9.7- Respiratory Tests Flashcards
how does pleuritic, musclular, fx, herpes, pericardial, myocardial infarction chest pain show
pleuritix- sharp pain
fx- sudden pain
muscular- worse on moving
herpes- severe pain pre rash
pericardial- sharp (relieved leaning forward)
myocardial infarction- crushing, sudden onset
what are the main respiratory tests (5)
Spiroetry blood gases + elctros -Pulse oximetry -lactate -HbCo, ACE, ICE etc
What is FVC and FEV1
FVC- forced vital capacity (most that can be exhaled w effort
FEV1- forced expiration of volume in one second
if there is a reduced + restricted FEV1/FVC what does that mean
reduced- obstruction disease (asthma/copd)
in restriction- no chance
causes and lab results in acute respiratory acidosis
causes: choking, bronchopneumonia, asthma
Lab- Blood pCO2 rises, H+ increased. Blood pO2 lowers
Casues and lab results in chronic respiratory acidosis
causes- chronic bronchitis, emphysema, chronic asthma, bronchiectasis
Abnormal lab results- Peak expiratory flow reduced, FEV1/FVC recuced, pCOs double
what is respiratory alkalosis caused by
- hysteria
- mechanical over ventilation
- raised intracranial pressue
- hypoxia
- salickylate overdose early
what stims ventilation (3)
- Increase pCO2
- fall in pH
- decreased pO2
what are the 4 main obstructive lung diseases
- Chronic obstructive pulmonary disease
- Asthma
- Bronchiectasis
- Cystic Fibrosis
what is COPD
- Chronic bronchitis- episodes of productive cough for atleast 3m for 2y
- Emphysema- enlargement of airspaces, destruction of perenchyma, closing of small airways
differences bw Emphysema (pink puffer) and COPD (Blue bloater)
Emphysema- Hyperventilation (SOB), o2/co2 down
COPD- hypventilateion, low o2, co2 up, edema
What is type 1 respiratory failure and what diseases is it seen in
Low pO2 + normal pCO2
-pulmonary edema, pulmonary fibrosis, lobar pnmoneia
What is type 2 respiratory failire and what is it seen in
Low O2 and High Co2
Bronchial pnemonia, Chronic bronchitis
What is the etiology of asthma (extrinicic and instrincic)
Extrinsic- hypersensitivity to pollen
Instrincic- Asprin, Nsaids, beta blockers etc
What are the asthma signss/sym
SOB
wheexe
worst in early morn
cough
Tests for asthma + findings
Spirometor- >15% airflow obstruction
Oesinophilia
Skin tests pos (raised IgE)
Tests for cystic fibrosis (3)
sweat chloride test
FVC low
lung volume increased
What is bronchiectasis and what is the triad and best test
Abnormal irrevesible dialation of medium airways
triad: persistent productive cough, copius purulent sputim, haemoptysis
CT
Sarcoidosis- what is it and lab results (3)
resitrictive lung disease
- high ACE
- may be hypercalciuria and hypercalcaemia
What is extrinsic allergic alveolitis: who is it seen in and how to measure it
Interstitial lung diseases in bird fanciers or farmers lung
measure paraquat (paraquat poisioning)
How to measure for goodpastures syndrome
Measure antiglomerular basement membrane
kidney as well as lung disease
What is pneumoconiosis and what is it caused by
Inflammation and fibrosis caused by occupational inhalation of mineral dust (progressive lung fibrosis)
symptoms of pneumoconiosis
Progressive dyspnoea, non productiove cough, hypoxaemia, decreased lung volume
What is a thrombotic pulmonary embolism
Clots from deep veuns in leg break off and travel to lungs
What is virchows triad and what is it for
pulmonary thromboembolism
- Endothelial trauma
- stasis
- Hypercoagubility
clinical features of pulmonary embolus
- asymptomatic
- chest pain
- pnemonia w/o chills
- sudden onset
What are the main lab findings for pulmonary embolus
- Serum lactate dehydrogenase increased
- Respiratory alkalosis w po2 reduced
Risk factors of pulmonary embolis
obese
surgery
smoker
oral contraceptives
non small cell carcinomas- how much of lung cancers and can it metastasize
half of lung cancers
maymetastatize readily
key lung cancer symptoms
persistent cough/breathlessness
harmoptysis
inf slow to clear
paraneoplatic syndrome
what are the 4 types of pleural effusions
Transudate- ultrafiltrate
exudates- inflammations
Empyema- purulent pleural effusion
haemothorax- blood in pleural space
pleural effusion s/s
decreased breath sounds, egonophony, decreased tactile fremits, pleural rub
Findings in pleural aspirtate that indicate trasudate or exudate
transudate <20g/l
Exudate >30g/l
