COMPS: Pulmonary Dx Tests/Procedures: Exam 1 Flashcards

1
Q

pH

Normal Value vs. Normal Range

A
  • Normal value ==== 7.40
  • Normal range===7.35-7.45
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2
Q

Metabolic Acidosis

*Diabetic Ketoacidosis

A
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3
Q

Respiratory Alkalosis

A
  • PaCO2<35; DEC PaCO2= DEC pH
    • hypERventilation
    • tachycardia
    • hypOkalemia
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4
Q

INvasive Pulm tests

A

bronchoscopy

Arterial blood gas analysis (ABG)

Cytological tests

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5
Q

PFF table

Normal

Restrictive

Obstructive

A

see pics

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6
Q

Hematological tests aid in assess. of what?

A

CP disease

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7
Q

Lung Diseases: 2 types

A
  1. Restrictive
  2. Obstructive
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8
Q

Hematological tests:

Anemia

A

LOW Hb

LOW RBC

LOW Hematocrit

*immune response

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9
Q

These are indicated to rule OUT PE

A

V/Q scans

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10
Q

V/Q scans

A
  • Xenon gas used to measure regional distribution of ventilation in lungs
    • pt inhales gas and holds breath while ventilation scans are made over lung field
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11
Q

FEV1/FVC=====

A

Air OUT 1sec/Air OUT entire time

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12
Q

Cytological Tests are checking for:

A

Bacteria

Fungi

Protozoa

Viruses

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13
Q

Flow-volume graph/loop

Normal

Restrictive

Obstructive

A

see pics

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14
Q

HCO3-

A
  • KIDNEY BASED
    • metabolic
    • Bicarb is a BASE
    • makes blood more BASIC!!!
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15
Q

Advantages vs. Disadvantages

Chest CT vs. Chest radiography (xray)

A

see pics

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16
Q

ABG

clinical notes:

ABGs are…..

A

time dependent

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17
Q

Pulmonary Function Test

all volumes and capacities

A

see pics

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18
Q

V/Q scans described by:

A

Neg.

Low Prob of PE

Intermed. Prob of PE

High Prob of PE

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19
Q

Abnormal ABG:

Acidosis

A

pH>7.35

PCO2> 45

HCO3- <22

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20
Q

What should you remember about “Capacities”

A

HAS TO BE MORE THAN ONE VOLUME ALWAYS

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21
Q

Normal Chest radiographs

A

see pics

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22
Q

What views taken for chest xray?

what do we WANT to see?

A
  • 2 views:
    • PA
    • L. Lat.
  • we want to see BLACK
    • ​==> Air in lungs

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23
Q

Abnormal ABG

Alkalosis

A

pH >7.45

PCO2 <35

HCO3- >26

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24
Q

Hematological tests:

Leukopenia

A

DEC WBC

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25
Q

Blood Gas Analysis/ABGs

Crucial to assess probs related to what?

A

Acid-base balance, ventilation, oxygenation

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26
Q

VC vs. FVC

A

SAME THING

FVC is 6secs

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27
Q

PaO2

NORMAL

A

80-100

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28
Q

Hematological tests:

Anemia

Polycythemia

Leukocytosis

Leukopenia

ALL ARE WHAT?

A

IMMUNE RESPONSES

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29
Q

Typical Hematological Tests include:

A
  • ABGs
  • electrolytes
  • CBC’s
  • coagulation studies
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30
Q

Residual volume

A

NO participation in gas exchange

air we cannot use

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31
Q

Total Lung Capacity

TLC ====

A

ALL air in lungs

EVERYTHING added together

~5L

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32
Q

%SAT should be

A

> 95%

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33
Q

Range of PaCO2

A

35-45

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34
Q

Chest imaging

chest radiograph

MOST COMMONLY USED DX TEST

where is pt placed?

A

pt placed b/w x-ray machine & cassette

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35
Q

PaO2

<80

A
  • hypoxemia
    • mild= 60-80
    • mod= 40-60
    • severe= <40
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36
Q

ABGS

A

SEE PICS

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37
Q

Chest imaging:

V/Q Scan

what are we looking for?

A

PE

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38
Q

Respiratory Alkalosis

A

see pics

39
Q

ABGs in Acute Care

A

used to assess current cond’s

40
Q

PCO2

A
  • LUNGS based (respiratory)
    • CO2 is an ACID
    • makes blood more acidic!!!
41
Q

Chest x-rays

Densities

Low vs High vs. Intermediate

A

Low== air (black on xray)

High== bone (white)

Intermed== fluid and soft tissue (gray)

42
Q

Compensation: pursuit to Homeostasis

Uncompensated

A

1 gas & pH is NOT normal

1 gas IS normal

*nothing is being done to compensate for pH change

43
Q

Typical ABG report:

A
  • arterial pH
  • pp’s of CO2
  • pp’s of O2
  • O2 sats
  • bicarb concentration (HCO3)
  • based excess
44
Q

Respiratory Acidosis

A

see pics

45
Q

Tidal Volume

TV

A

NORMAL air in/out

~600mL– M

~400mL– F

46
Q

Functional Residual Capacity =====

A

ERV+ RV

47
Q

PFT is a test of…..

A

Diffusion

48
Q

Hematological tests:

Polycythemia

A

INC in:

Hb

RBC

Hematocrit

49
Q
A
50
Q

Metabolic Alkalosis

A

see pics

51
Q

Metabolic Acidosis

A
  • PaHCO3- <22; DEC PaHCO3- = DEC pH
    • hypERkalemia
    • Kussmaul respirations
      • ​compensatory hypERvent, diabetic ketoacidosis
    • severe diarrhea
    • renal failure
    • shock
52
Q

Pulmonary Function Test

What graph is best to used?

