ABG and CXR Flashcards
Type 1 resp failure
hypoxia
Type 2 resp failure
hypoxia
hypercapnia
Met acidosis
acidic pH
low HCO3
resp acidosis acute
acidic pH
high CO2
normal HCO3
resp acidosis chronic
acidic pH
high CO2
high HCO3
order of looking at ABG
- pH
- CO2
- HCO3
- O2
pO2 for a patient on 60% O2
-10 from 60% for pO2
therefore should have pO2 of 50
typical ABG after cardiac arrest
mixed metabolic and respiratory acidosis
BE of -9
lack a lot of base, meaning you are acidotic
BE +6
more base, meaning you are alkalotic
basics to CXR intro
name
date
AP vs PA
difference between AP and PA film for CXR
AP can make the heart appear larger
PA is normally used
ABCDE of CXR
A - airway (trachea) B - breathing (lungs) C - circulation (heart) D - diaphragm (under and CP angles) E - everything else (bones and soft tissue)
features of pleural effusion
blunting of CP angle
meniscus
opacification
locations of masses in CXR
peripheral
hilar
round lesion with dark and lighter areas
air free level
hilar and mediastinal lymphadenopathy D.Dx
lymphoma
TB
sarcoidosis
Heart failure / pulmonary oedema features on CXR
prominent hilar shadowing
fluffy appearance
cardiomegaly
dextrocardia
cardiac apex is on the right side
gastric bubble is on the right side too - situs vertus
primary ciliary dyskinesia
situs invertus
causes of pneumoperitoneum
laparoscopy
bowel perforation
PUD perforation
widespread rounded lesions / opacifications in both lung fields
lung metastases
RCC
lung fissures on the right lung
horizontal and oblique
RUL opacification D.Dx
infection - pneumonia
mass - causing collapse
air bronchogram
black markings of trapped air
free air in the skin / SC connective tissue space
surgical / SC emphysema
pneumomediastinum
air around the heart and aortic knuckle
upper lobe vessels should be visible on CXR, true or false
false
that is abnormal, sign of congestion
rounded heart shape D.Dx
dilated cardiomyopathy
pericardial effusion
cardiac tamponade
white out of hemithorax with mediastinal shift and tracheal deviation to affected side
pneumonectomy
empty space which becomes filled with fluid
unaffected lung hyperexpands and pushes away to affected side
white out and lung collapse has tracheal deviation to/away from affected side
deviation towards the collapse
white out and lung collapse has tracheal deviation to/away from affected side
deviation towards the collapse
D.Dx of cavity in upper lobe / apex
tumour
abscess
TB
D.Dx reticulo (lines) nodular (round) shadowing throughout the lungs
ILD
miliary TB
what do the following indicate on a CXR
line
meniscus
line - fluid level
meniscus - effusion
D.Dx for pneumomediastinum
oesophageal rupture
causes of respiratory acidosis
inadequate alveolar ventilation leading to CO2 retention: asthma COPD pneumonia respiratory depression - opioids, BZD GBS mechanical ventilation
causes of respiratory alkalosis
excessive alveolar ventilation (hyperventilation) and blowing off CO2: anxiety / panic attack pain hypoxia PE pneumothorax mechanical ventilation
causes of metabolic acidosis with a raised anion gap
anything causing ^ acid production:
DKA
lactic acidosis
aspirin overdose
causes of metabolic acidosis with a normal/decreased anion gap
decreased acid excretion ie retaining H+:
GI loss of HCO3 - diarrhoea, stoma
renal tubular acidosis
Addisons disease
causes of metabolic alkalsosis
loss of H+ and increased HCO3:
GI loss of H+ - vomiting
renal loss of H+ - diuretics, HF, nephrotic syndrome, cirrhosis, Conns syndrome
milk alkali syndrome
causes of mixed respiratory and metabolic acidosis
cardiac arrest
multi organ failure
