Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PCH CCTC Study > Lung and Heart/Lung > Flashcards

Lung and Heart/Lung Flashcards

(83 cards)

Start Studying
1
Q

The 4 common indications for lung transplant are…

A
  • Obstructive disease
  • Restrictive disease
  • Septic disease
  • Vascular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

COPD/Emphysemia are examples of what type of lung disease?

A

Obstructive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What disorder leads to a build-up of AAT (A1AT) in the liver and a decrease of AAT in the lungs (causes lung disease).

A

Alpha-1 Antitrypsin Deficiency (ATT/A1AT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ATT/A1AT is an example of which kind of lung disease?

A

Obstructive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Idiopathic pulmonary fibrosis is an example of which kind of lung disease?

A

Restrictive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Sarcoidosis-inflammatory disease is an example of which kind of lung disease?

A

Restrictive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cystic fibrosis is an example of which kind of lung disease?

A

Septic lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A double lung transplant will usually be required for which kind of lung diseases?

2 items

A
  • Restrictive disease
  • Septic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The disease where bronchial tubes are permanently damaged, widened, and thickened, resulting in frequent infections and blockages of the airway is called…

A

Bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bronchiectasis is an example of which kind of lung disease?

A

Septic lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Primary pulmonary hypertension is an example of what kind of lung disease?

A

Vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Eisenmengers Syndrome caused by?

A

a congenital heart defect, which causes pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic Pulmonary Thromboembolism is an example of which kind of lung disease?

A

Vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the indicates for a heart-lung transplant?

3 items

A
  • irreparable congenital cardiac defects with end-stage pulmonary hypertension
  • end-stage lung disease with left heart failure
  • end-stage lung disease with irreparable ischemic heart disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Transplant for restrictive lung disease is considered with what testing results?

4 testing results, 1 diagnosis

A
  • Post BD FVC <60-70% predicted
  • DLCO <50-60%
  • PaO2 <55 mm Hg
  • PaCO2 >= 45 mm Hg
  • Secondary Pulmonary Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Transplant for obstructive lung disease is considered with…

3 items

A
  • Post BD FEV1 <25% predicted
  • PaCO2 >= 55 mm Hg
  • Increased pulmonary artery pressures with progressive deterioration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Transplant for vascular disease is considered when…

Regarding function…

A

low functional status despite optimal treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Transplant for septic disease is considered with…

4 results, 1 trend

A
  • Post BD FEV1 <30% predicted
  • FVC <= 40% predicted
  • PaO2 <= 55 mm Hg
  • PaCO2 >= 45 mm Hg
  • Progressive decline in clinic course
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Absolute contraindications to lung transplant are…

3 items

A
  • HIV+, HepBsAg+, Hep C with abnormal biopsy
  • Active or recent cigarette smoking
  • Significant neurological, renal, hepatic, or cardiac impairment (at time of eval)

Malignancy, which includes other types of transplants as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Transplant evaluation specific to lung includes…

7 items

A
  • PFTs
  • CXR
  • Exercise studies
  • Rehab (PT/RT consult)
  • V/Q scan
  • Barium swallow
  • Cardiac cath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

On the Pulmonary Function Test, what is the following:

TLC

A

Total lung capacity

The total volume of gas contained in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

On the Pulmonary Function Test, what is the following:

FRC

A

Functional residual capacity

The volume of gas left in lungs after comfortable expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

On the Pulmonary Function Test, what is the following:

RV

A

Residual volume

The volume of gas left in the lungs after forced expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

On the Pulmonary Function Test, what is the following:

