Respiratory Physiology and Pulmonary Symptoms

Question 1

Normal acid/base disturbance of pregnancy

Answer 1

Compensated respiratory alkalosis

Question 2

How does oxygen consumption change during pregnancy?

Answer 2

Increased by 20 to30%.

Question 3

How does carbon dioxide production change during pregnancy?

Answer 3

Increases 30 to 35%

Question 4

How does tidal volume change during pregnancy? Why?

Answer 4

Increases slightly due to progesterone mediated increase in hypercapnic respiratory drive.

Question 5

How does respiratory rate change during pregnancy? Minute vent?

Answer 5

Resp rate does not change but due to increased TV, MV is increased.

Question 6

How does cardiac output change in pregnancy? Why?

Answer 6

Increased CO 2/2 increased HR and SV.

Question 7

How does Valsalva maneuver affect DLCO testing?

Answer 7

Increased intrathoracic pressure leading to decreased pulmonary capillary flow with reduced DLCO.

Question 8

How does exercised affect DLCO?

Answer 8

Increased pulmonary capillary blood flow, so increased DLCO

Question 9

Volume of blood defining massive hemoptysis

Answer 9

100ml/hr or 500mls in 24hr

Question 10

Fist step in stabilizing massive hemoptysis

Answer 10

Intubation and bronchoscopy

Question 11

Which biologic for asthma is considered safe in pregnancy?

Answer 11

Omalizumab is safe but should not be started during pregnancy due to risk of anaphylaxis.

Question 12

Which asthma meds are safe in pregnancy?

Answer 12

Inhaled SABA, Inhaled LABA, ICS, LRA, and omalizumab

Question 13

Steroids given in first trimester of pregnancy increase risk of?

Answer 13

Cleft palate

Question 14

Minimal usability criteria for spirometry

Answer 14

No cough or glottic closure in 1st second, back extrapolated volume <5% or 0.1L whichever is greater, no evidence of faulty zero flow setting

Question 15

Repeatability criteria for spirometry

Answer 15

Difference between 2 largest FVCs and FEV1s be <0.15L

Question 16

_____ is a rare condition affecting multiple organs and is characterized by non-Langerhans histiocytes most commonly presenting with sclerotic lesions of the long bones.

Answer 16

Erdheim-Chester Disease (about 50% have lung involvement with dyspnea and cough)

Question 17

_____ is a mutation detected in more than half of patients with Erdheim Chester Disease.

Answer 17

BRAF V600

Question 18

The _____ protein is usually positive in patient with LCH.

Answer 18

S100

Question 19

Studies have confirmed that long term oxygen therapy for at least ___ hours a day is superior to no oxygen and LTOT for ___ hr/day was superior to ___hr/day.

Answer 19

15; 24; 12

Question 20

Swimming induced pulmonary edema is caused by _____.

Answer 20

effect of hydrostatic forces acting on the heart and lungs

Question 21

The treatment of swimming induced pulmonary edema is _______.

Answer 21

Supportive care (potentially NIPPV if needed)

Question 22

Idiopathic pulmonary hemosiderosis presents with ____

Answer 22

DAH