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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. Typically - in the presence of obstructive disease - the flow-volume curve looks

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2. Rhonchi occur during
Insufficient oxygenation of hemoglobin in the lungs
PaCO2
Either inspiration or expiration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

3. Which bronchus is wider - shorter - and more vertically placed?
Right
Larger airways
Normal to increased FEV1%
Alveoli to the blood

4. Bohr Effect of pH: right shift
Decreased Hb-O2 affinity
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
There is an inverse relationship between pressure and volume
Postero-anterior (PA) and lateral view series

5. Continuous lung sounds
'crackles' or 'rales'
Oxygen (O2)
Wheezes - high-pitched - musical sounds - distinct whistling quality
Expiratory volume - and there is a prolonged expiratory time

6. FEV1% in restrictive disease
Insufficient oxygenation of hemoglobin in the lungs
Normal to increased FEV1%
Inflammation of the adjacent parietal pleura
A reliable and consistent classification of auditory findings

7. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Pneumonia - obstructive lung disease - and late pulmonary edema
Lung volumes - but find it difficult to exhale rapidly
The total amount of air that can be exhaled following a maximal inhalation

8. PaCO2
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
Inspiration
Partial pressure of CO2 in the arterial blood

9. high CO2 = high acidity =
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Altering the respiratory rate and/or the tidal volume
release of O2 from Hb
Larger airways

10. FEV1/FVC
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Pressure required to drive air through the airways
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

11. Expiratory stridor indicates
Carboxyhemoglobin
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Perfusion
Lung volumes - but no difficulty or delay in exhaling what volume they do have

12. Restrictive Disease: Expiratory volume is reduced more than
Decreased Hb-O2 affinity
The total amount of air that can be exhaled following a maximal inhalation
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

13. Examples of restrictive disease
Pulse oximetry
Partial pressure of CO2 in the arterial blood
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Total lung capacity (TLC)

14. Normal lung sounds
Partial pressure of O2 in the arterial blood
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Air to move from the upper airway to the farthest alveolar reaches
Postero-anterior (PA) and lateral view series

15. Which bronchus is more susceptible to aspiration of foreign bodies?
Partial pressure of oxygen in the alveoli
The amount of air that can be inhaled after normal inspiration
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
Right

16. most important factor that influences the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2)
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
Increased Hb-O2 affinity
Altering the respiratory rate and/or the tidal volume

17. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Difficulty breathing or shortness of breath
Mediastinum
Spirometry
Partial pressure of oxygen in the alveoli

18. Pulmonary ventilation is varied by
Altering the respiratory rate and/or the tidal volume
Inspiration
Blue or bluish-gray discoloration of the skin or mucous membranes
'crackles' or 'rales'

19. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Partial pressure of O2 in the arterial blood
Spirometry
Decreased pressure
Acinus

20. The trachea divides into
Manubrio-sternal junction (angle of Louis)
Total lung capacity (TLC)
right and left mainstem bronchi
Increased work of breathing

21. Pulse Oximetry does not detect
Sternocleidomastoid - Scalene Muscles
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
Hypoventilation or modest changes in the PaO2
Normal to increased FEV1%

22. Normal range of PaCO2
Postero-anterior (PA) and lateral view series
2 - each wavelength is partially absorbed by hemoglobin
35 to 45 mmHg
Spirometry

23. The spirometry printout usually includes

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24. The purpose of respiration is to...
Alveoli to the blood
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Diffusion

25. The presence of pressure gradients causes respiratory gases to move from
quickly - usually reaching a plateau within 6.0 seconds
Right
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Insufficient oxygenation of hemoglobin in the lungs

26. Apnea is defined as
Increased Hb-O2 affinity
PaCO2
No respiration for > 20 seconds
Insufficient oxygenation of hemoglobin in the lungs

27. forced vital capacity (FVC)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Overcome some of the problems associated with low blood flow to the probe site
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Obstructive lung disease from restrictive lung disease

28. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Obstructive lung disease from restrictive lung disease
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Functional residual capacity (FRC)

29. Bohr Effect of pH is graphed as
Interstitial diseases or early pulmonary edema
Blue or bluish-gray discoloration of the skin or mucous membranes
Oxygen-Hemoglobin Dissociation Curve
Dyspnea that awakens the patient several hours after going to sleep

30. FEV1% in obstructive disease
5 years - to detect obstruction and determine its reversibility
Ventilation - Diffusion - Perfusion
release of O2 from Hb - as heat is a by-product of metabolism.
results in a lower than normal FEV1%

31. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Diffusion
Increased work of breathing
Mediastinum
A tracing of the lung volume against time in seconds

32. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dullness replaces resonance
Either inspiration or expiration
10 to 11 cm long and about 2 cm in diameter
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

33. Which lobe has an inferior tongue-like projection called the lingula?
Inside of the thoracic cavity wall and the upper surface of the diaphragm
There is an inverse relationship between pressure and volume
Fraction (%age) of inspired oxygen
Left upper lobe

34. Continuous lung sounds occur during...
Either inspiration or expiration
Dullness replaces resonance
Hypoventilation or modest changes in the PaO2
Partial pressure of oxygen (PO2)

35. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Larger airways
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Altering the respiratory rate and/or the tidal volume
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

36. The internal intercostals decrease the transverse diameter of the chest during
Total lung capacity (TLC)
80%
Mouth as well as through the chest wall
Expiration

37. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Narrowed nearly to the point of closure
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
The amount of air that can be exhaled after expiration

38. Stridor is a high-pitched - noisy respiration - Which is indicative of...
'crackles' or 'rales'
Partial pressure of oxygen (PO2)
Upper respiratory obstruction - usually in the trachea or larynx
PaCO2

39. PACO2
Tongue
Partial pressure of carbon dioxide in the alveoli
Spirometry
Partial pressure of CO2 in the arterial blood

40. Respiration involves
Portable antero-posterior (AP) view
T4 or T5 - and just below the manubrio-sternal joint
Postero-anterior (PA) and lateral view series
Ventilation - Diffusion - Perfusion

41. terminal respiratory unit
Interstitial diseases or early pulmonary edema
Either inspiration or expiration
Acinus
Sternocleidomastoid - Scalene Muscles

42. Continuous lung sounds occur in the setting of...
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Spirometry
Bronchospasm - mucosal edema - or excessive secretions
Partial pressure of oxygen in the alveoli

43. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
A sensor placed over a translucent area of arterial pulsation
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

44. Bronchial breath sounds
Significant pulmonary impairment
Inflammation of the adjacent parietal pleura
Hypoventilation or modest changes in the PaO2
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

45. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
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
Mediastinum
The total amount of air that can be exhaled following a maximal inhalation
Immediate oxygenation with or without intubation

46. expiratory reserve
Manubrio-sternal junction (angle of Louis)
PaCO2
The amount of air that can be exhaled after expiration
Brief - discrete - non-musical sounds with a popping quality

47. During inspiration the diaphragm
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Inspiration
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Contracts

48. inspiratory reserve
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Difficulty breathing or shortness of breath
The amount of air that can be inhaled after normal inspiration

49. The normal FEV1 /FVC ratio is...
Increased Hb-O2 affinity
5 years - to detect obstruction and determine its reversibility
right and left mainstem bronchi
70%

50. Tachypnea is an
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
Partial pressure of oxygen in the alveoli
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Carboxyhemoglobin