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PT Pulmonary Pathology, Diagnosis and Management > Diagnostic Testing > Flashcards

Diagnostic Testing Flashcards

1
Q

Cytology:

A

Analysis of cells: how they form and function.

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2
Q

Laboratory tests:

A
  • Cytology: analysis of cells: how they form and function
  • Hematology: complete blood count, WBC, RBC, platelets.
  • Coagulation studies: how well id the blood clotting (partial thromboplastin time, prothrombin time)
  • Arterial Blood Gas (ABG): alveolar ventilation, oxygenation, acid-base balance, disease progression.
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3
Q

Arterial Blood Gas (ABG) can give information about

A
  • alveolar ventilation
  • oxygenation
  • acid-base balance
  • disease progression
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4
Q

would the venous blood gas lab result be the same as arterial blood gas?

A

no

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5
Q

PaCO2 > 50 =

A

respiratory failure​

  • Failure of pulmonary system to meet metabolic demands of body
  • Extent of failure is determined by accompanying change in pH
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6
Q

Acidosis + low HCO3 =

A

primary

metabolic acidosis

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7
Q

Is the problem uncompensated or compensated/compensating? Look at…

A

CO2

  • UNCOMPENSATED
    • pH is outside the normal range
    • PaCO2 is within the normal range
  • PARTIALLY COMPENSATED
    • Both pH and PaCO2 are outside the normal range
  • COMPENSATED
    • ​pH is within normal range
    • PaCO2 is outside normal range
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8
Q

Chronic respiratory acidosis: kidneys __________ bicarbonate

A

hold

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9
Q

Corresponding increase/decrease in HCO3- which indicates that the _____________ system is compensation

A

metabolic

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10
Q

Corresponding increase/decrease in PaCO2 which indicates that the _____________ system is compensation

A

respiratory

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11
Q

Kidneys can compensate for chronic respiratory disorders by either holding or dumping bicarbonate. Chronic respiratory acidosis: kidneys __________ bicarbonate

A

hold

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12
Q

In chronic respiratory alkalosis: kidneys will __________ bicarbonate

A

get rid of

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13
Q 
crime = acid
police = Bicarbonate (HCO3)
criminals = H+
A

nice

to get rid of the crime, the police hold on to criminals to be excreted by the kidneys

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14
Q

What affects Forced Vital Capacity?

A

Restrictive diseases

(fibrosis, scoliosis, diaphgram can’t move, obesity, pulmonary edema…)

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15
Q

Forced Expiratory Volume in 1 sec

A
  • Reflects airflow in large (& medium sized) airways
  • 75% - 80% of FVC should be exhaled in the first second
  • If decreased = obstructive disease
  • Large lungs = large FEV1
  • Large airway diameter = large FEV1
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16
Q

Measure volume and flow of air during inspiration and exhalation

A

Pulmonary Function Testing (PFT)

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17
Q

Provides graphic display of inspiratory and expiratory flows and volumes

A

Flow volume loops

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18
Q

Max amt of gas pt can exhale forcefully & quickly

A

Forced Vital Capacity (FVC)

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19
Q

FEV1/FVC

A
  • Decreased = obstructive disease
  • Near normal or elevated = restrictive disease
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20
Q

Normal Forced Vital Capacity

A

80%

  • Mild: 60-79%
  • Moderate: 51-59%
  • severely impaired < 50
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21
Q

Normal Forced Expiratory Volume in 1 second:

A

80%

  • Mild: 60-79%
  • Moderate 51-49%
  • Severe < 40%
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22
Q

Normal FEV1/FVC =

A

75%

  • Mild 60-74%
  • Moderate: 41-59%
  • Severe: <40%
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23
Q

What causes FVC to decrease?

A

restriction diseases, whatever restricts air into the lungs:

fibrosis, scoliosis, obesity, diaphragm can’t move.

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24
Q

What causes Forced Expiratory Volume in 1 sec to decrease?

A

obstructive diseases

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25
Q
  • if FEV1 and FEV1/FVC = decreased (less than 75%)
  • RV = increased
  • TLC = normal or increased
A

obstruction

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26
Q

Obstructive or restrictive?

A

Obstructive diseases causes Forced Expiratory Volume in 1 sec to decrease

27
Q

Obstructive or restrictive?

