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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. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
respiration
Portable antero-posterior (AP) view
Diffusion
Air-filled - fluid-filled - or solid

2. The presence of pressure gradients causes respiratory gases to move from
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
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
quickly - usually reaching a plateau within 6.0 seconds
Contracts

3. Which lung has an oblique fissure?
Pleural space
Normal to increased FEV1%
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
right & left

4. Restrictive Disease: Expiratory volume is reduced more than
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
There is an inverse relationship between pressure and volume
Inspiration
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

5. terminal respiratory unit
Nitrogen
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Acinus
The right middle lobe

6. Bronchial breath sounds
reduced in size - compared with a normal curve - due to lower lung volume
Cough
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Obstructive lung disease from restrictive lung disease

7. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
reduced in size - compared with a normal curve - due to lower lung volume
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Blood to the alveoli
70%

8. Obstructive disease refers to...
Mediastinum
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
release of O2 from Hb
Carboxyhemoglobin

9. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Perfusion
5 years - to detect obstruction and determine its reversibility
2 - each wavelength is partially absorbed by hemoglobin
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

10. Apnea is defined as
The amount of air that can be exhaled after expiration
No respiration for > 20 seconds
Spirometry
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

11. With restrictive disease - the flow-volume curve is...
Bicarbonate
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
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
reduced in size - compared with a normal curve - due to lower lung volume

12. Which lobe has an inferior tongue-like projection called the lingula?
The total amount of air that can be exhaled following a maximal inhalation
Contracts
T4 or T5 - and just below the manubrio-sternal joint
Left upper lobe

13. Obstructive Disease: Expiratory airflow is reduced more than
Soft - high-pitched and crisp
Expiratory volume - and there is a prolonged expiratory time
right and left mainstem bronchi
Lung volumes - but find it difficult to exhale rapidly

14. Compliance
Observing the pattern of breathing
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 amounts of unsaturated hemoglobin in capillary blood
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

15. increased volume results in
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Dyspnea upon assuming a recumbent position
Decreased pressure
Fraction (%age) of inspired oxygen

16. Spirometry normal range
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Obstructive lung disease from restrictive lung disease
80 to 120% of predicted value

17. Tachypnea is an
Either inspiration or expiration
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Diaphragm - External Intercostals
Partial pressure of carbon dioxide in the alveoli

18. The best indicator of adequate ventilation is the...
Left upper lobe
PaCO2
Increased amounts of unsaturated hemoglobin in capillary blood
'crackles' or 'rales'

19. Abnormal lung sounds are classified as
Obstructive lung disease from restrictive lung disease
Either continuous or discontinuous
Brief - discrete - non-musical sounds with a popping quality
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

20. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Mouth as well as through the chest wall
Air to move from the upper airway to the farthest alveolar reaches
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Inspiration

21. Coarse crackles result from
respiration
Air bubbles flowing through secretions or slightly closed airways during respiration
Mouth as well as through the chest wall
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

22. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
A good effort
Air-filled - fluid-filled - or solid
Total lung capacity (TLC)
Either inspiration or expiration

23. Percussion helps you establish whether the underlying tissues are...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Air-filled - fluid-filled - or solid
Decreased pressure
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

24. vital capacity (VC)
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
The total amount of air that can be exhaled following a maximal inhalation
'scooped out' or bowl-shaped
Perfusion

25. The trachea bifurcates into its mainstem bronchi at the level of...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Diffusion
Nitrogen
No respiration for > 20 seconds

26. The most reliable site for detecting central cyanosis is the...
2 - each wavelength is partially absorbed by hemoglobin
Tongue
Perfusion
PaCO2

27. Inspiratory stridor indicates
Either inspiration or expiration
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
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
results in a lower than normal FEV1%

28. A normal volume-time curve rises
Perfusion
quickly - usually reaching a plateau within 6.0 seconds
Acinus
Binding of O2 to Hb

29. tidal volume (Vt)
Air-filled - fluid-filled - or solid
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

30. What is the potential space between the visceral and parietal pleurae?
Significant pulmonary impairment
Pleural space
Lung volumes - but no difficulty or delay in exhaling what volume they do have
'scooped out' or bowl-shaped

31. Oxygen moves from the...
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Air bubbles flowing through secretions or slightly closed airways during respiration
Oxygen (O2)
Alveoli to the blood

32. The visceral pleura lines the...
Outer surface of each lung
Partial pressure of carbon dioxide in the alveoli
Soft - high-pitched and crisp
PaCO2

33. FEV1% in obstructive disease
results in a lower than normal FEV1%
Immediate oxygenation with or without intubation
Spirometry
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

34. Spirometry plots
'crackles' or 'rales'
A tracing of the lung volume against time in seconds
Mouth as well as through the chest wall
Pressure required to drive air through the airways

35. PaCO2
Lung volumes - but find it difficult to exhale rapidly
Total lung capacity (TLC)
Bronchospasm - mucosal edema - or excessive secretions
Partial pressure of CO2 in the arterial blood

36. 20.95% Atmospheric Composition
Oxygen (O2)
Immediate oxygenation with or without intubation
A tracing of the lung volume against time in seconds
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

37. residual volume
Either inspiration or expiration
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
Soft - high-pitched and crisp
Partial pressure of O2 in the arterial blood

38. Rhonchi are due to...
Diaphragm and the intercostal muscles
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Partial pressure of oxygen (PO2)
Excessive secretions and abnormal airway collapsibility

39. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Perfusion
Partial pressure of oxygen in the alveoli
The amount of air that can be exhaled after expiration

40. The tracheo-bronchial tree is a tubular system that provides a pathway for
Dyspnea that awakens the patient several hours after going to sleep
Sternocleidomastoid - Scalene Muscles
Air to move from the upper airway to the farthest alveolar reaches
The negative logarithm of hydrogen ions in the blood

41. Abnormal lung sounds AKA

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42. The parietal pleura lines the...
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Air to move from the upper airway to the farthest alveolar reaches

43. During inspiration the diaphragm
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
A good effort
Contracts

44. most important factor that influences the oxygen carrying capacity of hemoglobin
Outer surface of each lung
Tongue
Either inspiration or expiration
Partial pressure of oxygen (PO2)

45. Bohr Effect of pH: right shift
50%
70%
Decreased Hb-O2 affinity
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

46. Factors that influence the oxygen carrying capacity of hemoglobin
Speed of airflow - the higher the flow - the greater the resistance
Perfusion
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
80%

47. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Postero-anterior (PA) and lateral view series
right and left mainstem bronchi
Expiratory volume - and there is a prolonged expiratory time
A sensor placed over a translucent area of arterial pulsation

48. The active movement of gases between the ambient air and the lungs
Ventilation
Expiration
80 to 120% of predicted value
Narrowed nearly to the point of closure

49. The muscles of inspiration are the...
Diaphragm - External Intercostals
Postero-anterior (PA) and lateral view series
release of O2 from Hb
Mouth as well as through the chest wall

50. Which bronchus is more susceptible to aspiration of foreign bodies?
Contracts
Right
Tongue
Louder - lower-pitched - and slightly longer in duration