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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. low CO2 = low acidity =
Upper respiratory obstruction - usually in the trachea or larynx
Either inspiration or expiration
PaCO2
Binding of O2 to Hb

2. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Total lung capacity (TLC)
The amount of air that can be exhaled after expiration
Expiratory volume - and there is a prolonged expiratory time

3. Cyanosis is caused by
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Postero-anterior (PA) and lateral view series
Increased amounts of unsaturated hemoglobin in capillary blood
No

4. Inspiratory stridor becomes evident at about
70% occlusion of the airway
quickly - usually reaching a plateau within 6.0 seconds
Partial pressure of oxygen in the alveoli
respiration

5. Coarse crackles result from
Contracts
Air bubbles flowing through secretions or slightly closed airways during respiration
Lung volumes - but no difficulty or delay in exhaling what volume they do have
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

6. Continuous lung sounds occur during...
Blue or bluish-gray discoloration of the skin or mucous membranes
Either inspiration or expiration
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
right & left

7. During inspiration the diaphragm
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Air to move from the upper airway to the farthest alveolar reaches
Contracts
Left upper lobe

8. The purpose of respiration is to...
The total amount of air that can be exhaled following a maximal inhalation
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
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
results in a lower than normal FEV1%

9. Spirometry plots
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
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Bicarbonate
A tracing of the lung volume against time in seconds

10. Nitroglycerin applied to the probe area has been reported to...
Diaphragm - External Intercostals
Normal to increased FEV1%
The gas in the conducting airways does not participate in alveolar exchange
Overcome some of the problems associated with low blood flow to the probe site

11. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Dyspnea upon assuming a recumbent position
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Lung volumes - but no difficulty or delay in exhaling what volume they do have
A sensor placed over a translucent area of arterial pulsation

12. Bohr Effect of pH: left shift
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Increased Hb-O2 affinity
Overcome some of the problems associated with low blood flow to the probe site
Expiration

13. The tracheo-bronchial tree is a tubular system that provides a pathway for
No
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Air to move from the upper airway to the farthest alveolar reaches
Louder - lower-pitched - and slightly longer in duration

14. inspiratory reserve
Partial pressure of oxygen in the alveoli
A tracing of the lung volume against time in seconds
Soft - high-pitched and crisp
The amount of air that can be inhaled after normal inspiration

15. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Acinus
Spirometry
Diaphragm and the intercostal muscles
5 years - to detect obstruction and determine its reversibility

16. Coarse crackles are...
Blood to the alveoli
Louder - lower-pitched - and slightly longer in duration
Either inspiration or expiration
Increased work of breathing

17. PaO2
Blue or bluish-gray discoloration of the skin or mucous membranes
Outer surface of each lung
Binding of O2 to Hb
Partial pressure of O2 in the arterial blood

18. hypocapnia
Carboxyhemoglobin
Lowered carbon dioxide level - results from hyperventilation
35 to 45 mmHg
Contracts

19. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Diaphragm and the intercostal muscles
respiration
Larger airways
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

20. The pattern of breathing refers to...
'crackles' or 'rales'
10 to 11 cm long and about 2 cm in diameter
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

21. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Portable antero-posterior (AP) view
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Ventilation - Diffusion - Perfusion
Carboxyhemoglobin

22. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Inspiration
Nitrogen
results in a lower than normal FEV1%

23. Which lobe has an inferior tongue-like projection called the lingula?
release of O2 from Hb
Left upper lobe
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Dyspnea upon assuming a recumbent position

24. Late inspiratory crackles result from
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Inflammation of the adjacent parietal pleura
Dyspnea upon assuming a recumbent position
Difficulty breathing or shortness of breath

25. The trachea bifurcates into its mainstem bronchi at the level of...
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
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Lung volumes - but no difficulty or delay in exhaling what volume they do have

26. The spirometry printout usually includes

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27. Dyspnea is defined as
Difficulty breathing or shortness of breath
Sternocleidomastoid - Scalene Muscles
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
A reduction in lung capacity - secondary to scarring or extraneous material

28. Bronchial breath sounds
Diffusion
'adventitious' breath sounds
results in a lower than normal FEV1%
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

29. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Cough
Upper respiratory obstruction - usually in the trachea or larynx
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Lung volumes - but find it difficult to exhale rapidly

30. Discontinuous lung sounds are also called

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31. The presence of pressure gradients causes respiratory gases to move from
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
results in a lower than normal FEV1%
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Brief - discrete - non-musical sounds with a popping quality

32. Percussion helps you establish whether the underlying tissues are...
Contracts
Air-filled - fluid-filled - or solid
Mouth as well as through the chest wall
Partial pressure of oxygen (PO2)

33. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Brief - discrete - non-musical sounds with a popping quality
2 - each wavelength is partially absorbed by hemoglobin
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Inside of the thoracic cavity wall and the upper surface of the diaphragm

34. Chest Radiography: The most common chest X-ray series is the...
Pleural space
Postero-anterior (PA) and lateral view series
Perfusion
5 years - to detect obstruction and determine its reversibility

35. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dullness replaces resonance
Fraction (%age) of inspired oxygen
right
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

36. Oxygen moves from the...
Alveoli to the blood
Perfusion
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
Right

37. Respiration involves
Saturated with oxygen or unsaturated
Ventilation - Diffusion - Perfusion
Interstitial diseases or early pulmonary edema
Spirometry

38. Abnormal lung sounds are classified as
Partial pressure of oxygen (PO2)
Either continuous or discontinuous
Blue or bluish-gray discoloration of the skin or mucous membranes
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

39. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Normal to increased FEV1%
Spirometry
Binding of O2 to Hb
Alveoli to the blood

40. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Pleural space
Lung volumes - but find it difficult to exhale rapidly
Narrowed nearly to the point of closure
Increased work of breathing

41. PAO2
Partial pressure of oxygen in the alveoli
Either inspiration or expiration
Dyspnea that awakens the patient several hours after going to sleep
Spirometry

42. Vesicular breath sounds
The total amount of air in the lungs at the end of a maximal inhalation
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
Inspiration
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

43. FEV1% in obstructive disease
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
results in a lower than normal FEV1%
Fraction (%age) of inspired oxygen
500 to 800 mL

44. Continuous lung sounds often audible at the...
No
Mouth as well as through the chest wall
Decreased Hb-O2 affinity
Expiration

45. The best indicator of adequate ventilation is the...
right and left mainstem bronchi
PaCO2
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
To assess response to treatment

46. Restrictive disease refers to...
Inspiration
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
A reduction in lung capacity - secondary to scarring or extraneous material
Overcome some of the problems associated with low blood flow to the probe site

47. Central cyanosis results from
results in a lower than normal FEV1%
Insufficient oxygenation of hemoglobin in the lungs
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
70% occlusion of the airway

48. Resistance is dependent upon
A reliable and consistent classification of auditory findings
70% occlusion of the airway
Speed of airflow - the higher the flow - the greater the resistance
80 to 120% of predicted value

49. most important factor that influences the oxygen carrying capacity of hemoglobin
Increased amounts of unsaturated hemoglobin in capillary blood
Spirometry
Partial pressure of oxygen (PO2)
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

50. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Increased work of breathing
10 to 11 cm long and about 2 cm in diameter
50%