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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. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Inspiration
Carboxyhemoglobin
Narrowed nearly to the point of closure
Tongue

2. Normal lung sounds
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Perfusion
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Dyspnea upon assuming a recumbent position

3. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
The right middle lobe
A sensor placed over a translucent area of arterial pulsation
Portable antero-posterior (AP) view

4. Obstructive Disease: Expiratory airflow is reduced more than
Expiratory volume - and there is a prolonged expiratory time
Brief - discrete - non-musical sounds with a popping quality
Larger airways
right

5. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The atmospheric pressure
Ventilation - Diffusion - Perfusion
Mediastinum
Air bubbles flowing through secretions or slightly closed airways during respiration

6. PAO2
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Partial pressure of oxygen in the alveoli
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

7. Continuous lung sounds occur during...
Hypoventilation or modest changes in the PaO2
80%
Either inspiration or expiration
70% occlusion of the airway

8. normal subjects expel approximately how much of the FVC in the 1st second?
80%
Mediastinum
Acinus
The right middle lobe

9. The trachea is how long/wide?
The total amount of air that can be exhaled following a maximal inhalation
10 to 11 cm long and about 2 cm in diameter
Alveoli to the blood
Increased minute volume ventilation - which results in a lowered carbon dioxide level

10. The active movement of gases between the ambient air and the lungs
quickly - usually reaching a plateau within 6.0 seconds
Partial pressure of carbon dioxide in the alveoli
Ventilation
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

11. terminal respiratory unit
Acinus
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
A sensor placed over a translucent area of arterial pulsation
50%

12. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Nitrogen
Expiratory volume - and there is a prolonged expiratory time
A good effort

13. Discontinuous lung sounds are...
Dyspnea upon assuming a recumbent position
Brief - discrete - non-musical sounds with a popping quality
80 to 120% of predicted value
Functional residual capacity (FRC)

14. Coarse crackles result from
Larger airways
Outer surface of each lung
Air bubbles flowing through secretions or slightly closed airways during respiration
Spirometry

15. FIO2
70%
Carboxyhemoglobin
Fraction (%age) of inspired oxygen
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

16. Spirometry is useful in distinguishing
Diaphragm - External Intercostals
No respiration for > 20 seconds
PaCO2
Obstructive lung disease from restrictive lung disease

17. The acini consist of the...
'crackles' or 'rales'
A sensor placed over a translucent area of arterial pulsation
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
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

18. Hyperventilation is defined as
Air to move from the upper airway to the farthest alveolar reaches
Increased minute volume ventilation - which results in a lowered carbon dioxide level
500 to 800 mL
Expiration

19. office-based spirometry is recommended for patients as young as
Brief - discrete - non-musical sounds with a popping quality
Inside of the thoracic cavity wall and the upper surface of the diaphragm
5 years - to detect obstruction and determine its reversibility
The right middle lobe

20. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Manubrio-sternal junction (angle of Louis)
Air bubbles flowing through secretions or slightly closed airways during respiration
Spirometry
Either inspiration or expiration

21. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Manubrio-sternal junction (angle of Louis)
Dullness replaces resonance
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

22. high CO2 = high acidity =
Decreased pressure
Speed of airflow - the higher the flow - the greater the resistance
Inside of the thoracic cavity wall and the upper surface of the diaphragm
release of O2 from Hb

23. PaO2
Partial pressure of O2 in the arterial blood
Increased amounts of unsaturated hemoglobin in capillary blood
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Increased work of breathing

24. Boyle's Gas Law
Interstitial diseases or early pulmonary edema
Observing the pattern of breathing
There is an inverse relationship between pressure and volume
Immediate oxygenation with or without intubation

25. Late inspiratory crackles result from
Increased amounts of unsaturated hemoglobin in capillary blood
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
The rib above it
35 to 45 mmHg

26. Orthopnea is quantified by
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
right & left
release of O2 from Hb - as heat is a by-product of metabolism.

27. Cyanosis is caused by
500 to 800 mL
Upper respiratory obstruction - usually in the trachea or larynx
Increased amounts of unsaturated hemoglobin in capillary blood
A good effort

28. Apnea is defined as
Right
No respiration for > 20 seconds
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

29. Egophony

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30. forced expiratory volume in one second (FEV1)
Oxygen-Hemoglobin Dissociation Curve
Air to move from the upper airway to the farthest alveolar reaches
'scooped out' or bowl-shaped
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

31. What occurs passively as muscles relax?
Expiration
The total amount of air that can be exhaled following a maximal inhalation
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

32. Expiratory stridor indicates
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Inspiration
Postero-anterior (PA) and lateral view series

33. A normal volume-time curve rises
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
quickly - usually reaching a plateau within 6.0 seconds
'scooped out' or bowl-shaped
35 to 45 mmHg

34. Spirometry can be used to determine the severity of functional impairment as well as
Larger airways
Altering the respiratory rate and/or the tidal volume
To assess response to treatment
Bicarbonate

35. the lingula is analogous to...
Dullness replaces resonance
The right middle lobe
The atmospheric pressure
Spirometry

36. dead space ventilation
Dyspnea upon assuming a recumbent position
The gas in the conducting airways does not participate in alveolar exchange
Louder - lower-pitched - and slightly longer in duration
The atmospheric pressure

37. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Partial pressure of carbon dioxide in the alveoli
5 years - to detect obstruction and determine its reversibility
Perfusion
require supplemental oxygenation and possibly ABG analysis

38. Fine crackles are heard in
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Interstitial diseases or early pulmonary edema
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The total amount of air in the lungs at the end of a maximal inhalation

39. The trachea bifurcates into its mainstem bronchi at the level of...
Mediastinum
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Excessive secretions and abnormal airway collapsibility
Partial pressure of CO2 in the arterial blood

40. Pulse Oximetry does not detect
Postero-anterior (PA) and lateral view series
Hypoventilation or modest changes in the PaO2
Lung volumes - but find it difficult to exhale rapidly
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

41. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
The gas in the conducting airways does not participate in alveolar exchange
Mediastinum
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
release of O2 from Hb - as heat is a by-product of metabolism.

42. 78.08% Atmospheric Composition
Spirometry
70%
Nitrogen
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

43. Bronchial breath sounds
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Difficulty breathing or shortness of breath
The total amount of air in the lungs at the end of a maximal inhalation
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

44. Chest Radiography: The most common chest X-ray series is the...
Postero-anterior (PA) and lateral view series
Increase the intrathoracic space
No respiration for > 20 seconds
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

45. The best indicator of adequate ventilation is the...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
50%
PaCO2
Binding of O2 to Hb

46. With restrictive disease - the flow-volume curve is...
Mediastinum
reduced in size - compared with a normal curve - due to lower lung volume
There is an inverse relationship between pressure and volume
Hypoventilation or modest changes in the PaO2

47. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Manubrio-sternal junction (angle of Louis)
Expiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Pleural space

48. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
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
Expiratory volume - and there is a prolonged expiratory time
Right

49. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Decreased pressure
Carboxyhemoglobin
Obstructive lung disease from restrictive lung disease

50. Rhonchi originate in the...
Partial pressure of CO2 in the arterial blood
Larger airways
Significant pulmonary impairment
Partial pressure of O2 in the arterial blood