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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. The primary muscles of respiration are the...
Outer surface of each lung
Diaphragm and the intercostal muscles
results in a lower than normal FEV1%
Partial pressure of O2 in the arterial blood

2. Central cyanosis results from
70% occlusion of the airway
80%
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Insufficient oxygenation of hemoglobin in the lungs

3. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Increase the intrathoracic space
Ventilation - Diffusion - Perfusion

4. tidal volume (Vt)
Contracts
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
right
Dullness replaces resonance

5. Normal range of PaCO2
'scooped out' or bowl-shaped
Increase the intrathoracic space
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
35 to 45 mmHg

6. Compliance
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
Decreased pressure
Increased amounts of unsaturated hemoglobin in capillary blood
Postero-anterior (PA) and lateral view series

7. Spirometry is useful in distinguishing
Inflammation of the adjacent parietal pleura
Speed of airflow - the higher the flow - the greater the resistance
Contracts
Obstructive lung disease from restrictive lung disease

8. Discontinuous lung sounds are also called

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9. Rhonchi originate in the...
Observing the pattern of breathing
Larger airways
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Postero-anterior (PA) and lateral view series

10. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Upper respiratory obstruction - usually in the trachea or larynx
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Spirometry

11. The best indicator of adequate ventilation is the...
T4 or T5 - and just below the manubrio-sternal joint
Inflammation of the adjacent parietal pleura
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
PaCO2

12. FIO2
PaCO2
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Fraction (%age) of inspired oxygen
release of O2 from Hb - as heat is a by-product of metabolism.

13. increased volume results in
Difficulty breathing or shortness of breath
Decreased pressure
Inflammation of the adjacent parietal pleura
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

14. inspiratory reserve
Overcome some of the problems associated with low blood flow to the probe site
The amount of air that can be inhaled after normal inspiration
Oxygen (O2)
'scooped out' or bowl-shaped

15. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Obstructive lung disease from restrictive lung disease
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
70% occlusion of the airway
Wheezes - high-pitched - musical sounds - distinct whistling quality

16. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The gas in the conducting airways does not participate in alveolar exchange
Significant pulmonary impairment
The total amount of air in the lungs at the end of a maximal inhalation

17. within limits - increased temperature =
Postero-anterior (PA) and lateral view series
70%
release of O2 from Hb - as heat is a by-product of metabolism.
Increased work of breathing

18. vital capacity (VC)
Outer surface of each lung
Decreased pressure
Fraction (%age) of inspired oxygen
The total amount of air that can be exhaled following a maximal inhalation

19. Examples of restrictive disease
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Partial pressure of O2 in the arterial blood
To assess response to treatment

20. What is the potential space between the visceral and parietal pleurae?
Pleural space
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Inspiration
Portable antero-posterior (AP) view

21. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
The rib above it
2 - each wavelength is partially absorbed by hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Tongue

22. Orthopnea is quantified by
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
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 gas in the conducting airways does not participate in alveolar exchange
Pneumonia - obstructive lung disease - and late pulmonary edema

23. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
Tongue
Significant pulmonary impairment
Right

24. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Right
Diffusion
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Portable antero-posterior (AP) view

25. The normal FEV1 /FVC ratio is...
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
Hypoventilation or modest changes in the PaO2
Binding of O2 to Hb
70%

26. movement of blood through the capillaries in direct communication with the alveoli
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Inflammation of the adjacent parietal pleura
Lung volumes - but find it difficult to exhale rapidly
Perfusion

27. The upper airway accounts For what % of airway resistance?
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Immediate oxygenation with or without intubation
Increased minute volume ventilation - which results in a lowered carbon dioxide level
50%

28. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
70%
Diffusion
A good effort
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

29. 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
Excessive secretions and abnormal airway collapsibility
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Difficulty breathing or shortness of breath

30. Nitroglycerin applied to the probe area has been reported to...
Overcome some of the problems associated with low blood flow to the probe site
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)
Pneumonia - obstructive lung disease - and late pulmonary edema

31. Patients with restrictive disease have low
Increase the intrathoracic space
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Cough

32. Percussion helps you establish whether the underlying tissues are...
Air-filled - fluid-filled - or solid
Mouth as well as through the chest wall
Soft - high-pitched and crisp
'crackles' or 'rales'

33. Orthopnea is defined as
500 to 800 mL
Dyspnea upon assuming a recumbent position
Spirometry
Contracts

34. A normal volume-time curve rises
Narrowed nearly to the point of closure
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Bicarbonate
quickly - usually reaching a plateau within 6.0 seconds

35. The visceral pleura lines the...
A reduction in lung capacity - secondary to scarring or extraneous material
Dyspnea that awakens the patient several hours after going to sleep
The right middle lobe
Outer surface of each lung

36. Oxygen moves from the...
Tongue
Alveoli to the blood
Dyspnea upon assuming a recumbent position
Mouth as well as through the chest wall

37. Continuous lung sounds occur during...
Mouth as well as through the chest wall
quickly - usually reaching a plateau within 6.0 seconds
A reliable and consistent classification of auditory findings
Either inspiration or expiration

38. Pulse Oximetry is dependent on...
results in a lower than normal FEV1%
Normal to increased FEV1%
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

39. high CO2 = high acidity =
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
release of O2 from Hb
To assess response to treatment
Normal to increased FEV1%

40. normal subjects expel approximately how much of the FVC in the 1st second?
Oxygen (O2)
Dyspnea that awakens the patient several hours after going to sleep
The total amount of air that can be exhaled following a maximal inhalation
80%

41. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Brief - discrete - non-musical sounds with a popping quality
Postero-anterior (PA) and lateral view series
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Portable antero-posterior (AP) view

42. At rest - the use of accessory muscles is a sign of...
80%
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Significant pulmonary impairment
Fraction (%age) of inspired oxygen

43. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
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
50%
Dullness replaces resonance
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

44. What occurs passively as muscles relax?
Perfusion
Nitrogen
Bronchospasm - mucosal edema - or excessive secretions
Expiration

45. An efficient approach to examination of the patient begins with
Observing the pattern of breathing
500 to 800 mL
right
Excessive secretions and abnormal airway collapsibility

46. Normal lung sounds
Functional residual capacity (FRC)
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Lowered carbon dioxide level - results from hyperventilation

47. Peripheral cyanosis results from
Wheezes - high-pitched - musical sounds - distinct whistling quality
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
right & left
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

48. Respiration involves
35 to 45 mmHg
Ventilation - Diffusion - Perfusion
Increased work of breathing
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

49. Dyspnea is defined as
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Expiratory volume - and there is a prolonged expiratory time
Diffusion
Difficulty breathing or shortness of breath

50. Spirometry plots
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Right
Pressure required to drive air through the airways
A tracing of the lung volume against time in seconds