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Pulmonary Function Tests > Ch. 4 > Flashcards

Ch. 4 Flashcards

1
Q

What are the normal values for diagnosing pulmonary disease?

A

> 80% - <100%

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2
Q

All methods use what _______ .

A

CO

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3
Q

What is used to assess gas exchange and estimate lung volumes?

A

DLCO

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4
Q

What is DLCO?

A

Measures the diffusion of CO across the alveolar capillary membranes.

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5
Q

Why do we use DLCO?

A

Because carbon monoxide adheres to hemoglobin approximately 210 times more readily than O2.

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6
Q

Significant ⬇️ of CO in exhaled example w/diffused 80% or more indicates what?

A

Good gas exchange

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7
Q

If the measurements are the same or similar (diffused < 80%) what does that indicate?

A

Limited gas exchange

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8
Q

What are the 3 types of DLCO?

A

DLCOsb - single breath (most commonly used)
DLCOrb - restricted breath (research)
DLCOib - intrabreath (exercising)

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9
Q

How long do you hold DLCOsb?

A

10 sec

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10
Q

DLCOsb is good for everything except?

A

Exercise

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11
Q

DLCO will be inc. during exercise due to?

A

Inc. temp, ventilation, and flow.

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12
Q

DLCO is very sensitive to?

A

Distribution of ventilation and V/Q mismatch

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13
Q

Causes of V/Q mismatch?

A

Anything that hinders the body’s ability to deliver enough oxygen to your bloodstream.
• COPD exacerbation
• asthma
• pneumonia
• chronic bronchitis
• pulmonary edema
• airway obstruction
• PE
• OSA

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14
Q

What is HB?

A

Protein molecule in RBCs that carries oxygen from lungs to tissues, and returns CO2 to the body.

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15
Q

What are the ranges for hemoglobin?

A

13.5 - 17.5 (M)
12 - 15.5 (F)

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16
Q

How much does the machine use for males and females?

A

14.6% (M)
13.4% (F)

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17
Q

Low HB reduces ______ because there is not enough to carry and pick up ____ .

A

DLCO; CO

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18
Q

What is COHB?

A

Stable complex of CO that forms in RBCs when CO is inhaled

19
Q

What are the percentages for COHB?

A

<3% for non smokers
4-10% smokers
> 50% fatal
Machine consumes 2%

20
Q

When a patient smokes before the test or is a heavy smoker they will have?

A

An inc. COHB

21
Q

The amount of time to defuse the increase in CO will take longer than the predicted______ sec.

A

10

22
Q

If you make adjustments for elevated CO______ would be higher because it reduces the value of the predicted values.

A

DCO

23
Q

How do you perform a DLCOsb?

A
  1. patient breathes normal VT to establish baseline
  2. exhale to RV
  3. inhales to max RV and hold for 10 seconds
  4. inhale special gas mixture from reservoir or spirometer.
  5. tracer gas 0.3%, CO, 21%, O2, N2, CH4 or Ne
  6. exhales to RV
  7. basically in SVC w/10 second breath hold
24
Q

If you have a leak, your DLCO will be ______?

A

Increased

25
Q

The ______ method measures breath hold from _____ of the Ti to the midpoint of the alveolar sample.

A

Jones; 0.3

26
Q

All DLCO must be corrected to?

A

STPD (standard temp (0.C) and standard pressure (760 mmHg absolute) dry no H2O content.

27
Q

Temperature, pressure, volume, and condensation, will all be?

A

Increased

28
Q

All measurements are reported at ______?

A

BTPS (Body, temp, pressure, sats)

29
Q

BTPS presume the combined environmental circumstances of a body temperature of______
PB of ________ mmHg breathing sats w/water vapor (=100% relative humidity).

A

37 degrees C; 700

30
Q

For acceptable results you need…..

A

• average of two best tests (no more than 5)
• Tests must be acceptable & replicable
• results must be within 3mL/CO/min/mmHg

31
Q

Decrease in DLCO <80% means what?

A

• poor gas exchange
• restrictive or obstructive
• sarcoidosis
• scleroderma
• cystic fibrosis
• emphysema

32
Q

An increase in DLCO is associated with circumstances which there was an increase in _____ binding sites for _____ uptake.

A

HB;CO

33
Q

What are diseases that will have an increase DLCO

A

• Polycythemia
• Alveolar hemorrhage

34
Q

DLCO will always be increased during?

A

Exercise testing

35
Q

What do we do for an obstruction?

A

We look at DLCO to determine severity of gas exchange and emphysema

36
Q

Which obstructive disease is low?

A

Emphysema
CBABE
All other obstructive diseases are normal

37
Q

What do we do for a restriction?

A

Look at DLCO to see if restriction is interstitial or extrastitial

38
Q

DLCO < 80% means?

A

Restriction is happening inside lungs

39
Q

A normal DLCO means what?

A

Restriction is happening outside the lungs

40
Q

In mix defect defining ______ in the DLCO can be very _____.

A

Decrease;difficult

41
Q

We won’t know if the disease is ______ or ______.

A

Restrictive or obstructive

42
Q

Mixed defect relies on the patients…..?

A

• history
• work environment
• medical data (x-rays, lab, previous diagnosis)

43
Q

What is mixed defect used for?

A

To come up with a hypothesis or a possible diagnosis

Pulmonary Function Tests (8 decks)

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