VC

A

Vital capacity

The difference between TLC and RV lung volumes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
The Pulmonary Function Test determines...
The type of lung disease (restrictive/obstructive)
26
The FVC represents
the entire volume exhaled from the lungs in a forced breath
27
The FEV1 represents
the volume of gas exhaled in the first second of exhalation
28
The FEV1/FVC determines if
the lung disease is obstructive
29
The TLC determines if
the lung disease is restrictive
30
What does an FEV1 < 65-80% indicate?
mild obstruction
31
What does an FEV1 < 50-65% indicate?
moderate obstruction
32
What does an FEV1 < 50% indicate?
severe obstruction
33
What does a TLC of 65-80% indicate?
mild restriction
34
What does a TLC of 50-65% indicate?
moderate restriction
35
What does a TLC of < 50% indicate?
severe restriction
36
What is a V/Q scan?
an imaging test that uses a ventilation (V) scan to measure air flow in the lungs and a perfusion (Q) scan to see where blood flows in the lungs
37
What can a V/Q scan help rule out?
a pulmonary embolism/blood clots
38
What is the scoring system used for lung allocation when listing for transplant?
Lung Allocation Score (LAS)
39
At what age does the Lung Allocation Score begin?
12
40
Be familiar with the variables used in the Lung Allocation Score...
* FVC/Percent of FVC * PA systolic/mean * Central venous pressure * PCW pressure * PaO2 at rest * 6 minute walk test distance * Functional status * Presence of DM * Use of assisted ventilation * Age * Serum creatinine/hemoglobin/hematocrit/bilirubin * Blood gas (venous or arterial) pH/pCO2 * Height/weight * Disease diagnosis
41
Patients that are <12 years of age are categorized in one of two groups for lung transplant allocation scores. What are the groups? | 2 items
Priority 1 Priority 2
42
What are the requirements for being assigned Priority 1 for lung transplant listing? | 2 items
Have at least one of the following: * respiratory failure * pulmonary hypertension
43
What are the clinical requirements for respiratory failure determination for Priority 1 patients? | 4 items
* requires continuous mechanical ventilation * Requires supplemental O2 delivered by any means to achieve FiO2 greater than 50% in order to maintain O2 sats > 90% * Has an arterial or capillary PCO2 greater than 50 mmHg * Has a venous PCO2 greater than 56 mmHg
44
What are the clinical requirements for pulmonary hypertension determination for Priority 1 patients? | 5 items
* pulmonary vein stenosis involving 3 or more vessels One of the following despite medical therapy: * Cardiac index less than 2 L/min/M2 * Syncope * Hemoptysis * Suprasystemic PA pressure on cardiac catheterization or by echocardiogram estimate
45
If a patient <12 years of age does not meet Priority 1 requirements, at what Priority will they be listed?
Priority 2
46
How often must you update UNET to maintain the requirements for Priority 1 lung status?
Every 6 months
47
For adult patients with an LAS over 50, how often must requirements be updated?
Every 2 weeks
48
All LAS data for lung patients must be updated how often?
Every 6 months
49
What type of transplant is mandatory for septic lung disease? A. Single lung transplant B. Bilteral lung transplant C. Heart and lung transplant (single or bilateral)
B
50
What are the criteria for the optimal lung donor? | 7 items
* <55 years old * Clear CXR * Manageable sputum gram stain * PaO2 > 300 mmHg on FiO2 of 100%, 5 PEEP * Less than 72 hours on ventilar * No significant smoking history * Maximum ischemic time 4-6 hours
51
What is lung donor recipient matching based on? | 7 items
* ABO * LAS * Laterality * Size * Height * Recipient pathology * HLA considerations (crossmatching, HLA antigens, etc.)
52
Lung donor Swan-Ganz readings are... A. Required B. Encouraged but not Required C. No longer used D. Based on donor preference
B
53
In a lung transplant, the native lung is... A. Removed B. Left in place C. Relocated
A
54
The ideal ischemic time for lungs is...
Less than 6 hours. Ideally 4 hours.
55
What is the name of the typical procedure done on a single lung transplant?
a lateral thoracotomy
56
What is the name of the typical procedure done on a double lung transplant?
a sternotomy clamshell
57
What are immediate post-op concerns (more related to lungs than other organs)? | 4 items
* Re-perfusion injury * Loss of blood through chest tubes * Ability to wean from ventilator * Wean from vent as soon as possible to oxygen mask
58
What is the normal Pulmonary Artery Pressure: Systolic (PASP)?
15 - 25 mmHg
59
What is the normal Pulmonary Artery Pressure: Diastolic (PADP)?
8 - 15 mmHg
60
What is the normal Mean Pulmonary Artery Pressure (MPAP)?
10 - 20 mmHg
61
What is the normal Pulmonary Artery Wedge Pressure (PAWP)?
6 - 12 mmHg
62
What is the normal Central Venous Pressure (CVP)?
2 - 6 mmHg
63
What is the normal Left Atrial Pressure (LAP)?
6 - 12 mmHg
64
What is the normal cardiac output (CO)?
4 - 8 L/min
65
What is the normal Cardiac Index (CI)?
2.5 - 4 L/min/m2
66
What is the normal Stroke Volume (SV)?
60 - 100 mL/beat
67
What is the normal Stroke Volume Index (SVI)?
33 - 47 mL/m2/beat
68
What is the normal Systemic Vascular Resistance (SVR)?
800 - 1200 dynes * sec/cm5
69
What is the normal Systemic Vascular Resistance Index (SVRI)?
1970 - 2390 dynes * sec/cm5/m2
70
What is the normal Pulmonary Vascular Resistance (PVR)?
<250 dynes * sec/cm5
71
What is the normal Pulmonary Vascular Resistance Index (PVRI)?
255 - 285 dynes * sec/cm5/m2
72
How does a denervated heart affect a heart/lung transplant? | 2 items
* HR post transplant is higher at 100 vs 80 pre-transplant. * Takes longer for HR to increase with exercise
73
The goal of a heart/lung transplant is to achieve a negative fluid volume without affecting what?
The kidneys
74
How many drugs are typically used for immunosuppresion in a heart/lung transplant? 1 2 3 4
3
75
What immunosuppression should not be given in a heart/lung transplant until at least 6 weeks post-transplant?
Sirolimus
76
What medication will lung patients take for life?
Prednisone
77
What are the s/s of acute lung rejection? | 7 items
* dry, hacky cough * dyspnea * low grade fever, leukocytosis * crackles * Fall in FEV1 and FVC * Resting or exercise desaturation * CXR infilltrates
78
What are the biopsy grading scales for lungs?
79
What determines the treatment of acute lung rejection? | 3 items
* grade of rejection * # of episodes * Presence of infection
80
What are possible treatments for acute lung rejection? | 2 items
* corticosteroids (IV, PO, +/- taper) * Modification of immunosuppression
81
What is another name for chronic lung rejection?
bronciolitis obliterans
82
What are the signs of chronic lung rejection? | 5 items
* insidious onset of dyspnea, recurrent bronchitis * Productive cough * weight loss * Early drop in FEF 25/75 * irreversable drop in FEV1 of 20% from previous baseline
83
What are possible treatments for chronic lung rejection? | 5 items
* optimal immunosuppresion * Consider anti-proliferative agents * Monitoring of PFTs and CXR * Treatment of infections * Advanced lung disease = end of life care

PCH CCTC Study (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions