent area of arterial pulsation
A good effort

17. Inspiratory stridor becomes evident at about
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
70% occlusion of the airway
Inside of the thoracic cavity wall and the upper surface of the diaphragm
The amount of air that can be inhaled after normal inspiration

18. Bohr Effect of pH: right shift
80%
Functional residual capacity (FRC)
Decreased Hb-O2 affinity
Alveoli to the blood

19. Does lung tissue have pain fibers?
The atmospheric pressure
No
quickly - usually reaching a plateau within 6.0 seconds
Inspiration

20. An efficient approach to examination of the patient begins with
Observing the pattern of breathing
Hypoventilation or modest changes in the PaO2
Total lung capacity (TLC)
release of O2 from Hb

21. inspiratory reserve
80%
Perfusion
The amount of air that can be inhaled after normal inspiration
Blood to the alveoli

22. The primary muscles of respiration are the...
The atmospheric pressure
Diffusion
Diaphragm and the intercostal muscles
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

23. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Diffusion
Partial pressure of O2 in the arterial blood
No respiration for > 20 seconds

24. The acini consist of the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Oxygen-Hemoglobin Dissociation Curve
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

25. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Speed of airflow - the higher the flow - the greater the resistance
Altering the respiratory rate and/or the tidal volume
Air bubbles flowing through secretions or slightly closed airways during respiration
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

26. The tracheo-bronchial tree is a tubular system that provides a pathway for
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Pulse oximetry
Air to move from the upper airway to the farthest alveolar reaches
2 - each wavelength is partially absorbed by hemoglobin

27. FEV1% in restrictive disease
Obstruction below the vocal cords (subglottic or tracheal obstruction)
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Normal to increased FEV1%

28. normal adult tidal volume
500 to 800 mL
Mediastinum
Increase the intrathoracic space
The examiner can clearly distinguish the word that the pt speak or whispers

29. Inspiratory stridor indicates
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
The negative logarithm of hydrogen ions in the blood
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

30. The trachea divides into
right and left mainstem bronchi
There is an inverse relationship between pressure and volume
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Perfusion

31. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Decreased pressure

32. Spirometry: The result is stated as
Outer surface of each lung
To assess response to treatment
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
release of O2 from Hb

33. Rhonchi are due to...
The atmospheric pressure
Excessive secretions and abnormal airway collapsibility
Dullness replaces resonance
The rib above it

34. Continuous lung sounds occur during...
The examiner can clearly distinguish the word that the pt speak or whispers
Pulse oximetry
35 to 45 mmHg
Either inspiration or expiration

35. Rhonchi frequently clear after
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Diffusion
Cough
35 to 45 mmHg

36. The muscles of expiration are the...
Inflammation of the adjacent parietal pleura
35 to 45 mmHg
Overcome some of the problems associated with low blood flow to the probe site
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

37. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Immediate oxygenation with or without intubation
Inflammation of the adjacent parietal pleura
The atmospheric pressure
Either inspiration or expiration

38. Rhonchi
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Bronchospasm - mucosal edema - or excessive secretions
80 to 120% of predicted value

39. forced expiratory volume in one second (FEV1)
Expiration
A good effort
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
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

40. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Manubrio-sternal junction (angle of Louis)
Functional residual capacity (FRC)
500 to 800 mL
Portable antero-posterior (AP) view

41. Compliance
Upper respiratory obstruction - usually in the trachea or larynx
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
Nitrogen
Obstruction below the vocal cords (subglottic or tracheal obstruction)

42. movement of blood through the capillaries in direct communication with the alveoli
The amount of air that can be inhaled after normal inspiration
Increased amounts of unsaturated hemoglobin in capillary blood
Perfusion
'scooped out' or bowl-shaped

43. increased volume results in
Insufficient oxygenation of hemoglobin in the lungs
Decreased pressure
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

44. Dyspnea is defined as
Speed of airflow - the higher the flow - the greater the resistance
right & left
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
Difficulty breathing or shortness of breath

45. Patients with obstructive disease have normal
Diffusion
A sensor placed over a translucent area of arterial pulsation
Lung volumes - but find it difficult to exhale rapidly
Difficulty breathing or shortness of breath

46. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Pressure required to drive air through the airways
Lung volumes - but find it difficult to exhale rapidly
Spirometry
Pleural space

47. The pattern of breathing refers to...
Either inspiration or expiration
Bicarbonate
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

48. Rhonchi occur during
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
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Either inspiration or expiration
Ventilation

49. Examples of restrictive disease
The negative logarithm of hydrogen ions in the blood
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Increase the intrathoracic space
Insufficient oxygenation of hemoglobin in the lungs

50. Stridor is a high-pitched - noisy respiration - Which is indicative of...
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Upper respiratory obstruction - usually in the trachea or larynx
The negative logarithm of hydrogen ions in the blood