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ICM -- Pulmonology > Diagnostics: PFT > Flashcards

Diagnostics: PFT Flashcards

1
Q

Most accurate measure of Pulmonary fxn

A

Pleth Box

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2
Q

Signs of Air Trapping/Pseudorespiration

A

Decreased FVC, Increased TLC

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3
Q

Three types of pulmonary fxn testing?

A

Spirometry Lung Volumes Diffusing Capacity

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4
Q

Types of Spirometry tests

A

Methacholine Cronchodilator Challenge Neuromuscular Protocol

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5
Q

Types of Lung Volume Tests

A

Helium dilution Nitrogen washout Plethysmography

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6
Q

Why do PFTs?

A

Explain Dyspnea, hypoxemia Objectively Follow Disease Pre-Op Exams

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7
Q

Total Lung Capacity =

A

Inspir. Reserve + Tidal + Expiratory Reserve + Residual

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8
Q

Vital Capacity =

A

Insp. Reserve + Tidal + Exp. Reserve

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9
Q

Functional Residual Capacity =

A

Expiratory Reserve Vol + Residual Vol.

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10
Q

What do patients do in spirometry?

A

Maximal breath to TLC, then blows out as hard/fast as possible

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11
Q

Name for total volume expired in a spirometry test

A

Forced Vital Capacity

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12
Q

Name of the volume expired in the first second of a spirometry test?

A

FEV1

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13
Q

Most reproducible measure of flow rate over time

A

FEV1

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14
Q

In PFTing curves, the portion above the axis is _______ and the portion below the axis is ______

A

Exhalation Inhalation

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15
Q

Criteria for an acceptable PFT?

A

Smooth, Continuous curve Good Start Finish w/ plateau for 1 sec

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16
Q

Obstructive pattern should make you suspect…

A

Asthma, emphysema, Chronic Bronchitis

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17
Q

Restrictive pattern of PFT should make you suspect…

A

Pulm. fibrosis, Hypersensitivity pneumonitis, sarcoidosis, silicosis, neuromuscular probs

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18
Q

What happens in an extrathoracic resp probs

A

Closure on insp. Opening on expiration (Flat on bottom of loop) Example – Laryngeal Cancer, Vocal Cord Adduction

19
Q

What happens in intrathoracic resp probs

A

Open on inspiration, Closure on expiration (Flat on top, normal curve below)

20
Q

If no confidence intervals are given, what is the cutoff for diagnosing an obstruction?

A

70% FEV1/FVC Look for a scooped loop

21
Q

With an FEV1/FVC ration below 70%, you determine the patient has an obstructive disease. They have a normal FVC. What do you assess next?

A

Post-dilator FEV1 and FVC. If Albuterol fixes it, its Asthma. If not, its COPD

22
Q

How do you distinguish which type of COPD you have?

A

DLCO Down in emphysema Normal in Chronic bronchitis

23
Q

How do you determine is a restrictive lung disease patient has a parenchymal or extrapulmonary restriction?

A

DLCO Down in parenchymal Normal in extrapulmonary

24
Q

Sign of a positive bronchodilator change

A

FEV1 or FVC increase of 12% AND absolute chance of 200 mL after bronchodilaton

25
Q

In mathacholine testing, a FEV1 drop of ______ at a low concentration is diagnostic of hyperresponsiveness

A

more than 20%

26
Q

Neuromuscular disease presents as…

A

Restriction

27
Q

What do you do in neuromuscular testing

A

Assess resp. muscle strength (make patient forcibly inhale/exhale against a closed mouthpiece attached to a pressure gauge).

28
Q

Normal Max Inspiratory Pressure? Expiratory?

A

Insp. – 65 Expiratory – 80

29
Q

Normal Maximal Voluntary Ventillation

A

Normal is FEV1 x 35

30
Q

How does a Helium Dilution test work?

A

Known volume of inert gas (He) at a known concentration is inhaled. Gas is diluted by air volume already in lungs. Concentration of exhaled gas is measured, reflects the initial volume of gas in the lungs.

31
Q

How does a Nitrogen Washout test work?

A

Put a person on 100% Oxygen, measure the amount of Nitrogen being released with their breaths over time.

32
Q

What happens in plethysmography?

A

Subject makes an inspiratory effort against a closed airway, which increased the volume of the lung. Airway pressure decreases and the box pressure increases. Use P1V1=P2V2

33
Q

Volume measured by He dilutiona nd Nitrogen washout?

A

Functional Volume Does NOT measure areas with Trapped Gas Inaccurate in severe obstructive lung disease

34
Q

What are you learning in a DLCO test?

A

The amoutn of gas that is able to diffuse across the alveolar-capillary membrane

35
Q

How do you measure diffusing capacity?

A

Inhale known conc. of CO + Helium to TLC. Hold breath for 10 seconds Exhale and measure the CO and Helium in expired gas

36
Q

Main determinants of diffusing capacity?

A

Surface Area Capillary Flow Membrane Diffusing Capacity (kCO)

37
Q

DLCO =

A

KCO X VA

38
Q

In a patient with normal lung volumes and spirometry, a low DLCO indicates…

A

Pulmonary vascular disorder.

39
Q

Interpret

A

Normal PFT

40
Q

Interpret

A

PFT Obstructive

41
Q

Intrepret

A

PFT - Restrictive

42
Q

Fixed, Variable Extrathoracic, or Variable Intrathoracic?

A

Fixed

43
Q

Fixed, Variable Extrathoracic, or Variable Intrathoracic?

A

Variabe Extrathoracic

44
Q

Fixed, Variable Extrathoracic, or Variable Intrathoracic?

A

Variable Intrathoracic

ICM -- Pulmonology (9 decks)

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