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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. 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
Partial pressure of oxygen (PO2)
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

2. The main bronchi are divided into smaller branches that begin to subdivide into
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Diaphragm and the intercostal muscles
35 to 45 mmHg
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

3. Continuous lung sounds occur in the setting of...
Bronchospasm - mucosal edema - or excessive secretions
The gas in the conducting airways does not participate in alveolar exchange
Ventilation - Diffusion - Perfusion
Increased rate of breathing and is commonly associated with a decrease in tidal volume

4. Continuous lung sounds
Dyspnea that awakens the patient several hours after going to sleep
The amount of air that can be inhaled after normal inspiration
Wheezes - high-pitched - musical sounds - distinct whistling quality
right and left mainstem bronchi

5. Abnormal lung sounds are classified as
Pneumonia - obstructive lung disease - and late pulmonary edema
Either continuous or discontinuous
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
500 to 800 mL

6. Rhonchi occur during
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Inspiration
Perfusion
Either inspiration or expiration

7. Abnormal lung sounds AKA

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8. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Diffusion
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Upper respiratory obstruction - usually in the trachea or larynx
Increased minute volume ventilation - which results in a lowered carbon dioxide level

9. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Expiratory volume - and there is a prolonged expiratory time
A sensor placed over a translucent area of arterial pulsation
Manubrio-sternal junction (angle of Louis)
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

10. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Soft - high-pitched and crisp
A sensor placed over a translucent area of arterial pulsation
Spirometry

11. Rhonchi frequently clear after
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
Cough
Dullness replaces resonance
Increase the intrathoracic space

12. low CO2 = low acidity =
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Spirometry
Binding of O2 to Hb
Expiratory volume - and there is a prolonged expiratory time

13. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Difficulty breathing or shortness of breath
Partial pressure of oxygen in the alveoli
No respiration for > 20 seconds

14. Continuous lung sounds occur during...
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
A sensor placed over a translucent area of arterial pulsation
Either inspiration or expiration
Excessive secretions and abnormal airway collapsibility

15. Which bronchus is wider - shorter - and more vertically placed?
Right
Normal to increased FEV1%
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

16. gas exchange across the alveolar-pulmonary capillary membranes
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Normal to increased FEV1%
Interstitial diseases or early pulmonary edema
Diffusion

17. Does lung tissue have pain fibers?
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Carboxyhemoglobin
The total amount of air that can be exhaled following a maximal inhalation
No

18. 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
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Either inspiration or expiration
Increased work of breathing

19. PACO2
Partial pressure of carbon dioxide in the alveoli
70%
Air-filled - fluid-filled - or solid
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

20. The visceral pleura lines the...
'crackles' or 'rales'
Outer surface of each lung
Expiratory volume - and there is a prolonged expiratory time
Postero-anterior (PA) and lateral view series

21. Pectoriloquy
A tracing of the lung volume against time in seconds
Air bubbles flowing through secretions or slightly closed airways during respiration
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The examiner can clearly distinguish the word that the pt speak or whispers

22. Airway resistance refers to...
The atmospheric pressure
70% occlusion of the airway
Pressure required to drive air through the airways
Increased amounts of unsaturated hemoglobin in capillary blood

23. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Pressure required to drive air through the airways
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Either continuous or discontinuous

24. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Inspiration
Mediastinum
Expiration
Soft - high-pitched and crisp

25. Spirometry normal range
Inspiration
Partial pressure of carbon dioxide in the alveoli
80 to 120% of predicted value
Air-filled - fluid-filled - or solid

26. normal adult tidal volume
Tongue
Increased minute volume ventilation - which results in a lowered carbon dioxide level
500 to 800 mL
Oxygen-Hemoglobin Dissociation Curve

27. Discontinuous lung sounds are...
'scooped out' or bowl-shaped
Brief - discrete - non-musical sounds with a popping quality
'crackles' or 'rales'
Perfusion

28. hypocapnia
Inspiration
Lowered carbon dioxide level - results from hyperventilation
Observing the pattern of breathing
Dullness replaces resonance

29. The muscles of expiration are the...
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Partial pressure of O2 in the arterial blood
Oxygen-Hemoglobin Dissociation Curve
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

30. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Narrowed nearly to the point of closure
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The right middle lobe
PaCO2

31. Examples of obstructive disease
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Right
Bronchospasm - mucosal edema - or excessive secretions
35 to 45 mmHg

32. Respiration involves
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Ventilation - Diffusion - Perfusion
Sternocleidomastoid - Scalene Muscles
Pulse oximetry

33. movement of blood through the capillaries in direct communication with the alveoli
Oxygen-Hemoglobin Dissociation Curve
Expiration
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Perfusion

34. Spirometry: The result is stated as
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
To assess response to treatment
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Dyspnea upon assuming a recumbent position

35. Normal range of PaCO2
Interstitial diseases or early pulmonary edema
35 to 45 mmHg
T4 or T5 - and just below the manubrio-sternal joint
The amount of air that can be inhaled after normal inspiration

36. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Either inspiration or expiration
Lowered carbon dioxide level - results from hyperventilation
Dullness replaces resonance
Partial pressure of CO2 in the arterial blood

37. An efficient approach to examination of the patient begins with
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
release of O2 from Hb
Observing the pattern of breathing
'crackles' or 'rales'

38. Bohr Effect of pH is graphed as
A good effort
Oxygen-Hemoglobin Dissociation Curve
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Lung volumes - but find it difficult to exhale rapidly

39. Auscultation of the chest depends on...
A reliable and consistent classification of auditory findings
Dyspnea that awakens the patient several hours after going to sleep
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
80%

40. The active movement of gases between the ambient air and the lungs
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Left upper lobe
Larger airways
Ventilation

41. Boyle's Gas Law
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
There is an inverse relationship between pressure and volume
Obstruction below the vocal cords (subglottic or tracheal obstruction)
'crackles' or 'rales'

42. Bohr Effect of pH: left shift
The gas in the conducting airways does not participate in alveolar exchange
Increased Hb-O2 affinity
Louder - lower-pitched - and slightly longer in duration
Interstitial diseases or early pulmonary edema

43. Bronchophony
Either inspiration or expiration
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
Air-filled - fluid-filled - or solid
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

44. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
Right
right
Dyspnea that awakens the patient several hours after going to sleep

45. Which lung has an oblique fissure?
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
Difficulty breathing or shortness of breath
right & left
10 to 11 cm long and about 2 cm in diameter

46. Pulse Oximetry is dependent on...
Partial pressure of O2 in the arterial blood
Air to move from the upper airway to the farthest alveolar reaches
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Diffusion

47. Obstructive disease refers to...
70%
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Acinus
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

48. Patients with restrictive disease have low
Blood to the alveoli
'adventitious' breath sounds
Lung volumes - but no difficulty or delay in exhaling what volume they do have
35 to 45 mmHg

49. The spirometry printout usually includes

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50. Spirometry is useful in distinguishing
Oxygen (O2)
Mediastinum
Observing the pattern of breathing
Obstructive lung disease from restrictive lung disease