General

Question 1

What is the indication for chest tube insertion based on pleural fluid?

Answer 1

Indications of complicated parapneumonic effusion/empyema: pH < 7.20, glucose < 50% of plasma glucose, LDH > 1000 units/L, or a positive gram stain culture

Question 2

What 3 factors are thought to cause increased pulmonary vascular resistance that characterizes PAH?

Answer 2

Vasoconstriction, remodeling of the pulmonary vessel wall, thrombosis in situ

Question 3

What are the causes of hypoxemia?

Answer 3

Decreased inspired oxygen (altitude), hypoventilation (respiratory center depression, neuromuscular disease, or respiratory failure), shunt, V/Q mismatch, diffusion defect

Question 4

What are the causes of hypoxia?

Answer 4

hypoxemic hypoxia, anemia, decrease cardiac output or decreasde local perfusion, decreased release of oxygen from hemoglobin to tissues, cyanide poisoning

Question 5

What shifts the oxyhemoglobin curve to the left (increased O2 affinity)?

Answer 5

alkalosis, hypocarbia, hypothermia, decreased DPG, COhb, fetal Hb

Question 6

What is the expected compensation of a respiratory acidosis?

Answer 6

Change in HCO3 = 0.10 x change in PaCO2 (acute)

Change in HCO3 = 0.35 x change in PaCO2 (chronic)

Question 7

WHat is the expected compensation of a respiratory alkalosis?

Answer 7

Change in HCO3 = 0.2 x change in PaCO2 (acute)

Change in HCO3 = 0.5 x change in PaCO2 (chronic)

Question 8

What is the expected compensation of a Metabolic acidosis?

Answer 8

Change in PaCO2 = 1.2 x change in HCO3

Question 9

What is the expected compensation of a metabolic alkalosis?

Answer 9

change in PaCO2 = 0.9 x change in HCO3

Question 10

What is FEV25-75?

Answer 10

The average flow during the middle half of the FVC maneuver. It is redcued when resistance to airflow increases due to airway obstruction and can correlate with FEV1

Question 11

By what change do you need to see in FEV1 or FVC to indicate reversibility?

Answer 11

200 cc and improve 12% or more

Question 12

What percent change needs to be seen in a bronchial challenge?

Answer 12

20% decrease

Question 13

What disease process can be seen in decreased diffusion capacity of the lung of carbon monoxide?

Answer 13

emphysema, ILD, pulmonary vascular diseases

Question 14

Low DLCO with normal TLC

Answer 14

consider pulmonary vascular disease

Question 15

Normal DLCO with low TLC

Answer 15

chest wall or neuromuscular disease

Question 16

Low DLCO and Low TLC

Answer 16

ILD

Question 17

What do maximal inspiratory pressure and maximal expiratory pressure indicate?

Answer 17

PImax for diaphragmatic muscles, Pexpiratory for abdominal muscles of respiratory