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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. Late inspiratory crackles result from
Sternocleidomastoid - Scalene Muscles
10 to 11 cm long and about 2 cm in diameter
require supplemental oxygenation and possibly ABG analysis
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

2. What may prevent cyanosis from appearing?
Air-filled - fluid-filled - or solid
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
respiration
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

3. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Mediastinum
Portable antero-posterior (AP) view
Blue or bluish-gray discoloration of the skin or mucous membranes
No

4. Which lung has a horizontal fissure?
Binding of O2 to Hb
Manubrio-sternal junction (angle of Louis)
Outer surface of each lung
right

5. The primary muscles of respiration are the...
Obstruction below the vocal cords (subglottic or tracheal obstruction)
80%
Diaphragm and the intercostal muscles
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

6. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Increased amounts of unsaturated hemoglobin in capillary blood
require supplemental oxygenation and possibly ABG analysis
Manubrio-sternal junction (angle of Louis)
Pressure required to drive air through the airways

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

8. Spirometry plots
require supplemental oxygenation and possibly ABG analysis
'adventitious' breath sounds
A tracing of the lung volume against time in seconds
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

9. The main bronchi are divided into smaller branches that begin to subdivide into
Dullness replaces resonance
Cough
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Air-filled - fluid-filled - or solid

10. The pattern of breathing refers to...
No respiration for > 20 seconds
Spirometry
80 to 120% of predicted value
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

11. Oximetry readings of < 94%
Bicarbonate
require supplemental oxygenation and possibly ABG analysis
50%
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

12. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
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
Partial pressure of carbon dioxide in the alveoli
Increased work of breathing

13. Bronchial breath sounds
Portable antero-posterior (AP) view
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 (PO2) - Bohr effect of pH - Temperature
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

14. Continuous lung sounds occur during...
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Sternocleidomastoid - Scalene Muscles
Either inspiration or expiration
Oxygen-Hemoglobin Dissociation Curve

15. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Speed of airflow - the higher the flow - the greater the resistance
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Increase the intrathoracic space
Partial pressure of carbon dioxide in the alveoli

16. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Normal to increased FEV1%
50%
Spirometry

17. Abnormal lung sounds AKA

18. Chest Radiography: The most common chest X-ray series is the...
Brief - discrete - non-musical sounds with a popping quality
Wheezes - high-pitched - musical sounds - distinct whistling quality
The amount of air that can be exhaled after expiration
Postero-anterior (PA) and lateral view series

19. The accessory muscles are the...
No
Saturated with oxygen or unsaturated
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Sternocleidomastoid - Scalene Muscles

20. low CO2 = low acidity =
Narrowed nearly to the point of closure
Spirometry
Binding of O2 to Hb
Functional residual capacity (FRC)

21. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Saturated with oxygen or unsaturated
Oxygen-Hemoglobin Dissociation Curve
Functional residual capacity (FRC)
Blue or bluish-gray discoloration of the skin or mucous membranes

22. Spirometry can be used to determine the severity of functional impairment as well as
A reduction in lung capacity - secondary to scarring or extraneous material
Interstitial diseases or early pulmonary edema
'scooped out' or bowl-shaped
To assess response to treatment

23. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
T4 or T5 - and just below the manubrio-sternal joint
Inspiration
Air bubbles flowing through secretions or slightly closed airways during respiration

24. vital capacity (VC)
Blue or bluish-gray discoloration of the skin or mucous membranes
Pleural space
The total amount of air that can be exhaled following a maximal inhalation
No respiration for > 20 seconds

25. A state-of-the-art - inexpensive - non-invasive - simple method to monitor a patient's percent hemoglobin saturation with oxygen (SaO2) - without having to obtain an arterial blood specimen
release of O2 from Hb
Pulse oximetry
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Increased amounts of unsaturated hemoglobin in capillary blood

26. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
70% occlusion of the airway
Immediate oxygenation with or without intubation
Left upper lobe
Manubrio-sternal junction (angle of Louis)

27. The trachea is how long/wide?
10 to 11 cm long and about 2 cm in diameter
Postero-anterior (PA) and lateral view series
Increased work of breathing
To assess response to treatment

28. PaCO2
Either inspiration or expiration
35 to 45 mmHg
Partial pressure of CO2 in the arterial blood
'adventitious' breath sounds

29. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Immediate oxygenation with or without intubation
Perfusion
Partial pressure of oxygen (PO2)
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

30. 78.08% Atmospheric Composition
Insufficient oxygenation of hemoglobin in the lungs
Diaphragm - External Intercostals
Nitrogen
Portable antero-posterior (AP) view

31. Paroxysmal nocturnal dyspnea (PND) is...
Dyspnea that awakens the patient several hours after going to sleep
The atmospheric pressure
Obstructive lung disease from restrictive lung disease
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

32. Restrictive Disease: Expiratory volume is reduced more than
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
Perfusion
results in a lower than normal FEV1%

33. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Brief - discrete - non-musical sounds with a popping quality
Manubrio-sternal junction (angle of Louis)
Ventilation - Diffusion - Perfusion

34. Restrictive disease refers to...
2 - each wavelength is partially absorbed by hemoglobin
A reduction in lung capacity - secondary to scarring or extraneous material
The total amount of air that can be exhaled following a maximal inhalation
Spirometry

35. most important factor that influences the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2)
Decreased Hb-O2 affinity
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

36. Factors that influence the oxygen carrying capacity of hemoglobin
The amount of air that can be exhaled after expiration
Perfusion
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

37. Apnea is defined as
Excessive secretions and abnormal airway collapsibility
require supplemental oxygenation and possibly ABG analysis
Saturated with oxygen or unsaturated
No respiration for > 20 seconds

38. Continuous lung sounds occur in the setting of...
Bronchospasm - mucosal edema - or excessive secretions
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Fraction (%age) of inspired oxygen
The total amount of air in the lungs at the end of a maximal inhalation

39. the lingula is analogous to...
The right middle lobe
There is an inverse relationship between pressure and volume
Inflammation of the adjacent parietal pleura
Oxygen (O2)

40. PAO2
Blood to the alveoli
Larger airways
quickly - usually reaching a plateau within 6.0 seconds
Partial pressure of oxygen in the alveoli

41. Normal lung sounds
The examiner can clearly distinguish the word that the pt speak or whispers
80%
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

42. tidal volume (Vt)
The gas in the conducting airways does not participate in alveolar exchange
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Decreased pressure
release of O2 from Hb - as heat is a by-product of metabolism.

43. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Either inspiration or expiration
The atmospheric pressure
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Dyspnea upon assuming a recumbent position

44. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Diffusion
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
Excessive secretions and abnormal airway collapsibility
Upper respiratory obstruction - usually in the trachea or larynx

45. The acini consist of the...
A good effort
Expiratory volume - and there is a prolonged expiratory time
5 years - to detect obstruction and determine its reversibility
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

46. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Wheezes - high-pitched - musical sounds - distinct whistling quality
Either inspiration or expiration
Diffusion
A good effort

47. Airway resistance refers to...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Pressure required to drive air through the airways
Partial pressure of carbon dioxide in the alveoli
80 to 120% of predicted value

48. forced vital capacity (FVC)
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Air to move from the upper airway to the farthest alveolar reaches
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
The amount of air that can be exhaled after expiration

49. Respiration involves
Ventilation - Diffusion - Perfusion
Blood to the alveoli
Decreased pressure
T4 or T5 - and just below the manubrio-sternal joint

50. Hyperventilation is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Insufficient oxygenation of hemoglobin in the lungs
respiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions