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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. normal adult tidal volume
Tongue
Increase the intrathoracic space
500 to 800 mL
Lung volumes - but no difficulty or delay in exhaling what volume they do have

2. Pulse Oximetry is dependent on...
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Sternocleidomastoid - Scalene Muscles
Soft - high-pitched and crisp
To assess response to treatment

3. Discontinuous lung sounds are also called

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4. The internal intercostals decrease the transverse diameter of the chest during
The total amount of air that can be exhaled following a maximal inhalation
reduced in size - compared with a normal curve - due to lower lung volume
A tracing of the lung volume against time in seconds
Expiration

5. Orthopnea is defined as
Dyspnea upon assuming a recumbent position
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Inflammation of the adjacent parietal pleura
Lung volumes - but find it difficult to exhale rapidly

6. forced expiratory volume in one second (FEV1)
Dullness replaces resonance
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
Increase the intrathoracic space
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

7. Examples of obstructive disease
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
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
80%

8. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Decreased Hb-O2 affinity
Right
Manubrio-sternal junction (angle of Louis)
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

9. Oxygen moves from the...
Alveoli to the blood
Increased Hb-O2 affinity
Either continuous or discontinuous
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

10. Fine crackles are heard in
Interstitial diseases or early pulmonary edema
No respiration for > 20 seconds
No
quickly - usually reaching a plateau within 6.0 seconds

11. inspiratory reserve
The atmospheric pressure
Contracts
The amount of air that can be inhaled after normal inspiration
Mouth as well as through the chest wall

12. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Ventilation
Diaphragm - External Intercostals
quickly - usually reaching a plateau within 6.0 seconds
A good effort

13. A normal volume-time curve rises
The right middle lobe
5 years - to detect obstruction and determine its reversibility
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
quickly - usually reaching a plateau within 6.0 seconds

14. The trachea divides into
A reliable and consistent classification of auditory findings
Blue or bluish-gray discoloration of the skin or mucous membranes
Larger airways
right and left mainstem bronchi

15. FIO2
Sternocleidomastoid - Scalene Muscles
Fraction (%age) of inspired oxygen
Right
Increased minute volume ventilation - which results in a lowered carbon dioxide level

16. The spirometry printout usually includes

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17. Pectoriloquy
Normal to increased FEV1%
The examiner can clearly distinguish the word that the pt speak or whispers
Oxygen (O2)
Contracts

18. within limits - increased temperature =
Air-filled - fluid-filled - or solid
Partial pressure of oxygen (PO2)
release of O2 from Hb - as heat is a by-product of metabolism.
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

19. Examples of restrictive disease
Perfusion
A good effort
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

20. Pulse Oximetry does not detect
Mediastinum
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Mouth as well as through the chest wall
Hypoventilation or modest changes in the PaO2

21. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Expiratory volume - and there is a prolonged expiratory time
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Hypoventilation or modest changes in the PaO2
Alveoli to the blood

22. Spirometry normal range
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Portable antero-posterior (AP) view
80 to 120% of predicted value
Lung volumes - but find it difficult to exhale rapidly

23. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
Pneumonia - obstructive lung disease - and late pulmonary edema
50%
500 to 800 mL

24. 20.95% Atmospheric Composition
Oxygen (O2)
The right middle lobe
right
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

25. Vesicular breath sounds
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Acinus
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
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

26. Which lung has a horizontal fissure?
Acinus
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Increase the intrathoracic space
right

27. Abnormal lung sounds are classified as
Narrowed nearly to the point of closure
Decreased pressure
Either continuous or discontinuous
Overcome some of the problems associated with low blood flow to the probe site

28. Spirometry can be used to determine the severity of functional impairment as well as
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Bicarbonate
To assess response to treatment
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

29. gas exchange across the alveolar-pulmonary capillary membranes
Bicarbonate
A reliable and consistent classification of auditory findings
Diffusion
T4 or T5 - and just below the manubrio-sternal joint

30. Spirometry is useful in distinguishing
Carboxyhemoglobin
Diaphragm and the intercostal muscles
Obstructive lung disease from restrictive lung disease
Oxygen (O2)

31. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
Right
Carboxyhemoglobin
To assess response to treatment

32. Bronchiovesicular breath sounds
The gas in the conducting airways does not participate in alveolar exchange
Either inspiration or expiration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Spirometry

33. 78.08% Atmospheric Composition
Inspiration
Bronchospasm - mucosal edema - or excessive secretions
Nitrogen
Interstitial diseases or early pulmonary edema

34. The trachea is how long/wide?
Observing the pattern of breathing
Pneumonia - obstructive lung disease - and late pulmonary edema
10 to 11 cm long and about 2 cm in diameter
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

35. Tachypnea is an
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
There is an inverse relationship between pressure and volume
Increased rate of breathing and is commonly associated with a decrease in tidal volume
respiration

36. movement of blood through the capillaries in direct communication with the alveoli
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Perfusion
PaCO2
Functional residual capacity (FRC)

37. Boyle's Gas Law
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Left upper lobe
There is an inverse relationship between pressure and volume
Inspiration

38. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Increased Hb-O2 affinity
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Immediate oxygenation with or without intubation

39. Central cyanosis results from
Outer surface of each lung
Insufficient oxygenation of hemoglobin in the lungs
Partial pressure of oxygen (PO2)
Perfusion

40. Oximetry readings of < 94%
Either continuous or discontinuous
Speed of airflow - the higher the flow - the greater the resistance
require supplemental oxygenation and possibly ABG analysis
'crackles' or 'rales'

41. Percussion helps you establish whether the underlying tissues are...
Mouth as well as through the chest wall
Air-filled - fluid-filled - or solid
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Tongue

42. high CO2 = high acidity =
release of O2 from Hb
Ventilation
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
There is an inverse relationship between pressure and volume

43. PaCO2
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
No respiration for > 20 seconds
Partial pressure of CO2 in the arterial blood
Ventilation - Diffusion - Perfusion

44. Inspiratory stridor becomes evident at about
A good effort
Dyspnea that awakens the patient several hours after going to sleep
Dyspnea upon assuming a recumbent position
70% occlusion of the airway

45. Compliance
Larger airways
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
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

46. Pulmonary ventilation is varied by
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Altering the respiratory rate and/or the tidal volume
Mediastinum
'crackles' or 'rales'

47. Spirometry: The result is stated as
Right
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Inflammation of the adjacent parietal pleura

48. The presence of pressure gradients causes respiratory gases to move from
Expiration
release of O2 from Hb
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Excessive secretions and abnormal airway collapsibility

49. Respiration involves
Ventilation - Diffusion - Perfusion
Diaphragm and the intercostal 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
Nitrogen

50. Restrictive disease refers to...
Excessive secretions and abnormal airway collapsibility
A reduction in lung capacity - secondary to scarring or extraneous material
The negative logarithm of hydrogen ions in the blood
Soft - high-pitched and crisp