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Monica Respiratory > Biochemistry Tests > Flashcards

Biochemistry Tests Flashcards

1
Q

sputum examination

A 
appearance 
clear/colourless (chronic bronchitis)
yellow-green (pulmonary infection)
red (haemoptysis)
black (smoke, coal dust)
frothy white-pink (pulmonary oedema)

sample –> laboratory -microscopy , culture, cytology

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2
Q

peak expiratory flow

A

maximal forced expiration through peak flow meter

  • estimates airway calibre
  • more effort-dependent
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3
Q

pulse oximetry

A 
peripheral O2 sat
non invasive
less than/equal to 80% = abnormal
pneumonia less than 92% = serious sign
-check ABG for PaCO2
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4
Q

pulse oximetry complication

A 
poor perfusion
motion
excess light
skin pigmentation
nail varnish
dyshaemoglobinaemias
CO poisoning
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5
Q

arterial blood gas

A

herparinized blood - taken from radial/ femoral artery
pH, PaO2, PaCO2 meaured
FiO2 noted

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6
Q

Normal pH ABG

A

7.35-7.45

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7
Q

ph<7.35

A

acidosis

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8
Q

ph>7.45

A

alkalosis

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9
Q

normal PaO2

A

10.5-13.5pKa

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10
Q

hypoxia ccauses

A

ventilation/perfusion mismatch
hypoventilation
abnormal diffusion
right o left cardiac heart shunts

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11
Q

severe hypoxia

A

PaO2 <8kPa

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12
Q

normal PaCO2

A

4.5-6kPa

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13
Q

PaCO2 <4.5kPa

A

hyperventilation

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14
Q

PaCO2 >6.0kPa

A

hypoventilation

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15
Q

Type 1 resp failure

A

too little O2
PaO2<8kPa
PaCO2<6kPa

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16
Q

Type 2 resp failure

A

PaO2<8kPa
PaCO2>6kPa
little O2
too much CO2

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17
Q

What does spirometry measure

A

functional lung volumes

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18
Q

How are FEV1s and FVCs cmeasyred

A

full forced expiration in a spirometer

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19
Q

when does exhalation finish

A

until no more breaths = exhaled

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20
Q

is FEV1 or PEF more effort dependent

A

PEF

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21
Q

what does FEV1/FVC ratio give estimate of

A

airflow obstruction severity

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22
Q

Obstructive defect FEV1/FVC ratio

A

<75%

23
Q

Restrictive defect FEV1/FVC

A

equal to > than normal

24
Q

Normal FEV1/FVC ratio

A

75-80%

25
Q

Obstructive defect examples

A

asthma

COPD

26
Q

Restrictive defect examples

A 
Lung fibrosis
Sarcoidosis
Pneumoconiosis
Interstitial pneumonias
Connective tissue diseases
Pleural effusions
Obesity
Kyphoscoliosis
Neuromuscular problems
27
Q

what does Alveolar arterial oxygen gradient measure

A

difference in O2 pressure between alveolar + arterial sides

28
Q

Aa gradient normal breathing range

A
  1. 2-1.5 kPa (25 yrs)

1. 5-3.0 kPa (75 yrs)

29
Q

high Aa gradient hypoxia

A

O2 transfer problem

30
Q

normal Aa gradient hypoxia

A

hypoventilation

31
Q

lung capacities used to distinguish obstructive/ restrictive diseases

A

Total lung capacity

Residual volume

32
Q

In obstructive airway disease what happens to TLC and RV

A

Increased

33
Q

TLC and RV are reduced in

A

Restrictive lung diseases

Musculoskeletal abnormalities

34
Q

explain gas transfer coefficient

A

CO diffusing capacity
measures
-CO uptake from single inspiration in standard time
-lung volume by helium dilution

35
Q

gas transfer coefficient = high

A

alveolar haemorrhage

36
Q

gas transfer coefficient = low

A

emphysema

37
Q

what does the flow volume loop measure

A

flow at various lung volumes

38
Q

radiology used in chest medicine

A 
chest x-ray
ultrasound
radio-nucleotide scans
computed tomography
pulmonary angiography
39
Q

what is ultrasound used for

A

diagnosis + guide drainage of pleural effusions + emphysema

40
Q

radionucleotide scans are used for

A

ventilation/perfusion scans
-diagnose PE

bone scans
bone metastases

41
Q

what is computed tomography used for

A 
thorax
diagnosing + staging lung cancer
imaging hila, mediastinum, pleura 
high resolution CT
-diagnose interstitial lung disease + bronchiectasis
CT pulmonary angiography
-PE diagnosis
42
Q

fibreoptic bronchoscopy

A

local anaesthetic via nose or mouth
susoected lung carcinomas
slowly resolving pneumonia in immunosuppressed
interstitial lung disease

43
Q

pre procedure investigations fibreoptic bronchoscophy

A 
FBC
CXR
spirometry
pulse oximetry
ABGs
44
Q

bronchoalveolar lavage

A

at time of bronchoscopy

instil + aspirate known vl warmed, buffered 0.9% saline into distal airway

45
Q

bronchoalveolar lavage diagnostic indications

A

suspected malignancy
pneumonia immunocompromised
suspected TB
interstitial lung disease

46
Q

bronchoalbeolar lavage complication

A

hypoxia
transient fever
transient CXR shadow

47
Q

types of lung biopsy

A

percutaneous needle biopsy
transbronchial biopsy
open lung biopsy

48
Q

percutaneous needle biopsy

A

under radiological guidance

peripheral lung + pleural lesions

49
Q

transbronchial biopsy

A

@ bronchoscopy

diagnose diffuse lung disease

50
Q

surgical procedures

A

rigid bronchoscopy
mediastinoscopy
mediastinotomy
thoracoscopy

51
Q

rigid bronchoscopy

A

widen lumen
larger mucosal biopsies
controls bleeding
removes foreign bodies

52
Q

mediastinoscopy

mediastinotomy

A

examination + biopsy of mediastinal lymph nodes/ lesions

53
Q

thoracoscopy

A

examination + biopsy of
pleural lesions
drainage of pleural effusion
talcpleurodesis

Monica Respiratory (21 decks)

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