PANCE PULMONOLOGY BLUEPRINT |ACTUAL
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
To diagnose chronic bronchitis, the patient has to have had a productive cough for at least
....
A. 1 year
B. 2 months a year for 2 consecutive years
C. 2 months a year for 3 consecutive years
D. 3 months a year for 2 consecutive years
E. 3 months a year for 3 consecutive years
CORRECT ANSWER
D. 3 months a year for 2 consecutive years
Question 2
MC etiology of chronic bronchitis
A. Infection
B. Smoking
C. Air pollution
D. Hazardous dust
E. Idiopathic
CORRECT ANSWER
B. Smoking
1
, Chronic inflammation → mucous gland hyperplasia, goblet cell mucus production,
dysfunctional + damaged cilia, & infiltration of neutrophils and CD8+ cells
Question 3
What are the cardinal symptoms of chronic bronchitis?
A. Purulent sputum, wheezing, congestion
B. Cyanotic, obese, dx of emphysema
C. Chronic cough, sputum production, dyspnea
D. Rhonchi, obstructive pattern, fever
E. Respiratory acidosis, restrictive pattern, SOB
CORRECT ANSWER
C. Chronic cough, sputum production, dyspnea
Others
+/- prolonged expiration.
Crackles (rales), rhonchi, wheezing
+/- Signs of cor pulmonale (enlarged tender liver, JVD, peripheral edema)
Cyanosis and obesity "blue bloaters".
30-40 yrs
Peripheral edema
Question 4
What is the gold standard of diagnosis for COPD?
2
,A. Clinical diagnosis
B. Chest CT
C. EKG
D. Endoscopy
E. PFT
CORRECT ANSWER
E. PFT
Pulmonary function test: gold standard
Obstructive pattern, not fully reversible
Airway obstruction: decreased FEV1, decreased FEV1/FVC <70% predicted, decreased
FVC.
GOLD criteria looks at FEV1 and FEV1/FVC ratio
Hyperinflation: increased volumes (eg, RV,TLC,RV/TLC,FRC). Normal DLCO.
Question 5
Which of the following would be noted in a PFT of chronic bronchitis?
A. Restrictive pattern
B. Hyperinflation
C. Decreased DLCO
D. Increased FEV1
CORRECT ANSWER
B. Hyperinflation
Obstructive pattern, not fully reversible
3
, Airway obstruction: decreased FEV1, decreased FEV1/FVC <70% predicted, decreased
FVC.
GOLD criteria looks at FEV1 and FEV1/FVC ratio
Hyperinflation: increased volumes (eg, RV,TLC,RV/TLC,FRC). Normal DLCO.
Question 6
Your patient has severe chronic bronchitis. Which of the following tests is NOT something
you would expect to find in a patient with this diagnosis?
A. ABG: respiratory alkalosis
B. EKG: RVH, right atrial enlargement
C. CXR: increased AP diameter and vascular markings
D. CBC: increased hemoglobin and hematocrit
E. PFT: decreased FEV1, decreased FEV1/FVC <70%
CORRECT ANSWER
A. ABG: respiratory alkalosis
ABG: respiratory acidosis (severe hypoxemia and hypercapnia).
Pulmonary function test: gold standard
Obstructive pattern, not fully reversible
Airway obstruction: decreased FEV1, decreased FEV1/FVC <70% predicted, decreased
FVC.
GOLD criteria looks at FEV1 and FEV1/FVC ratio
Hyperinflation: increased volumes (eg, RV,TLC,RV/TLC,FRC). Normal DLCO.
CXR: pulmonary HTN (eg, enlarged right heart border, increased AP diameter and
vascular markings)
EKG: cor pulmonale (eg, RVH, right atrial enlargement, right axis deviation).
4
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
To diagnose chronic bronchitis, the patient has to have had a productive cough for at least
....
A. 1 year
B. 2 months a year for 2 consecutive years
C. 2 months a year for 3 consecutive years
D. 3 months a year for 2 consecutive years
E. 3 months a year for 3 consecutive years
CORRECT ANSWER
D. 3 months a year for 2 consecutive years
Question 2
MC etiology of chronic bronchitis
A. Infection
B. Smoking
C. Air pollution
D. Hazardous dust
E. Idiopathic
CORRECT ANSWER
B. Smoking
1
, Chronic inflammation → mucous gland hyperplasia, goblet cell mucus production,
dysfunctional + damaged cilia, & infiltration of neutrophils and CD8+ cells
Question 3
What are the cardinal symptoms of chronic bronchitis?
A. Purulent sputum, wheezing, congestion
B. Cyanotic, obese, dx of emphysema
C. Chronic cough, sputum production, dyspnea
D. Rhonchi, obstructive pattern, fever
E. Respiratory acidosis, restrictive pattern, SOB
CORRECT ANSWER
C. Chronic cough, sputum production, dyspnea
Others
+/- prolonged expiration.
Crackles (rales), rhonchi, wheezing
+/- Signs of cor pulmonale (enlarged tender liver, JVD, peripheral edema)
Cyanosis and obesity "blue bloaters".
30-40 yrs
Peripheral edema
Question 4
What is the gold standard of diagnosis for COPD?
2
,A. Clinical diagnosis
B. Chest CT
C. EKG
D. Endoscopy
E. PFT
CORRECT ANSWER
E. PFT
Pulmonary function test: gold standard
Obstructive pattern, not fully reversible
Airway obstruction: decreased FEV1, decreased FEV1/FVC <70% predicted, decreased
FVC.
GOLD criteria looks at FEV1 and FEV1/FVC ratio
Hyperinflation: increased volumes (eg, RV,TLC,RV/TLC,FRC). Normal DLCO.
Question 5
Which of the following would be noted in a PFT of chronic bronchitis?
A. Restrictive pattern
B. Hyperinflation
C. Decreased DLCO
D. Increased FEV1
CORRECT ANSWER
B. Hyperinflation
Obstructive pattern, not fully reversible
3
, Airway obstruction: decreased FEV1, decreased FEV1/FVC <70% predicted, decreased
FVC.
GOLD criteria looks at FEV1 and FEV1/FVC ratio
Hyperinflation: increased volumes (eg, RV,TLC,RV/TLC,FRC). Normal DLCO.
Question 6
Your patient has severe chronic bronchitis. Which of the following tests is NOT something
you would expect to find in a patient with this diagnosis?
A. ABG: respiratory alkalosis
B. EKG: RVH, right atrial enlargement
C. CXR: increased AP diameter and vascular markings
D. CBC: increased hemoglobin and hematocrit
E. PFT: decreased FEV1, decreased FEV1/FVC <70%
CORRECT ANSWER
A. ABG: respiratory alkalosis
ABG: respiratory acidosis (severe hypoxemia and hypercapnia).
Pulmonary function test: gold standard
Obstructive pattern, not fully reversible
Airway obstruction: decreased FEV1, decreased FEV1/FVC <70% predicted, decreased
FVC.
GOLD criteria looks at FEV1 and FEV1/FVC ratio
Hyperinflation: increased volumes (eg, RV,TLC,RV/TLC,FRC). Normal DLCO.
CXR: pulmonary HTN (eg, enlarged right heart border, increased AP diameter and
vascular markings)
EKG: cor pulmonale (eg, RVH, right atrial enlargement, right axis deviation).
4