A

see pics !!!

53
Q

NON-invasive Pulm tests:

A

chest x ray

chest CT

chest V/Q scan

pulm function test (PFF)

oximetry (PulseOx)

54
Q

PFT is the relative diff. b/w partial pressures of gas in _________

A

Alveoli and Pulmonary blood

55
Q

ABGs are repeated when?

A

If ventilator modes OR support change

56
Q

PFF
Restrictive

cannot get air IN

A

NOTE: ratios w/ Restrictive and normal are SAME

57
Q

Oximetry is looking for what?

A

O2 bound to Hb or anything bound to Hb

58
Q

Abnormal Chest radiographs

Acute CHF

A

see pics

59
Q

Compensaton ABGs: Pursuit to Homeostasis

FULL

A

BOTH gases either high or low

pH normal

*both are compensating for pH

60
Q

Metabolic Alkalosis

A
  • PaHCO3- >26; INC PaHCO3- = INC pH
    • Tachycardia
    • compensatory hypOvent.
    • severe vomiting
    • excess. GI suctioning
    • diuretics
    • excessive NaHCO3
61
Q

PFF:

Obstructive

can’t get air OUT

A

MASSIVE TLC

HIGHER TLC

62
Q

V/Q scans

how do you measure regional distrib. of Pulmonary blood flow in lungs

A
  • pt injected intravenously w/ radioactive iodine
    • serial perfustion scans made
63
Q

Invasive Pulmonary tests or…

A

INSIDE body

64
Q

Chest imaging

Bronchoscopy

A
  • Fiber optic bronchoscopy
    • goes DOWN airways
65
Q

Amt of gas entering pulm blood flow per unit time

A

PFT

66
Q

Chest imagining chest CT

WHAT IS IT

A

digital chest radiography

narrow beam of x-rays move across field of exam.

67
Q

Oximetry is measurement of?

A

Oxyhemoglobin saturation

  • PulseOx
    • quick/accurate
68
Q

Inspiratory Capacity ====

A

IRV + TV

69
Q

How do we take ABGs?

A

Arterial sample

**Quick ID of 4 primary disorders based on pH and CO2

70
Q

Non-invasive Pulm tests:

Chest imaging

chest radiograph

MOST COMMONLY USED DX TEST

A
  • Det’s anatomic abnorms & patho. processes w/in chest
71
Q

Lung Diseases:

Restrictive ===

MORE i’s

A

Cannot get air IN

more I’s in restrictive===can’t get air In

72
Q

Compensation ABGs: pursuit to Homeostasis

Partial

A

pH normal

1 gas is normal

*1 gas trying to compensate for pH

73
Q

V/Q Scan pics

A

see attached

74
Q

Respiratory Acidosis ===

A
  • PaCO2 <35; DEC PaCO2== INC pH
    • ​hypOvent.== hypoxia
    • hypERkalemia== INC K+
    • RESPIRATORY depression
    • airway obstruction
75
Q

Bicarbonate or HCO3-

Normal Value vs. Normal Range

A
  • Normal value === 24
  • Normal range==22-26
76
Q

OPP. of V/Q scan

A

PFT

  • Diffusing capacity of Lung
    • DL
  • Diffusing capacity of Lung for Carbon Monoxide
    • DLCO
77
Q

Normal PFF

A

Normal ratios

78
Q

Blood Gas Analysis/ABGs

*ABG Ninja!!!

USE IT!!!

A

SEE PICS

79
Q

PCO2

Normal value vs. Normal Range

A
  • Normal value === 40
  • Normal range == 35-45

***SAME AS pH….kinda!!!

80
Q

Inspiratory Reserve Volume

IRV

A

Breating in as deep as you can AFTER normal breath

after TV

81
Q

Expiratory Reserve Volume

ERV

A

all air we can force OUT of lungs AFTER NORMAL EXHALE

82
Q

Normal Range of O2 should be….

A

>80

83
Q

ABGs and Venous blood gases

A

CAN provide status of pH and PaCO2

84
Q

Vital Capacity

A

MAX inhale to MAX exhale

85
Q

Hematological tests:

Leukocytosis

A

INC WBC

86
Q

FEV1 ====

A

forced Exp volume in 1 sec

87
Q

PFT:

abnorm values attributed to 3 key factors:

A
    1. DECd perfusion
    1. INCd thickness of capillary-alveolar membrane
    1. DECd functional surf. area of capillary-alveolar membrane
88
Q

When FEV1/FVC is LOWER or SLOWER ====

A

Obstructive

LOWER==more severe

89
Q

Chest CT primary use

A

dx of tumors and PE

360deg x-rays

HIGH res. pics

90
Q

Bronchoscopy indicated to assess for:

A
  • integrity of airways
  • DEEP specific suctioning of viscous secretions
  • Bronchial anastomosis issues
  • Condition of lung tissue
91
Q

V/Q Scans

V/Q

Zones of West

A
92
Q

PFT is a measure of integrity of function of the lung unit OR

A

Alveolar Function

93
Q

Lung Diseases

Obstructive

more o’s

A

Cannot get air OUT

More O’s in Obstructive

can’t get air OUT

94
Q

when FEV1/FVC is HIGHER =====

A

Restrictive

MORE restriction