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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Oxygen moves from the...
Alveoli to the blood
Blood to the alveoli
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
70%

2. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Air bubbles flowing through secretions or slightly closed airways during respiration
Dullness replaces resonance
10 to 11 cm long and about 2 cm in diameter
The right middle lobe

3. Normal lung sounds
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Diffusion
5 years - to detect obstruction and determine its reversibility
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

4. PACO2
Expiration
Partial pressure of carbon dioxide in the alveoli
Obstructive lung disease from restrictive lung disease
'scooped out' or bowl-shaped

5. PaCO2
Wheezes - high-pitched - musical sounds - distinct whistling quality
5 years - to detect obstruction and determine its reversibility
Outer surface of each lung
Partial pressure of CO2 in the arterial blood

6. office-based spirometry is recommended for patients as young as
Air bubbles flowing through secretions or slightly closed airways during respiration
5 years - to detect obstruction and determine its reversibility
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Left upper lobe

7. The muscles of expiration are the...
10 to 11 cm long and about 2 cm in diameter
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Nitrogen
Pressure required to drive air through the airways

8. The primary muscles of respiration are the...
Diffusion
No
Diaphragm and the intercostal muscles
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

9. Boyle's Gas Law
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
There is an inverse relationship between pressure and volume
A reduction in lung capacity - secondary to scarring or extraneous material
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

10. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Inspiration
A reliable and consistent classification of auditory findings
Insufficient oxygenation of hemoglobin in the lungs

11. within limits - increased temperature =
A reliable and consistent classification of auditory findings
Diffusion
release of O2 from Hb - as heat is a by-product of metabolism.
70% occlusion of the airway

12. terminal respiratory unit
Ventilation
Interstitial diseases or early pulmonary edema
Dyspnea that awakens the patient several hours after going to sleep
Acinus

13. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Larger airways
The atmospheric pressure
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
Pressure required to drive air through the airways

14. The trachea is how long/wide?
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
10 to 11 cm long and about 2 cm in diameter
Inspiration
Increased work of breathing

15. What may prevent cyanosis from appearing?
The atmospheric pressure
Expiratory volume - and there is a prolonged expiratory time
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Soft - high-pitched and crisp

16. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Mediastinum
Observing the pattern of breathing
Right
Functional residual capacity (FRC)

17. Spirometry can be used to determine the severity of functional impairment as well as
Inspiration
35 to 45 mmHg
Perfusion
To assess response to treatment

18. pain in lung conditions usually arises from
The atmospheric pressure
right & left
Partial pressure of oxygen in the alveoli
Inflammation of the adjacent parietal pleura

19. Examples of obstructive disease
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Immediate oxygenation with or without intubation
The rib above it
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

20. Cyanosis is caused by
Cough
right and left mainstem bronchi
50%
Increased amounts of unsaturated hemoglobin in capillary blood

21. The trachea divides into
Expiration
Carboxyhemoglobin
Difficulty breathing or shortness of breath
right and left mainstem bronchi

22. The internal intercostals decrease the transverse diameter of the chest during
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Expiration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
To assess response to treatment

23. Bronchiovesicular breath sounds
Decreased Hb-O2 affinity
Inspiration
Upper respiratory obstruction - usually in the trachea or larynx
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

24. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
80 to 120% of predicted value
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Expiration

25. Coarse crackles are heard in
Pneumonia - obstructive lung disease - and late pulmonary edema
The negative logarithm of hydrogen ions in the blood
80%
Difficulty breathing or shortness of breath

26. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Altering the respiratory rate and/or the tidal volume
No
'scooped out' or bowl-shaped

27. movement of blood through the capillaries in direct communication with the alveoli
Fraction (%age) of inspired oxygen
Diffusion
'adventitious' breath sounds
Perfusion

28. Pulse Oximetry is dependent on...
results in a lower than normal FEV1%
Bronchospasm - mucosal edema - or excessive secretions
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

29. PAO2
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Partial pressure of oxygen in the alveoli
Perfusion
The total amount of air that can be exhaled following a maximal inhalation

30. Spirometry: The result is stated as
Increased amounts of unsaturated hemoglobin in capillary blood
Immediate oxygenation with or without intubation
Dyspnea that awakens the patient several hours after going to sleep
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

31. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
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
Immediate oxygenation with or without intubation
Pleural space
Dyspnea upon assuming a recumbent position

32. Bronchial breath sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
Ventilation
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Saturated with oxygen or unsaturated

33. Carbon dioxide moves from the...
35 to 45 mmHg
Insufficient oxygenation of hemoglobin in the lungs
Blood to the alveoli
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

34. Bohr Effect of pH: right shift
Decreased Hb-O2 affinity
Increased amounts of unsaturated hemoglobin in capillary blood
Left upper lobe
Either inspiration or expiration

35. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
The gas in the conducting airways does not participate in alveolar exchange
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

36. Hyperventilation is defined as
Oxygen (O2)
No
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

37. Patients with restrictive disease have low
No
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
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Ventilation

38. Inspiratory stridor becomes evident at about
Ventilation
Normal to increased FEV1%
70% occlusion of the airway
Manubrio-sternal junction (angle of Louis)

39. inspiratory reserve
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
The amount of air that can be inhaled after normal inspiration
The gas in the conducting airways does not participate in alveolar exchange
No respiration for > 20 seconds

40. the lingula is analogous to...
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Dyspnea that awakens the patient several hours after going to sleep
The right middle lobe
Insufficient oxygenation of hemoglobin in the lungs

41. Rhonchi originate in the...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Acinus
results in a lower than normal FEV1%
Larger airways

42. Apnea is defined as
No respiration for > 20 seconds
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
release of O2 from Hb
Pneumonia - obstructive lung disease - and late pulmonary edema

43. Abnormal lung sounds are classified as
Oxygen (O2)
Either continuous or discontinuous
80%
Observing the pattern of breathing

44. The normal FEV1 /FVC ratio is...
Carboxyhemoglobin
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Pneumonia - obstructive lung disease - and late pulmonary edema
70%

45. The spirometry printout usually includes

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46. dead space ventilation
Lowered carbon dioxide level - results from hyperventilation
The gas in the conducting airways does not participate in alveolar exchange
Acinus
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

47. Tachypnea is an
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
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
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

48. Paroxysmal nocturnal dyspnea (PND) is...
Dyspnea that awakens the patient several hours after going to sleep
Speed of airflow - the higher the flow - the greater the resistance
Inspiration
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

49. Factors that influence the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Perfusion
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Left upper lobe

50. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Outer surface of each lung
2 - each wavelength is partially absorbed by hemoglobin
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Diffusion