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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. Restrictive Disease: Expiratory volume is reduced more than
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Overcome some of the problems associated with low blood flow to the probe site

2. During inspiration the diaphragm
Increased amounts of unsaturated hemoglobin in capillary blood
The examiner can clearly distinguish the word that the pt speak or whispers
results in a lower than normal FEV1%
Contracts

3. Coarse crackles are...
Louder - lower-pitched - and slightly longer in duration
Ventilation - Diffusion - Perfusion
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

4. Carbon dioxide moves from the...
Blood to the alveoli
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Difficulty breathing or shortness of breath
PaCO2

5. high CO2 = high acidity =
Contracts
Increased amounts of unsaturated hemoglobin in capillary blood
release of O2 from Hb
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

6. The upper airway accounts For what % of airway resistance?
Either inspiration or expiration
50%
A tracing of the lung volume against time in seconds
Tongue

7. The external intercostal muscles increase the antero-posterior chest diameter during
The gas in the conducting airways does not participate in alveolar exchange
Inspiration
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
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

8. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Upper respiratory obstruction - usually in the trachea or larynx
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Dyspnea that awakens the patient several hours after going to sleep
Oxygen-Hemoglobin Dissociation Curve

9. most important factor that influences the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2)
Altering the respiratory rate and/or the tidal volume
The amount of air that can be inhaled after normal inspiration
reduced in size - compared with a normal curve - due to lower lung volume

10. Orthopnea is defined as
The rib above it
Soft - high-pitched and crisp
Dyspnea upon assuming a recumbent position
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

11. Percussion helps you establish whether the underlying tissues are...
Brief - discrete - non-musical sounds with a popping quality
Air-filled - fluid-filled - or solid
release of O2 from Hb - as heat is a by-product of metabolism.
Dullness replaces resonance

12. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
50%
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
A good effort
Inside of the thoracic cavity wall and the upper surface of the diaphragm

13. The spirometry printout usually includes

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14. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
require supplemental oxygenation and possibly ABG analysis
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
A tracing of the lung volume against time in seconds

15. Expiratory stridor indicates
Increase the intrathoracic space
Upper respiratory obstruction - usually in the trachea or larynx
A reliable and consistent classification of auditory findings
Obstruction below the vocal cords (subglottic or tracheal obstruction)

16. Continuous lung sounds often audible at the...
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Mouth as well as through the chest wall
quickly - usually reaching a plateau within 6.0 seconds
10 to 11 cm long and about 2 cm in diameter

17. The accessory muscles are the...
Functional residual capacity (FRC)
Diaphragm - External Intercostals
Sternocleidomastoid - Scalene Muscles
Cough

18. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
2 - each wavelength is partially absorbed by hemoglobin
80%
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

19. PaO2
Either continuous or discontinuous
No
Partial pressure of O2 in the arterial blood
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

20. Which bronchus is more susceptible to aspiration of foreign bodies?
Right
Pleural space
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
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

21. FIO2
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Fraction (%age) of inspired oxygen
Inspiration

22. pH
A reduction in lung capacity - secondary to scarring or extraneous material
There is an inverse relationship between pressure and volume
The negative logarithm of hydrogen ions in the blood
Outer surface of each lung

23. Nitroglycerin applied to the probe area has been reported to...
Partial pressure of carbon dioxide in the alveoli
Oxygen (O2)
Overcome some of the problems associated with low blood flow to the probe site
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

24. What occurs passively as muscles relax?
Ventilation - Diffusion - Perfusion
'adventitious' breath sounds
Expiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

25. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Pneumonia - obstructive lung disease - and late pulmonary edema
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Perfusion
Dullness replaces resonance

26. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Diffusion
Lowered carbon dioxide level - results from hyperventilation
Air-filled - fluid-filled - or solid
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

27. The muscles of inspiration are the...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Diaphragm - External Intercostals
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Ventilation - Diffusion - Perfusion

28. Orthopnea is quantified by
Inspiration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Tongue
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

29. forced vital capacity (FVC)
'scooped out' or bowl-shaped
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Expiratory volume - and there is a prolonged expiratory time
The right middle lobe

30. Hyperventilation is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Perfusion
Mediastinum
Air to move from the upper airway to the farthest alveolar reaches

31. gas exchange across the alveolar-pulmonary capillary membranes
Blue or bluish-gray discoloration of the skin or mucous membranes
T4 or T5 - and just below the manubrio-sternal joint
Diffusion
Expiration

32. Which lobe has an inferior tongue-like projection called the lingula?
Left upper lobe
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Insufficient oxygenation of hemoglobin in the lungs
Increased work of breathing

33. The primary muscles of respiration are the...
results in a lower than normal FEV1%
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Diaphragm and the intercostal muscles
Normal to increased FEV1%

34. Examples of obstructive disease
Fraction (%age) of inspired oxygen
Outer surface of each lung
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage

35. Which lung has an oblique fissure?
reduced in size - compared with a normal curve - due to lower lung volume
right & left
The amount of air that can be inhaled after normal inspiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

36. Inspiratory stridor indicates
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Alveoli to the blood
Increased amounts of unsaturated hemoglobin in capillary blood
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

37. Rhonchi
Dullness replaces resonance
Partial pressure of O2 in the arterial blood
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Altering the respiratory rate and/or the tidal volume

38. Restrictive disease refers to...
70% occlusion of the airway
The atmospheric pressure
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
A reduction in lung capacity - secondary to scarring or extraneous material

39. The normal FEV1 /FVC ratio is...
70%
Nitrogen
Postero-anterior (PA) and lateral view series
Inspiration

40. Boyle's Gas Law
Diffusion
Dyspnea upon assuming a recumbent position
There is an inverse relationship between pressure and volume
A sensor placed over a translucent area of arterial pulsation

41. Spirometry is useful in distinguishing
Upper respiratory obstruction - usually in the trachea or larynx
Diffusion
Obstructive lung disease from restrictive lung disease
Either inspiration or expiration

42. 78.08% Atmospheric Composition
Nitrogen
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Total lung capacity (TLC)
Partial pressure of oxygen (PO2)

43. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Pneumonia - obstructive lung disease - and late pulmonary edema
Alveoli to the blood
The right middle lobe

44. Bohr Effect of pH: left shift
Spirometry
Increased Hb-O2 affinity
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
results in a lower than normal FEV1%

45. PaCO2
Pneumonia - obstructive lung disease - and late pulmonary edema
Partial pressure of CO2 in the arterial blood
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

46. Tachypnea is an
T4 or T5 - and just below the manubrio-sternal joint
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Insufficient oxygenation of hemoglobin in the lungs
Increased rate of breathing and is commonly associated with a decrease in tidal volume

47. Bronchophony
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
Nitrogen
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
Difficulty breathing or shortness of breath

48. Continuous lung sounds occur in the setting of...
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
Either continuous or discontinuous
Bronchospasm - mucosal edema - or excessive secretions
The rib above it

49. Continuous lung sounds
Postero-anterior (PA) and lateral view series
Wheezes - high-pitched - musical sounds - distinct whistling quality
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Speed of airflow - the higher the flow - the greater the resistance

50. Rhonchi occur during
500 to 800 mL
Either inspiration or expiration
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Spirometry in the diagnosis - severity staging - and monitoring of these conditions