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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 plots
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
Decreased pressure
The right middle lobe
A tracing of the lung volume against time in seconds

2. inspiratory reserve
Increased rate of breathing and is commonly associated with a decrease in tidal volume
The amount of air that can be inhaled after normal inspiration
A tracing of the lung volume against time in seconds
Left upper lobe

3. Apnea is defined as
Lung volumes - but find it difficult to exhale rapidly
Manubrio-sternal junction (angle of Louis)
No respiration for > 20 seconds
Oxygen (O2)

4. terminal respiratory unit
Difficulty breathing or shortness of breath
The amount of air that can be inhaled after normal inspiration
Increased Hb-O2 affinity
Acinus

5. The interspace between two ribs (intercostal space) is numbered by
The rib above it
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
The atmospheric pressure
Acinus

6. Peripheral cyanosis results from
Expiration
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Perfusion
Upper respiratory obstruction - usually in the trachea or larynx

7. FIO2
Fraction (%age) of inspired oxygen
Either inspiration or expiration
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

8. office-based spirometry is recommended for patients as young as
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
5 years - to detect obstruction and determine its reversibility
Spirometry
Wheezes - high-pitched - musical sounds - distinct whistling quality

9. Continuous lung sounds occur in the setting of...
Wheezes - high-pitched - musical sounds - distinct whistling quality
Bronchospasm - mucosal edema - or excessive secretions
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
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

10. The purpose of respiration is to...
Either inspiration or expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Outer surface of each lung
No respiration for > 20 seconds

11. Bohr Effect of pH: right shift
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Decreased Hb-O2 affinity
require supplemental oxygenation and possibly ABG analysis
Cough

12. Pulmonary ventilation is varied by
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
Altering the respiratory rate and/or the tidal volume
Normal to increased FEV1%
Pulse oximetry

13. Discontinuous lung sounds are also called

14. Pectoriloquy
Wheezes - high-pitched - musical sounds - distinct whistling quality
Fraction (%age) of inspired oxygen
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
The examiner can clearly distinguish the word that the pt speak or whispers

15. Spirometry can be used to determine the severity of functional impairment as well as
Speed of airflow - the higher the flow - the greater the resistance
To assess response to treatment
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Increased work of breathing

16. Patients with obstructive disease have normal
Dullness replaces resonance
Lung volumes - but find it difficult to exhale rapidly
A reliable and consistent classification of auditory findings
The amount of air that can be inhaled after normal inspiration

17. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Air-filled - fluid-filled - or solid
Increased work of breathing
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
70%

18. FEV1% in obstructive disease
results in a lower than normal FEV1%
Spirometry
Increased work of breathing
Louder - lower-pitched - and slightly longer in duration

19. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Spirometry
Air bubbles flowing through secretions or slightly closed airways during respiration
Postero-anterior (PA) and lateral view series

20. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
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
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Perfusion
Inspiration

21. Which lobe has an inferior tongue-like projection called the lingula?
80 to 120% of predicted value
Sternocleidomastoid - Scalene Muscles
Wheezes - high-pitched - musical sounds - distinct whistling quality
Left upper lobe

22. Pulse Oximetry is dependent on...
Diffusion
Acinus
Decreased Hb-O2 affinity
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

23. Normal lung sounds
Either inspiration or expiration
Partial pressure of carbon dioxide in the alveoli
Nitrogen
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

24. What is the potential space between the visceral and parietal pleurae?
Right
Pleural space
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
A reliable and consistent classification of auditory findings

25. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Inspiration
Louder - lower-pitched - and slightly longer in duration
50%
Air-filled - fluid-filled - or solid

26. pain in lung conditions usually arises from
The total amount of air in the lungs at the end of a maximal inhalation
500 to 800 mL
Inflammation of the adjacent parietal pleura
Increased amounts of unsaturated hemoglobin in capillary blood

27. Spirometry: The result is stated as
Partial pressure of O2 in the arterial blood
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The gas in the conducting airways does not participate in alveolar exchange
Contracts

28. pH
The negative logarithm of hydrogen ions in the blood
Increased amounts of unsaturated hemoglobin in capillary blood
Air-filled - fluid-filled - or solid
The rib above it

29. Restrictive Disease: Expiratory volume is reduced more than
Bicarbonate
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

30. The most reliable site for detecting central cyanosis is the...
Nitrogen
Tongue
Pressure required to drive air through the airways
Significant pulmonary impairment

31. normal subjects expel approximately how much of the FVC in the 1st second?
Blood to the alveoli
Immediate oxygenation with or without intubation
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
80%

32. Continuous lung sounds occur during...
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The negative logarithm of hydrogen ions in the blood
Either inspiration or expiration
Nitrogen

33. With restrictive disease - the flow-volume curve is...
Either inspiration or expiration
Overcome some of the problems associated with low blood flow to the probe site
There is an inverse relationship between pressure and volume
reduced in size - compared with a normal curve - due to lower lung volume

34. forced expiratory volume in one second (FEV1)
Increased minute volume ventilation - which results in a lowered carbon dioxide level
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
Mediastinum
PaCO2

35. FEV1% in restrictive disease
Normal to increased FEV1%
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
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
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

36. 20.95% Atmospheric Composition
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Cough
There is an inverse relationship between pressure and volume
Oxygen (O2)

37. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Functional residual capacity (FRC)
Fraction (%age) of inspired oxygen
50%
right and left mainstem bronchi

38. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Spirometry
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
Manubrio-sternal junction (angle of Louis)
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

39. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Oxygen-Hemoglobin Dissociation Curve
Partial pressure of carbon dioxide in the alveoli
'adventitious' breath sounds
Narrowed nearly to the point of closure

40. The trachea is how long/wide?
Increased work of breathing
Larger airways
The total amount of air that can be exhaled following a maximal inhalation
10 to 11 cm long and about 2 cm in diameter

41. Obstructive Disease: Expiratory airflow is reduced more than
Altering the respiratory rate and/or the tidal volume
Mouth as well as through the chest wall
Expiratory volume - and there is a prolonged expiratory time
Partial pressure of O2 in the arterial blood

42. Examples of restrictive disease
Mouth as well as through the chest wall
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
Postero-anterior (PA) and lateral view series

43. The muscles of expiration are the...
Alveoli to the blood
Oxygen-Hemoglobin Dissociation Curve
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

44. Dyspnea is defined as
Excessive secretions and abnormal airway collapsibility
Observing the pattern of breathing
Difficulty breathing or shortness of breath
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

45. Factors that influence the oxygen carrying capacity of hemoglobin
Significant pulmonary impairment
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
right and left mainstem bronchi
Obstructive lung disease from restrictive lung disease

46. low CO2 = low acidity =
A reduction in lung capacity - secondary to scarring or extraneous material
Binding of O2 to Hb
respiration
Alveoli to the blood

47. FEV1/FVC
Diaphragm - External Intercostals
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Observing the pattern of breathing

48. The visceral pleura lines the...
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Outer surface of each lung
'adventitious' breath sounds

49. The trachea divides into
Overcome some of the problems associated with low blood flow to the probe site
right and left mainstem bronchi
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Lung volumes - but no difficulty or delay in exhaling what volume they do have

50. Tachypnea is an
Partial pressure of carbon dioxide in the alveoli
Saturated with oxygen or unsaturated
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Increased rate of breathing and is commonly associated with a decrease in tidal volume