A

restrictive diseases causes FVC to decrease, and TLC, RV, FRC decrease

28
Q
  • TLC = decreased
  • RV, VC, and FRC = usually decreased
A

Restrictive

29
Q

x-rays go through body without being absorbed (dark areas) are more..

A

radiolucent

30
Q

x-rays thta are absorbed in lighter areas are more

A

radiopaque

31
Q

air in an x-ray is______

A

rediolucent

32
Q

bone is a x-ray is white because is

A

radiopaque

33
Q

in an radiograph what is lighter (whiter) muscle or fat?

A

muscle is lighter

34
Q
  • Standard for looking at anatomy of chest
  • Views usually described as PA, AP, Lateral
A

Chest X-ray (CXR)

35
Q
A
36
Q
A
  • COPD
  • Barrel chest
  • Widened intercostal spaces
  • Flattened hemi-diaphragms
  • Squared off costophrenic angles
  • Rib angles approaching 90 degrees
37
Q
A

Pneumonia

38
Q
A

atelectasis

partial collapse

39
Q
A

atelectasis

40
Q

Used to look for pulmonary nodule

A

Computed Tomography (CT Scan)

41
Q

Used primarily for soft tissue and lymph nodes

A

MRI (Magnetic Resonance Imaging)

42
Q

imaging test that uses x-rays and special dye to see inside the arteries

A

Pulmonary Angiogram

43
Q

Direct visualization of the bronchial tree through a scope

A

Bronchoscopy

44
Q

Radionuclide V/Q Scan

A

Examine by x-ray—how areas of lung are being ventilated and perfused:

  • Inhale radioisotope
  • Inject radioisotope
  • Poor ventilation: may be airway obstruction
  • Poor perfusion: may be PE
45
Q
A

Radionuclide V/Q Scan:

Examine by x-ray—how areas of lung are being ventilated and perfused

46
Q
A

Radionuclide V/Q Scan

47
Q

True or false: bronchoscopy can be used to clear secretions

A

true

48
Q
A

Pulmonary Angiogram

49
Q
A

Pulmonary Angiogram

50
Q
  • Catheter inserted and carefully fed into and through the right side of the heart to the pulmonary artery (leads to the lungs)
  • Dye injected in to the catheter once in the correct location
  • X-ray images are taken to see how the dye moves through the lungs’ arteries
  • Dye helps detect blockages to blood flow
A

Pulmonary Angiogram

51
Q

Better view of soft tissue than CT scan, but is more expensive and takes longer

A

MRI

52
Q

Amount of gas (CO, carbon monoxide) entering the pulmonary blood flow per unit time

A

DL or DLCO (diffusing capacity of the lung)

53
Q

What gas is used in DLCO or DL (diffusing capacity of the lung)?

A

CO (carbon monoxide) is used as it has a greater affinity for hemoglobin

54
Q

Diffusing capacity of the lungs can be reduced in three cases:

A
  • Decreased hemoglobin
  • Increased thickness of alveolar-capillary membrane
  • Decreased surface area for diffusion (primary factor), (COPD).
55
Q

Which is the most important confounding factor in PFT?

A

poor effort from the patient,

make sure pt puts maximun effort

56
Q

In PFT, if the pt’s value falls outside the predicted value by more than ____% is considered abnormal

A

25%

57
Q

heard over the trachea, ratio?

A

tracheal sound

1:1 with gap

58
Q

Sound heard over the sternum or manubrium, ratio?

A

Bronchial

1:2 with gap

59
Q

Sound heard anteriorly at the 1st and 2nd ICS and posteriorly between the scapulae

A

bronchovesicular

1:1 continuous

60
Q

Heard throughout lung periphery

A

vesicular

3:1 continuous

61
Q

(smoking) pack years =

A

packs per day x years smoked

62
Q

70 pack years =

A

1 pack per day for 70 years

or 2 pack per day for 35 years

63
Q

10 pack year

A

1 pack per day for 10 years

2 packs 5 years

64
Q

PFT measured again 5-20 minutes after bronchodilator. Normal or PURELY restrictive disease
should show differences in what?

A

no difference

PT Pulmonary Pathology, Diagnosis and Management (10 decks)

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