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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Nitroglycerin applied to the probe area has been reported to...
Partial pressure of carbon dioxide in the alveoli
Overcome some of the problems associated with low blood flow to the probe site
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Dullness replaces resonance

2. Coarse crackles result from
Spirometry
'scooped out' or bowl-shaped
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Air bubbles flowing through secretions or slightly closed airways during respiration

3. The pattern of breathing refers to...
release of O2 from Hb
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Functional residual capacity (FRC)
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

4. The tracheo-bronchial tree is a tubular system that provides a pathway for
require supplemental oxygenation and possibly ABG analysis
Insufficient oxygenation of hemoglobin in the lungs
Total lung capacity (TLC)
Air to move from the upper airway to the farthest alveolar reaches

5. The normal FEV1 /FVC ratio is...
T4 or T5 - and just below the manubrio-sternal joint
70%
Portable antero-posterior (AP) view
require supplemental oxygenation and possibly ABG analysis

6. With restrictive disease - the flow-volume curve is...
Binding of O2 to Hb
A reliable and consistent classification of auditory findings
Right
reduced in size - compared with a normal curve - due to lower lung volume

7. A normal volume-time curve rises
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
A reliable and consistent classification of auditory findings
quickly - usually reaching a plateau within 6.0 seconds
Obstructive lung disease from restrictive lung disease

8. Paroxysmal nocturnal dyspnea (PND) is...
Dyspnea that awakens the patient several hours after going to sleep
Ventilation - Diffusion - Perfusion
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

9. Spirometry: The result is stated as
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Expiratory volume - and there is a prolonged expiratory time
Increase the intrathoracic space
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

10. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Interstitial diseases or early pulmonary edema
Fraction (%age) of inspired oxygen
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

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

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12. FEV1% in restrictive disease
Oxygen-Hemoglobin Dissociation Curve
Significant pulmonary impairment
require supplemental oxygenation and possibly ABG analysis
Normal to increased FEV1%

13. Bronchiovesicular breath sounds
To assess response to treatment
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
The total amount of air in the lungs at the end of a maximal inhalation
Partial pressure of O2 in the arterial blood

14. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Partial pressure of carbon dioxide in the alveoli
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
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

15. The presence of pressure gradients causes respiratory gases to move from
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
There is an inverse relationship between pressure and volume
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

16. Late inspiratory crackles result from
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Pleural space
Right
Louder - lower-pitched - and slightly longer in duration

17. During inspiration the diaphragm
Immediate oxygenation with or without intubation
Acinus
Contracts
Brief - discrete - non-musical sounds with a popping quality

18. Chest Radiography: The most common chest X-ray series is the...
To assess response to treatment
Partial pressure of oxygen in the alveoli
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Postero-anterior (PA) and lateral view series

19. The primary muscles of respiration are the...
T4 or T5 - and just below the manubrio-sternal joint
A tracing of the lung volume against time in seconds
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Diaphragm and the intercostal muscles

20. Normal lung sounds
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The examiner can clearly distinguish the word that the pt speak or whispers
Ventilation

21. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
Blood to the alveoli
A good effort
A sensor placed over a translucent area of arterial pulsation
Postero-anterior (PA) and lateral view series

22. Rhonchi frequently clear after
Cough
Increased work of breathing
Left upper lobe
Saturated with oxygen or unsaturated

23. residual volume
A tracing of the lung volume against time in seconds
Fraction (%age) of inspired oxygen
Wheezes - high-pitched - musical sounds - distinct whistling quality
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

24. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
80 to 120% of predicted value
Increased Hb-O2 affinity
Mediastinum
Acinus

25. Rhonchi
Brief - discrete - non-musical sounds with a popping quality
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Partial pressure of oxygen (PO2)
right and left mainstem bronchi

26. The active movement of gases between the ambient air and the lungs
The atmospheric pressure
Difficulty breathing or shortness of breath
Ventilation
The rib above it

27. Cyanosis
Dullness replaces resonance
Expiratory volume - and there is a prolonged expiratory time
A sensor placed over a translucent area of arterial pulsation
Blue or bluish-gray discoloration of the skin or mucous membranes

28. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Mediastinum
Brief - discrete - non-musical sounds with a popping quality
'crackles' or 'rales'
Diffusion

29. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
respiration
Blue or bluish-gray discoloration of the skin or mucous membranes
'crackles' or 'rales'
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

30. The spirometry printout usually includes

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31. Does lung tissue have pain fibers?
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
release of O2 from Hb - as heat is a by-product of metabolism.
Either inspiration or expiration
No

32. The interspace between two ribs (intercostal space) is numbered by
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
The rib above it
Either inspiration or expiration

33. Patients with restrictive disease have low
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Altering the respiratory rate and/or the tidal volume
5 years - to detect obstruction and determine its reversibility
80%

34. within limits - increased temperature =
Obstructive lung disease from restrictive lung disease
release of O2 from Hb - as heat is a by-product of metabolism.
Partial pressure of O2 in the arterial blood
Saturated with oxygen or unsaturated

35. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
Diffusion
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

36. Auscultation of the chest depends on...
A reliable and consistent classification of auditory findings
80%
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 sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

37. Examples of restrictive disease
Nitrogen
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Perfusion
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

38. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Inflammation of the adjacent parietal pleura
Blood to the alveoli
A sensor placed over a translucent area of arterial pulsation
Increase the intrathoracic space

39. high CO2 = high acidity =
release of O2 from Hb
Binding of O2 to Hb
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
T4 or T5 - and just below the manubrio-sternal joint

40. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
5 years - to detect obstruction and determine its reversibility
Increased amounts of unsaturated hemoglobin in capillary blood
Dyspnea upon assuming a recumbent position

41. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Perfusion
No
500 to 800 mL
Saturated with oxygen or unsaturated

42. expiratory reserve
Partial pressure of O2 in the arterial 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
The amount of air that can be exhaled after expiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

43. Cyanosis appears when
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Carboxyhemoglobin
Significant pulmonary impairment

44. FEV1/FVC
The atmospheric pressure
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Expiratory volume - and there is a prolonged expiratory time
10 to 11 cm long and about 2 cm in diameter

45. office-based spirometry is recommended for patients as young as
Pleural space
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
T4 or T5 - and just below the manubrio-sternal joint
5 years - to detect obstruction and determine its reversibility

46. increased volume results in
There is an inverse relationship between pressure and volume
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Portable antero-posterior (AP) view
Decreased pressure

47. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Postero-anterior (PA) and lateral view series
Portable antero-posterior (AP) view
Wheezes - high-pitched - musical sounds - distinct whistling quality
Oxygen (O2)

48. The upper airway accounts For what % of airway resistance?
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Mediastinum
50%
Decreased Hb-O2 affinity

49. Tachypnea is an
Upper respiratory obstruction - usually in the trachea or larynx
Increased rate of breathing and is commonly associated with a decrease in tidal volume
The amount of air that can be exhaled after expiration
reduced in size - compared with a normal curve - due to lower lung volume

50. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dullness replaces resonance
Brief - discrete - non-musical sounds with a popping quality
There is an inverse relationship between pressure and volume
The examiner can clearly distinguish the word that the pt speak or whispers