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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. forced vital capacity (FVC)
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
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Nitrogen

2. The purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Larger airways
T4 or T5 - and just below the manubrio-sternal joint
Sternocleidomastoid - Scalene Muscles

3. Inspiratory stridor indicates
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
50%
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

4. 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
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
right and left mainstem bronchi
50%

5. The volume of gas remaining in the lungs at the end of normal expiration is called the...
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Pneumonia - obstructive lung disease - and late pulmonary edema
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
Functional residual capacity (FRC)

6. FEV1% in obstructive disease
Total lung capacity (TLC)
Normal to increased FEV1%
results in a lower than normal FEV1%
right & left

7. Airway resistance refers to...
right and left mainstem bronchi
Altering the respiratory rate and/or the tidal volume
Pressure required to drive air through the airways
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

8. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
Soft - high-pitched and crisp
Binding of O2 to Hb
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

9. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Increased Hb-O2 affinity
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Expiration
A sensor placed over a translucent area of arterial pulsation

10. Tachypnea is an
'crackles' or 'rales'
Inside of the thoracic cavity wall and the upper surface of the diaphragm
require supplemental oxygenation and possibly ABG analysis
Increased rate of breathing and is commonly associated with a decrease in tidal volume

11. During inspiration the diaphragm
Contracts
The negative logarithm of hydrogen ions in the blood
Decreased Hb-O2 affinity
Narrowed nearly to the point of closure

12. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Spirometry
Wheezes - high-pitched - musical sounds - distinct whistling quality
A tracing of the lung volume against time in seconds
Dyspnea upon assuming a recumbent position

13. Does lung tissue have pain fibers?
Mouth as well as through the chest wall
No
PaCO2
Increased work of breathing

14. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Diffusion
Upper respiratory obstruction - usually in the trachea or larynx
Louder - lower-pitched - and slightly longer in duration

15. The trachea is how long/wide?
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
10 to 11 cm long and about 2 cm in diameter
Binding of O2 to Hb
Blue or bluish-gray discoloration of the skin or mucous membranes

16. FEV1% in restrictive disease
Wheezes - high-pitched - musical sounds - distinct whistling quality
70% occlusion of the airway
Normal to increased FEV1%
'scooped out' or bowl-shaped

17. With restrictive disease - the flow-volume curve is...
Partial pressure of carbon dioxide in the alveoli
Carboxyhemoglobin
Brief - discrete - non-musical sounds with a popping quality
reduced in size - compared with a normal curve - due to lower lung volume

18. The parietal pleura lines the...
No
Air bubbles flowing through secretions or slightly closed airways during respiration
5 years - to detect obstruction and determine its reversibility
Inside of the thoracic cavity wall and the upper surface of the diaphragm

19. the lingula is analogous to...
The negative logarithm of hydrogen ions in the blood
The right middle lobe
Upper respiratory obstruction - usually in the trachea or larynx
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

20. Oxygen moves from the...
Total lung capacity (TLC)
right & left
Alveoli to the blood
The amount of air that can be inhaled after normal inspiration

21. Bohr Effect of pH: right shift
Functional residual capacity (FRC)
Mouth as well as through the chest wall
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Decreased Hb-O2 affinity

22. Spirometry normal range
80 to 120% of predicted value
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
quickly - usually reaching a plateau within 6.0 seconds
Diaphragm - External Intercostals

23. Coarse crackles are heard in
Pleural space
Pneumonia - obstructive lung disease - and late pulmonary edema
Mediastinum
Brief - discrete - non-musical sounds with a popping quality

24. Continuous lung sounds occur during...
The examiner can clearly distinguish the word that the pt speak or whispers
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Either inspiration or expiration
Portable antero-posterior (AP) view

25. Oximetry readings of < 94%
require supplemental oxygenation and possibly ABG analysis
Interstitial diseases or early pulmonary edema
Lung volumes - but find it difficult to exhale rapidly
right & left

26. Nitroglycerin applied to the probe area has been reported to...
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
The amount of air that can be exhaled after expiration
Overcome some of the problems associated with low blood flow to the probe site
Air to move from the upper airway to the farthest alveolar reaches

27. Rhonchi originate in the...
Carboxyhemoglobin
PaCO2
A tracing of the lung volume against time in seconds
Larger airways

28. PAO2
quickly - usually reaching a plateau within 6.0 seconds
Diffusion
Partial pressure of oxygen in the alveoli
Perfusion

29. FIO2
Fraction (%age) of inspired oxygen
A reduction in lung capacity - secondary to scarring or extraneous material
Partial pressure of CO2 in the arterial blood
Larger airways

30. Late inspiratory crackles result from
Total lung capacity (TLC)
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
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
No respiration for > 20 seconds

31. A normal volume-time curve rises
Air-filled - fluid-filled - or solid
quickly - usually reaching a plateau within 6.0 seconds
Alveoli to the blood
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

32. Compliance
Fraction (%age) of inspired oxygen
70% occlusion of the airway
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)

33. What occurs passively as muscles relax?
Significant pulmonary impairment
Either continuous or discontinuous
quickly - usually reaching a plateau within 6.0 seconds
Expiration

34. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
Mouth as well as through the chest wall
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

35. Examples of restrictive disease
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Tongue
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
80 to 120% of predicted value

36. Abnormal lung sounds AKA

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37. Which lung has an oblique fissure?
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
right & left
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

38. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Dullness replaces resonance
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Perfusion
Increase the intrathoracic space

39. Hyperventilation is defined as
A reduction in lung capacity - secondary to scarring or extraneous material
Increased minute volume ventilation - which results in a lowered carbon dioxide level
The rib above it
'adventitious' breath sounds

40. FEV1/FVC
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Nitrogen
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

41. The vital capacity and the residual volume together constitute the...
Increased Hb-O2 affinity
Expiratory volume - and there is a prolonged expiratory time
Total lung capacity (TLC)
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

42. The main bronchi are divided into smaller branches that begin to subdivide into
Brief - discrete - non-musical sounds with a popping quality
Spirometry
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

43. Pulse Oximetry does not detect
Hypoventilation or modest changes in the PaO2
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Partial pressure of carbon dioxide in the alveoli

44. Spirometry: The result is stated as
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
PaCO2
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Narrowed nearly to the point of closure

45. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiration
Observing the pattern of breathing
Lung volumes - but no difficulty or delay in exhaling what volume they do have
2 - each wavelength is partially absorbed by hemoglobin

46. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Blue or bluish-gray discoloration of the skin or mucous membranes
Increased work of breathing
Dullness replaces resonance
Wheezes - high-pitched - musical sounds - distinct whistling quality

47. Respiration involves
Inflammation of the adjacent parietal pleura
Increased amounts of unsaturated hemoglobin in capillary blood
Ventilation - Diffusion - Perfusion
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

48. pain in lung conditions usually arises from
Inside of the thoracic cavity wall and the upper surface of the diaphragm
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
reduced in size - compared with a normal curve - due to lower lung volume
Inflammation of the adjacent parietal pleura

49. Pulmonary ventilation is varied by
Altering the respiratory rate and/or the tidal volume
The amount of air that can be exhaled after expiration
Partial pressure of carbon dioxide in the alveoli
Speed of airflow - the higher the flow - the greater the resistance

50. Bronchophony
Partial pressure of O2 in the arterial blood
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
Spirometry
The rib above it