Pulm lecture 5

Question 1

Saba is used for what?

Answer 1

COPD and asthma

Question 2

LABA is used for what?

Answer 2

COPD and asthma, usually w/ICS

Question 3

SAMAs primarily used in?

Answer 3

COPD

Question 4

LAMAs primarily used in?

Answer 4

COPD

Question 5

Define hypoxia?

Answer 5

Low pO2 in the tissues

Question 6

Define hypoxemia?

Answer 6

Low O2 in the blood

Question 7

What are some causes of hypoxia?

Answer 7

Altitude, alveolar hypoventilation, dec. diffusion, VQ mismatch, shunt (anatomic)

Question 8

What is the barometric pressure in Albuquerque? At sea level?

Answer 8

ABQ = 630mmHg; sea level = 760 mmHg

Question 9

What is the PaO2 in ABQ? At se level?

Answer 9

ABQ = 72; sea level = 100

Question 10

The relative ventilation and perfusion of all alveoli determine what?

Answer 10

PaO2 of the blood ñ different alveoli may have widely different amounts of ventilation and perfusion, but the key for normal is the have matching of vent/perfusion.

Question 11

What is the percentage of a normal shunt?

Answer 11

2-5%

Question 12

At what percentage is it pathologic?

Answer 12

15.00%

Question 13

What is the normal range for PaO2?

Answer 13

70-80 (ABQ. This # elevation dependent remember.)

Question 14

What is the normal range for PaCO2?

Answer 14

35-40 (40 hypoventilation, respiratory acidosis)

Question 15

What is the normal range for HCO3?

Answer 15

24-28

Question 16

How can you tell if someone is in compensation?

Answer 16

If pH is NORMAL and pCO2 and HCO3 are abnormal, then compensation exists (either the kidneys or lungs are compensating for the imbalance. If the ph Is ABNORMAL and both pCO2 and HCO3 are abnormal, two separate processes can be occurring w/o compensation).

Question 17

Which figure is affected in respiratory acidosis and what are some causes?

Answer 17

Elevated PaCO2; drug OD, COPS exacerbation w/respiratory failure. The underlying mechanism is hypoventilation eventually leading to hypoxia

Question 18

Which figure is affected in respiratory alkalemia and what are some causes?

Answer 18

PaCO2 low; sepsis, altitude, aspirin OD, hyperventilation, anxiety/hysteria etc., cirrhosis (any lung dz that leads to SOB can cause)

Question 19

Which figure is affected in metabolic acidosis and what are some causes?

Answer 19

HCO3 is low; lactic acidosis, ketoacidosis, renal failure, severe diarrhea

Question 20

Which figure is affected in metabolic alkalosis and what are some causes?

Answer 20

High HCO3; diuretics, vomiting, ng suction

Question 21

Which of the imbalances is an anion gap associated?

Answer 21

Metabolic Acidosis

Question 22

What does spirometry measure?

Answer 22

Measure flow and volumes, volume vs. time. Can determine: FEV1, FVC, FEV1/FVC, forced expiratory flow

Question 23

Does FEV1 measure air in large or small airways?

Answer 23

Large

Question 24

Does forced vital capacity measure air flow in small or large airways?

Answer 24

Small airways

Question 25

What is the main different between obstructive and restrictive lung disease as far as spiromety is concerned?

Answer 25

In obstructive the FEV1/FVC ratio is decreased (

Question 26

What is broncoprovocation useful for?

Answer 26

To diagnose asthma (used with methacholine, histamine or other)

Question 27

What does a flow volume loop measure?

Answer 27

Forced inspiratory and expiratory flow rate (augments spirometry). Used to evaluate upper airway obstruction (stridor, unexplained dyspnea