ABG and CXR

Question 1

Type 1 resp failure

Answer 1

hypoxia

Question 2

Type 2 resp failure

Answer 2

hypoxia

hypercapnia

Question 3

Met acidosis

Answer 3

acidic pH

low HCO3

Question 4

resp acidosis acute

Answer 4

acidic pH
high CO2
normal HCO3

Question 5

resp acidosis chronic

Answer 5

acidic pH
high CO2
high HCO3

Question 6

order of looking at ABG

Answer 6

1. pH
2. CO2
3. HCO3
4. O2

Question 7

pO2 for a patient on 60% O2

Answer 7

-10 from 60% for pO2

therefore should have pO2 of 50

Question 8

typical ABG after cardiac arrest

Answer 8

mixed metabolic and respiratory acidosis

Question 9

BE of -9

Answer 9

lack a lot of base, meaning you are acidotic

Question 10

BE +6

Answer 10

more base, meaning you are alkalotic

Question 11

basics to CXR intro

Answer 11

name
date
AP vs PA

Question 12

difference between AP and PA film for CXR

Answer 12

AP can make the heart appear larger

PA is normally used

Question 13

ABCDE of CXR

Answer 13

A - airway (trachea)
B - breathing (lungs)
C - circulation (heart)
D - diaphragm (under and CP angles)
E - everything else (bones and soft tissue)

Question 14

features of pleural effusion

Answer 14

blunting of CP angle
meniscus
opacification

Question 15

locations of masses in CXR

Answer 15

peripheral

hilar

Question 16

round lesion with dark and lighter areas

Answer 16

air free level

Question 17

hilar and mediastinal lymphadenopathy D.Dx

Answer 17

lymphoma
TB
sarcoidosis

Question 18

Heart failure / pulmonary oedema features on CXR

Answer 18

prominent hilar shadowing
fluffy appearance
cardiomegaly

Question 19

dextrocardia

Answer 19

cardiac apex is on the right side

gastric bubble is on the right side too - situs vertus

Question 20

primary ciliary dyskinesia

Answer 20

situs invertus

Question 21

causes of pneumoperitoneum

Answer 21

laparoscopy
bowel perforation
PUD perforation

Question 22

widespread rounded lesions / opacifications in both lung fields

Answer 22

lung metastases

RCC

Question 23

lung fissures on the right lung

Answer 23

horizontal and oblique

Question 24

RUL opacification D.Dx

Answer 24

infection - pneumonia

mass - causing collapse

Question 25

air bronchogram

Answer 25

black markings of trapped air

Question 26

free air in the skin / SC connective tissue space

Answer 26

surgical / SC emphysema

Question 27

pneumomediastinum

Answer 27

air around the heart and aortic knuckle

Question 28

upper lobe vessels should be visible on CXR, true or false

Answer 28

false | that is abnormal, sign of congestion

Question 29

rounded heart shape D.Dx

Answer 29

dilated cardiomyopathy pericardial effusion cardiac tamponade

Question 30

white out of hemithorax with mediastinal shift and tracheal deviation to affected side

Answer 30

pneumonectomy empty space which becomes filled with fluid unaffected lung hyperexpands and pushes away to affected side

Question 31

white out and lung collapse has tracheal deviation to/away from affected side

Answer 31

deviation towards the collapse

Question 32

white out and lung collapse has tracheal deviation to/away from affected side

Answer 32

deviation towards the collapse

Question 33

D.Dx of cavity in upper lobe / apex

Answer 33

tumour abscess TB

Question 34

D.Dx reticulo (lines) nodular (round) shadowing throughout the lungs

Answer 34

ILD | miliary TB

Question 35

what do the following indicate on a CXR line meniscus

Answer 35

line - fluid level | meniscus - effusion

Question 36

D.Dx for pneumomediastinum

Answer 36

oesophageal rupture

Question 37

causes of respiratory acidosis

Answer 37

``` inadequate alveolar ventilation leading to CO2 retention: asthma COPD pneumonia respiratory depression - opioids, BZD GBS mechanical ventilation ```

Question 38

causes of respiratory alkalosis

Answer 38

``` excessive alveolar ventilation (hyperventilation) and blowing off CO2: anxiety / panic attack pain hypoxia PE pneumothorax mechanical ventilation ```

Question 39

causes of metabolic acidosis with a raised anion gap

Answer 39

anything causing ^ acid production: DKA lactic acidosis aspirin overdose

Question 40

causes of metabolic acidosis with a normal/decreased anion gap

Answer 40

decreased acid excretion ie retaining H+: GI loss of HCO3 - diarrhoea, stoma renal tubular acidosis Addisons disease

Question 41

causes of metabolic alkalsosis

Answer 41

loss of H+ and increased HCO3: GI loss of H+ - vomiting renal loss of H+ - diuretics, HF, nephrotic syndrome, cirrhosis, Conns syndrome milk alkali syndrome

Question 42

causes of mixed respiratory and metabolic acidosis

Answer 42

cardiac arrest | multi organ failure