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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. normal adult tidal volume
Increased work of breathing
70% occlusion of the airway
Immediate oxygenation with or without intubation
500 to 800 mL

2. FEV1/FVC
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Increased Hb-O2 affinity
Total lung capacity (TLC)

3. Rhonchi occur during
Either inspiration or expiration
Interstitial diseases or early pulmonary edema
Diaphragm - External Intercostals
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

4. Apnea is defined as
A reliable and consistent classification of auditory findings
The examiner can clearly distinguish the word that the pt speak or whispers
Narrowed nearly to the point of closure
No respiration for > 20 seconds

5. Which bronchus is more susceptible to aspiration of foreign bodies?
require supplemental oxygenation and possibly ABG analysis
Postero-anterior (PA) and lateral view series
Right
Either inspiration or expiration

6. Restrictive Disease: Expiratory volume is reduced more than
There is an inverse relationship between pressure and volume
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Dullness replaces resonance
Expiration

7. The accessory muscles are the...
right & left
Sternocleidomastoid - Scalene Muscles
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
80 to 120% of predicted value

8. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Immediate oxygenation with or without intubation
Mouth as well as through the chest wall
Perfusion

9. Nitroglycerin applied to the probe area has been reported to...
Increased Hb-O2 affinity
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Observing the pattern of breathing
Overcome some of the problems associated with low blood flow to the probe site

10. The active movement of gases between the ambient air and the lungs
Right
Ventilation
Contracts
Excessive secretions and abnormal airway collapsibility

11. Tachypnea is an
Diaphragm - External Intercostals
Lung volumes - but find it difficult to exhale rapidly
Decreased pressure
Increased rate of breathing and is commonly associated with a decrease in tidal volume

12. The muscles of inspiration are the...
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Interstitial diseases or early pulmonary edema
Cough
Diaphragm - External Intercostals

13. high CO2 = high acidity =
70%
To assess response to treatment
release of O2 from Hb
Tongue

14. Which lung has a horizontal fissure?
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Diffusion
right
Dyspnea upon assuming a recumbent position

15. Examples of restrictive disease
Saturated with oxygen or unsaturated
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Insufficient oxygenation of hemoglobin in the lungs
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

16. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Tongue
Right

17. At rest - the use of accessory muscles is a sign of...
35 to 45 mmHg
Significant pulmonary impairment
Pulse oximetry
Difficulty breathing or shortness of breath

18. expiratory reserve
The amount of air that can be exhaled after expiration
Excessive secretions and abnormal airway collapsibility
right
Perfusion

19. The trachea is how long/wide?
Nitrogen
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
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
10 to 11 cm long and about 2 cm in diameter

20. Fine crackles are heard in
release of O2 from Hb - as heat is a by-product of metabolism.
Portable antero-posterior (AP) view
Interstitial diseases or early pulmonary edema
Decreased pressure

21. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
A sensor placed over a translucent area of arterial pulsation
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
A reliable and consistent classification of auditory findings
Insufficient oxygenation of hemoglobin in the lungs

22. vital capacity (VC)
The rib above it
The total amount of air that can be exhaled following a maximal inhalation
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Bronchospasm - mucosal edema - or excessive secretions

23. What occurs passively as muscles relax?
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
Expiration
Partial pressure of carbon dioxide in the alveoli
Ventilation

24. The trachea divides into
right and left mainstem bronchi
Partial pressure of oxygen in the alveoli
Louder - lower-pitched - and slightly longer in duration
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

25. Cyanosis is caused by
The negative logarithm of hydrogen ions in the blood
Outer surface of each lung
Increased amounts of unsaturated hemoglobin in capillary blood
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

26. Which lobe has an inferior tongue-like projection called the lingula?
Left upper lobe
Tongue
Right
Pleural space

27. The internal intercostals decrease the transverse diameter of the chest during
Expiration
Mediastinum
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
reduced in size - compared with a normal curve - due to lower lung volume

28. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
2 - each wavelength is partially absorbed by hemoglobin
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Right
Decreased pressure

29. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increased Hb-O2 affinity
Increase the intrathoracic space
Significant pulmonary impairment
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

30. Carbon dioxide moves from the...
Blood to the alveoli
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
right and left mainstem bronchi
To assess response to treatment

31. Chest Radiography: The most common chest X-ray series is the...
Brief - discrete - non-musical sounds with a popping quality
Expiratory volume - and there is a prolonged expiratory time
Postero-anterior (PA) and lateral view series
Partial pressure of O2 in the arterial blood

32. pain in lung conditions usually arises from
Perfusion
Inflammation of the adjacent parietal pleura
The atmospheric pressure
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

33. 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
Pulse oximetry
Either inspiration or expiration
Blood to the alveoli
Air bubbles flowing through secretions or slightly closed airways during respiration

34. PAO2
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Partial pressure of oxygen in the alveoli
Air bubbles flowing through secretions or slightly closed airways during respiration
Increase the intrathoracic space

35. Pulmonary ventilation is varied by
Altering the respiratory rate and/or the tidal volume
Alveoli to the blood
2 - each wavelength is partially absorbed by hemoglobin
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

36. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
The atmospheric pressure
Dyspnea upon assuming a recumbent position
50%

37. Orthopnea is defined as
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Dyspnea upon assuming a recumbent position
release of O2 from Hb
Louder - lower-pitched - and slightly longer in duration

38. low CO2 = low acidity =
Carboxyhemoglobin
Binding of O2 to Hb
Obstructive lung disease from restrictive lung disease
Expiratory volume - and there is a prolonged expiratory time

39. Bronchial breath sounds
Mediastinum
Upper respiratory obstruction - usually in the trachea or larynx
Insufficient oxygenation of hemoglobin in the lungs
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

40. Pulse Oximetry is dependent on...
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Expiration
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
A tracing of the lung volume against time in seconds

41. Spirometry normal range
Overcome some of the problems associated with low blood flow to the probe site
Increased rate of breathing and is commonly associated with a decrease in tidal volume
80 to 120% of predicted value
Left upper lobe

42. The normal FEV1 /FVC ratio is...
The negative logarithm of hydrogen ions in the blood
Carboxyhemoglobin
'adventitious' breath sounds
70%

43. Orthopnea is quantified by
Diffusion
Bronchospasm - mucosal edema - or excessive secretions
T4 or T5 - and just below the manubrio-sternal joint
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

44. FEV1% in obstructive disease
results in a lower than normal FEV1%
Diaphragm and the intercostal muscles
A tracing of the lung volume against time in seconds
Brief - discrete - non-musical sounds with a popping quality

45. Continuous lung sounds occur during...
Either inspiration or expiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Binding of O2 to Hb
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

46. The presence of pressure gradients causes respiratory gases to move from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
A reduction in lung capacity - secondary to scarring or extraneous material
A reliable and consistent classification of auditory findings
35 to 45 mmHg

47. What is the potential space between the visceral and parietal pleurae?
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Pleural space
Nitrogen
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

48. Dyspnea is defined as
Lowered carbon dioxide level - results from hyperventilation
Difficulty breathing or shortness of breath
Diffusion
To assess response to treatment

49. Pectoriloquy
Hypoventilation or modest changes in the PaO2
The examiner can clearly distinguish the word that the pt speak or whispers
Larger airways
The gas in the conducting airways does not participate in alveolar exchange

50. terminal respiratory unit
Oxygen (O2)
Acinus
The atmospheric pressure
Altering the respiratory rate and/or the tidal volume