Ch. 1 & 2 Quiz Flashcards

1
Q

What are the 4 indications for PFTs?

A

• diagnosis
• monitoring
• screening
• effects of chemicals or toxic meds

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2
Q

What are the 3 things PFTs measure?

A

• spirometry
• lung volumes & capacities
• DLCO

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3
Q

What is the gold standard for the diagnosis of obstructive disease?

A

Spirometry

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4
Q

What is the gold standard for restrictive disease?

A

Lung volumes & capacities

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5
Q

What does the DLCO measure?

A

Conductance of gas transfer from the inspired gas to the RBCs (Carbon monoxide [CO] “gas exchange”)

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6
Q

What are the 4 categories used to classify lung disease?

A

• obstructive
• restrictive
• mixed or combined
• pulmonary vascular disease

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7
Q

What are the 2 types of PFTs?

A

standard & specialized

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8
Q

What do standard PFTs consist of?

A

• spirometry
• DLCO
• lung volumes

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9
Q

Name 3 different specialized PFTs?

A

• ABG
• 6 min walk test
• exercise oximetry

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10
Q

Name a few things you should consider/notify the patient of when preparing for a test?

A

• no smoking
• no caffeine
• no large meals
• withhold meds
• no perfumes or colognes

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11
Q

How long should you withhold these meds?
Bronchodilators, Steroids, Maintenance drugs, Anticholinergic drugs?

A

Bronchodilators = 4-6 hrs
Steroids = never withhold
Maintenance drugs = 12 hrs
Anticholinergic = 24 hrs

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12
Q

What demographics should we consider for PFTs? What is the last one that is not included but we should still consider?

A

•Height
• Age
• Race
• Gender
weight

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13
Q

PFTs are _______ dependent

A

Effort

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14
Q

Tests must be ________ and ________

A

Acceptable ; replicable

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15
Q

Name 3 reasons a test may be invalid?

A

Coughing
Pain
Poor pt effort

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16
Q

To get valid results pt must be ________

A

Coached

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17
Q

What are some things you should do when you get invalid test results?

A

• re- instruct
• re demonstrate
• re encourage
• ask another therapist
• try again

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18
Q

You must get ______ replicable tests in a maximum of ______ attempts

A

3 ; 8

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19
Q

What are the 2 types of vitals capacity?

A

SVC & FVC

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20
Q

What does SVC measure?

A

Total volume of air that can be exhaled after a maximum inspiration (relaxed)

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21
Q

What does FVC measure?

A

Total volume of air that can be exhaled out of the lungs after a maximum inhalation (blast it out! Forced)

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22
Q

What is the most widely used test in PFTs?

A

FVC

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23
Q

What circumstances would you see the SVC smaller than the the FVC? What does this indicate?

A

Never ; poor or effort

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24
Q

What circumstance would you see the FVC larger than the SVC?

A

Air trapping

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25
Q

What does the FEV1 measure? What is it measured during?

A

Amount of air measured in 1 sec? The FVC

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26
Q

How much air should you be able to blow out in the FEV1? If the pt blows out less what does that tell you?

A

75% ; severity

27
Q

What does the FEV1/FVC ratio define?

A

If there is an obstruction

28
Q

What does the FEV1 define?

A

The severity of obstruction (or restriction)

29
Q

What percentage indicates obstruction of the FEV1/FVC is less than?

A

75%

30
Q

FVC is used for _______?

A

Validation

31
Q

If the FVC is normal or higher than_____% you have an _______ only.

A

80 ; obstruction

32
Q

If the FVC is less than ______ % you may have an ________ ________ as well or a ________ ________.

A

80 ; restrictive component ; mixed effect

33
Q

FEV1 less than or equal too ___% to determine _______.

A

80 ; severity

34
Q

Put these in order from most important to less important for interpretation of PFTs? (FVC, FEV1, FEV1/FVC ratio)

A

2.FVC
1.FEV1/FVC ratio
3.FEV1

35
Q

What are the percentage value ranges for the classification of the severity measurements of FEV1

A

Mild = 70 to 79%
Moderate = 60 to 69%
Moderately severe = 50 to 59%
Severe = 35 to 49%
Very severe < 35%

36
Q

What type of flow volume loop is this?

A

Normal flow loop

37
Q

What type of flow volume loop is this?

A

Air trapping

38
Q

What type of flow volume loop is this?

A

Obstructed upper airway

39
Q

What type of low volume loop is this?

A

Small volume in, small volume out

40
Q

FEF 25 - 75% is measured during the ______ and after _______ .

A

FVC ; peak expiratory flow

41
Q

FEF 25 to 75% measures flow at which percentages?

A

• 25%
• 75 %

42
Q

Which test is the most accurate measure to determine patient effort?

A

FEF 50%

43
Q

Three test should be within _______ % of the FVC to meet criteria?

A

5

44
Q

Peak flow is defined as?

A

Maximal inspiration followed by maximal expiration

45
Q

What are the demographics we should consider for peak flow

A

Height
Age
Gender

46
Q

What patient population uses peak flow a lot

A

Asthma patients

47
Q

How many times/breaths should you do daily for peak flow? How long should you record results for?

A

3 times/breaths ; 2 weeks

48
Q

Describe the different zones for peak flow?

A

Green zone = all symptoms go symptom-free and managing adequately
Yellow zone = caution symptoms worsening contact your position
Red zone = danger! notify your physician or go

49
Q

What are the percentages for the three zones?

A

Green = 80 to 100%
Yellow = 50 to 79%
Red <50 %

50
Q

The MVV is maximum _______ and full _______ .

A

Inspiration ; expiration

51
Q

During the MVV, the patient will have what type of breathing?

A

Rapid, forced breathing

52
Q

During the MVV the patient is breathing ____ to _____ bpm and the test must last ____ to _____ seconds long.

A

90-100 ; 12-15

53
Q

What are the three things that the MVV measures?

A

Resistance
Lung compliance
Respiratory muscle strength

54
Q

What are the pre-and post-bronchodilator studies used to determine?

A

Reversibility of airway obstruction

55
Q

What is the most commonly used drug in pre-post a bronchidilators studies?

A

Albuterol

56
Q

Why do we use a high dose of albuterol in the pre-and post bronchodilator studies?

A

Albuterol has a rapid onset time

57
Q

You should stop an albuterol treatment if your patients heart rate increases by how much?

A

25 bpm

58
Q

T or F Levelalbuterol or Atrovent may be used in place of albuterol if the patient cannot/will not tolerate the increase in heart rate because these drugs do not have the effect?

A

True

59
Q

The FVC or FEV1 should increase by how much to indicate if the response to bronchodilator treatment is significant?

A

12% or more

60
Q

How far away from the mouth should a patient hold an MDI?

A

1 inch

61
Q

How long should a patient wait between breaths? Why?

A

30 seconds to one minute; time to observe any adverse reactions and give medication time to activate

62
Q

How long should the inspiratory hold last after inhaling the medication from an MDI?

A

5 to 10 seconds

63
Q

If an MDI or DPI contain steroids, what must the patient do? Why?

A

Rinse their mouth; failure to rinse can cause oral thrush