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Cardiopulmonary Diagnostic (PFTs) > Mid-Term > Flashcards

Mid-Term Flashcards

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1
Q

What are some indications For PFTs

A
  • Diagnosis
  • Screening (pre-op)
  • Monitoring
  • Effects of chemicals and toxic medications
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2
Q

What is the Gold standard for diagnosing obstructive diseases

A

Spirometry

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3
Q

What 3 tests are involved in PFT

A
  • Spirometry
  • Lung volumes
  • DLCO
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4
Q

What do we use to diagnose Restrictive diseases

A

Lung volumes

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5
Q

What do we use to diagnose gas exchange?

A

DLCO

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6
Q

For obstruction, DLCO is used to determine the (2)

A
  • severity of the obstruction
  • ruling out Emphseyma
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7
Q

Predicated values come from a national data base based on 4 demographics. What are they?

A

HGAR
- Height
- Gender
- Age
- Race

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8
Q

FEF 50% is the

A

most accurate measure used to determine pt effort

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9
Q

FEF 25%- 75% reflects

A

abnormalities in the small airway

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10
Q

When is FEV1 measured

A

during the FVC

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11
Q

FEV1 is called

A

Forced Expiratory Volume over 1 second

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12
Q

FEV1/FVC ratio defines

A

the obstruction

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13
Q

FEV1 defines the

A

degree/severity of the obstruction or restriction

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14
Q

If FEV1/ FVC ratio is less than ___% what does that indicate?

A

75%;
obstruction disease (CBABE)

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15
Q

If FVC is _______/high ( ____%) you have an…

A

normal;
80%
obstruction only

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16
Q

If FVC is low <80% you may have a

A

restrictive component or mixed

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17
Q

FEV1 <80% to determine if its

A

mild, moderate moderately severe, severe, or very severe

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18
Q

Mild is

A

70- 79%

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19
Q

Moderate is

A

60- 69%

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20
Q

Moderately severe is

A

50- 59%

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21
Q

Severe is

A

35- 49%

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22
Q

Very severe is

A

<35

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23
Q

Define Peakflow

A

A maximal inspiration, followed by a maximal forced exhalation

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24
Q

What are the predicated values based on for peak flow?

A

HAG
- Height
- Age
- Gender

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25
If you do not have FEV1/ FVC which do you look at first and why?
RV for air trapping
26
If RV is high what do you do?
Look at the TLC
27
If FVC is low (<80%) it is considered
mixed
28
If FVC is normal or high then you have an
Obstruction only
29
How do we measure a pt's height
W/o shoes
30
What are some contraindications for Spirometry testing?
- Myocardial infarction within the past month - Chest abdominal, facial, or oral pain - Stress incontinence - Dementia, confusion - Hemoptysis - Recent cataract surgery (extra pressure) - Recent abdominal or thoracic surgery
31
If you want a good effort then what must you do?
Coach pt
32
How do we know if test is valid?
If it is acceptable and replicable
33
HE measures (2)
FRC and estimate lung volumes
34
How long do we perform HE
until equilibrium is reached
35
For HE test how long do you have to wait until you can retest
5 minutes
36
Where do we measure alveolar pressure?
At the mouth when the shutter is clsoed
37
What can cause the DLCO to decrease? (7)
- Asthma - Emphysema - PNA - Pulmonary edema - OSA - COPD Exacerbation - Radiation
38
What can cause the DLCO to increase (3)
- Polycythemia (increased RBC) - Increase in pulmonary blood flow (e.g Exercise) - Alveolar hemorrhage
39
Would radiation increase or decrease DLCO?
Decrease
40
The jones method measures
breath hold from 0.3 of the inspiratory time to the midpoint of the alveolar sample
41
Minute ventilation equation
VE= VT x RR
42
Respiratory Exchange Ratio (RER) is the ratio between the
volume of carbon dioxide produced (VCO2) divided by the volume of O2 consumed (VO2)
43
Minute volume must be correlated w/
blood gas values to determine adequacy of ventilation
44
What is the normal minute volume in healthy adults
5 to 10 L/min
45
Low VE does not necessarily mean __________________ and high VE does not necessarily mean ________________ b/c not all breaths are created __________
hypoventilation; hyperventilation; equal
46
In the case of CO2 retention, Hyperventilation is not determined until....
ventilation is greater than what is needed to adequately remove excess CO2
47
Why must VE be correlated w/ blood gases
**VE does not determine Hypo/hyperventilation (Remember the body will compensate for an increased or decreased CO2)**
48
What is the criteria for hypoventilation?
- pH <7.35 - PCO2 > 45
49
What is the criteria for hyperventilation
- pH >7.45 - PCO2 <35
50
What are the 2 types of deadspace?
Anatomic Alveolar
51
Air in the upper airways that does not participate in gas exchange is
Anatomic deadspace
52
Lung volumes that are ventilated but not perfused by capillary blood flow. Air trapped in the small airways (alveoli) that cannot participate in gas exchange
Alveolar deadpsace
53
The combination of the 2 deadspaces are called
Respiratory or Physiological Deadspace
54
How do we measure dead space?
Exhaled gas is collected over a specified interval and measured
55
What is Bohr's equation
VD= (Paco-Peco2)/Paco2 x VT
56
Anatomic dead-space can be calculated as
1ml per pound or 2ml/kg of IBW
57
When can alveolar deadspace be calculated
During measurements of volumes
58
Alveolar ventilation is the part of ventilation that participates in
gas exchange at the alveolar level
59
What is the equation for VA
VA= (VT-VD) x RR
60
Dead space (VD) is considered equal to
anatomic dead space (1 ml/lb or 2ml/kg of IBW)
61
_________ is the pressure generated at the ________ during the _______ 100 milliseconds of an _____________ effort against an _____________ airway
P100 (Occlusion pressure); mouth; first; inspiratory; occluded
62
What is the normal range for P100?
1.5 to 5 cm H2O
63
P100 is helpful in determining the effects of..
treatment in pts w/ abnormal vent responses
64
What is P100 measured with?
Closed-circuit
65
Tidal volume is defined as the volume of
air inspired or expired during a normal respiratory cycle
66
What is the equation the Vt?
Vt=VE/RR
67
If a pt is hypoxic but they have a good DLCO, what could cause that?
Hypoventilation

Cardiopulmonary Diagnostic (PFTs) (6 decks)

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