diagnostic procedures Flashcards
what is the EVH (Eucapnic Voluntary Hyperpnea) challenge?
the sensitive and specific diagnostic method that triggers exercise-induced bronchoconstriction (EIBC) by hyperventilation of safe concentrations of dry gases
what is the EVH challenge protocol?
- prior:
- refrain from taking short-acting bronchodilators for 8 hours
- refrain from taking long-acting/sustained release bronchodilators for 48 hours in order to maximize the airway response
- FEV1 is taken before, 3 times.. highest one is the baseline for the test
- a ventilation rate of 21x FEV1 at baseline = a positive response for those with asthma
- a ventilation rate of 30x FEV1 at baseline is recommended for those without a diagnosis of asthma
- FEV1 assessed after 5, 10, 15, and 20 mins post challenge
what do different EVH responses mean?
- the percent decline between the FEV1 obtained pre-challenge and the FEV1 obtained post-challenge is used to determine the airway response
- EVH response >12% is considered a positive response
- FEV1 baseline - lowest FEV1 post-EVH x 100 = % decline
what will the FEV1 range be with someone with COPD?
between 50-79% of the predicted normal values with an FEV1/FVC of less than 70%
what are symptoms of COPD?
- SOB after activity
- cough & sputum production are more noticable
what is pulse oximetry?
measuring oxygen saturation or the percentage of hemoglobin saturated with oxyen in arterial blood
- normal levels = 95-100%
- 88% or below = hypoxemia
what is a holter monitor?
ambulatory or portable electrocardiogram (ECG)
- records the electrical activity of the heart continuously over 24 hours or longer
- a standard or “resting” ECG is one of the simplest and fastest tests used to evaluate the heart
why do people use holter monitors?
for patients suspected of/or with atrial fibrillation, pre ventricular contractions, pre atrial contractions, atrial flutter, and bradycardia
why would someone order a cholesterol test?
to get a better understanding of risk factors of a heart attack or other types of CVD
what does it mean when you have high triglycerides?
- you regularly eat more calories than you burn
- high levels can increase your risk of heart disease
how low should your triglyceride levels be?
less than 150 mg/dL (1.7 mmol/L)
what is non-high density lipoprotein (non-HDL-C)?
the difference between total cholesterol and HDL cholesterol
- includes cholesterol in lipoprotein particles that are involved in hardening of the arteries
what are high sensitivity C-reactive proteins (HS-CRP)?
- a protein made by the liver that plays an integral role in the body’s response to injury and infection
- key in the inflammatory response
- greater inflammation = increased risk of heart attack, stroke, and other CVDs
- buildup of fats, cholesterol and other substances (plaque) can resrtict blood flow, triggering a blood clot
why should HS-CRP tests be done multiple times, and how often?
- CRP levels can temporarily increase by many situations (ex: cold, or going for a long run)
- should be done twice, two weeks apart
what HS-CRP levels indicate higher risk of heart disease and what medications help?
- above 2.0 mg/L
- cholesterol-lowering statin medications