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Pulmonology

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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. Bronchiovesicular breath sounds
Spirometry
right & left
Increased work of breathing
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

2. normal subjects expel approximately how much of the FVC in the 1st second?
Narrowed nearly to the point of closure
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Air-filled - fluid-filled - or solid
80%

3. Discontinuous lung sounds are also called

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4. Compliance
release of O2 from Hb
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
A sensor placed over a translucent area of arterial pulsation
The examiner can clearly distinguish the word that the pt speak or whispers

5. The muscles of expiration are the...
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Obstructive lung disease from restrictive lung disease
The atmospheric pressure

6. Spirometry is useful in distinguishing
right and left mainstem bronchi
Manubrio-sternal junction (angle of Louis)
Obstructive lung disease from restrictive lung disease
35 to 45 mmHg

7. Pulmonary ventilation is varied by
Altering the respiratory rate and/or the tidal volume
Excessive secretions and abnormal airway collapsibility
respiration
80 to 120% of predicted value

8. The parietal pleura lines the...
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Excessive secretions and abnormal airway collapsibility
Blood to the alveoli

9. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Observing the pattern of breathing
Carboxyhemoglobin
Dullness replaces resonance
Contracts

10. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Bronchospasm - mucosal edema - or excessive secretions
To assess response to treatment
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

11. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Functional residual capacity (FRC)
There is an inverse relationship between pressure and volume
Diaphragm and the intercostal muscles

12. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
The total amount of air that can be exhaled following a maximal inhalation
Interstitial diseases or early pulmonary edema
The total amount of air in the lungs at the end of a maximal inhalation
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

13. Paroxysmal nocturnal dyspnea (PND) is...
Nitrogen
Dyspnea that awakens the patient several hours after going to sleep
Bronchospasm - mucosal edema - or excessive secretions
Altering the respiratory rate and/or the tidal volume

14. Boyle's Gas Law
500 to 800 mL
There is an inverse relationship between pressure and volume
Oxygen-Hemoglobin Dissociation Curve
50%

15. PaCO2
The amount of air that can be exhaled after expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Partial pressure of CO2 in the arterial blood
Increased work of breathing

16. Normal lung sounds
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Lowered carbon dioxide level - results from hyperventilation
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Lung volumes - but no difficulty or delay in exhaling what volume they do have

17. Chest Radiography: The most common chest X-ray series is the...
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Postero-anterior (PA) and lateral view series
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Oxygen-Hemoglobin Dissociation Curve

18. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
5 years - to detect obstruction and determine its reversibility
Expiration
Perfusion
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

19. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Narrowed nearly to the point of closure
70%

20. PaO2
Dyspnea that awakens the patient several hours after going to sleep
Partial pressure of O2 in the arterial blood
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Cough

21. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Functional residual capacity (FRC)
Partial pressure of CO2 in the arterial blood
respiration
Portable antero-posterior (AP) view

22. Peripheral cyanosis results from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Fraction (%age) of inspired oxygen
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Total lung capacity (TLC)

23. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Mouth as well as through the chest wall
Total lung capacity (TLC)
Binding of O2 to Hb

24. Rhonchi originate in the...
Expiration
Larger airways
right
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

25. Spirometry plots
Air bubbles flowing through secretions or slightly closed airways during respiration
Brief - discrete - non-musical sounds with a popping quality
A tracing of the lung volume against time in seconds
Mouth as well as through the chest wall

26. Patients with obstructive disease have normal
Narrowed nearly to the point of closure
Louder - lower-pitched - and slightly longer in duration
Lung volumes - but find it difficult to exhale rapidly
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

27. With restrictive disease - the flow-volume curve is...
reduced in size - compared with a normal curve - due to lower lung volume
Cough
Either inspiration or expiration
The total amount of air in the lungs at the end of a maximal inhalation

28. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
The negative logarithm of hydrogen ions in the blood
Inspiration
respiration
10 to 11 cm long and about 2 cm in diameter

29. Continuous lung sounds occur during...
Dullness replaces resonance
Acinus
Brief - discrete - non-musical sounds with a popping quality
Either inspiration or expiration

30. FIO2
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
No
Fraction (%age) of inspired oxygen
The negative logarithm of hydrogen ions in the blood

31. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Normal to increased FEV1%
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
2 - each wavelength is partially absorbed by hemoglobin
A tracing of the lung volume against time in seconds

32. Which bronchus is wider - shorter - and more vertically placed?
Normal to increased FEV1%
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Significant pulmonary impairment
Right

33. The primary muscles of respiration are the...
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Diaphragm and the intercostal muscles
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
respiration

34. The presence of pressure gradients causes respiratory gases to move from
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Alveoli to the blood
Blue or bluish-gray discoloration of the skin or mucous membranes
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

35. The purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Carboxyhemoglobin
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
reduced in size - compared with a normal curve - due to lower lung volume

36. 20.95% Atmospheric Composition
Decreased Hb-O2 affinity
Upper respiratory obstruction - usually in the trachea or larynx
Oxygen (O2)
Inside of the thoracic cavity wall and the upper surface of the diaphragm

37. Continuous lung sounds often audible at the...
The negative logarithm of hydrogen ions in the blood
Increased work of breathing
Mouth as well as through the chest wall
Alveoli to the blood

38. The trachea divides into
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
Tongue
Dullness replaces resonance
right and left mainstem bronchi

39. PACO2
5 years - to detect obstruction and determine its reversibility
Partial pressure of carbon dioxide in the alveoli
Blue or bluish-gray discoloration of the skin or mucous membranes
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

40. Coarse crackles result from
A good effort
Air bubbles flowing through secretions or slightly closed airways during respiration
The amount of air that can be exhaled after expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

41. Restrictive disease refers to...
Immediate oxygenation with or without intubation
A reduction in lung capacity - secondary to scarring or extraneous material
Expiration
Increased minute volume ventilation - which results in a lowered carbon dioxide level

42. The trachea is how long/wide?
10 to 11 cm long and about 2 cm in diameter
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Expiratory volume - and there is a prolonged expiratory time
Lung volumes - but no difficulty or delay in exhaling what volume they do have

43. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
Partial pressure of oxygen in the alveoli
Overcome some of the problems associated with low blood flow to the probe site
The total amount of air that can be exhaled following a maximal inhalation

44. The best indicator of adequate ventilation is the...
PaCO2
Altering the respiratory rate and/or the tidal volume
The negative logarithm of hydrogen ions in the blood
right & left

45. The main bronchi are divided into smaller branches that begin to subdivide into
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Saturated with oxygen or unsaturated
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

46. Rhonchi
Excessive secretions and abnormal airway collapsibility
'adventitious' breath sounds
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Brief - discrete - non-musical sounds with a popping quality

47. Pulse Oximetry is dependent on...
Outer surface of each lung
Lowered carbon dioxide level - results from hyperventilation
Decreased pressure
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

48. Patients with restrictive disease have low
Louder - lower-pitched - and slightly longer in duration
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Mouth as well as through the chest wall
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

49. Vesicular breath sounds
2 - each wavelength is partially absorbed by hemoglobin
Manubrio-sternal junction (angle of Louis)
Increased Hb-O2 affinity
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

50. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
results in a lower than normal FEV1%
Dullness replaces resonance
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Oxygen (O2)