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Acute Care > ECG's, Bloods & CXR > Flashcards

ECG's, Bloods & CXR Flashcards

1
Q

Put the following in order of density (least=radio-lucent to most=radio-opaque) on chest X-Ray

  • Fat
  • Bone/free blood
  • Air/gas
  • Water
  • Metal/contrast dyes
A 
Air/gas (black)
Fat (grey)
Water (pale grey-white)
Bone/free blood (white)
Metal/contrast dyes (white)
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2
Q

Name 4 mechanisms of lung collapse.

A
  • Hypoventilation
  • Obstruction (resorption)
  • Positive intra-pleural pressure (compression)
  • Surfactant impairment
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3
Q

What are the degrees of lung collapse?

A
  • Atelectasis
  • Segmental
  • Lobar
  • Lung
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4
Q

How can you identify a collapse on CXR?

A
  • Loss of volume
  • Movement of adjacent structures towards the collapse
  • Silhouette sign
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5
Q

What is consolidation?

A

Pathological condition where air is replaced in the lung with tissue or fluid of greater density

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6
Q

Causes of consolidation?

A
  • Fluid exudation (pulmonary oedema)
  • Exudation (infection or pulmonary haemorrhage)
  • Inhalation (gastric contents, toxic fumes)
  • Infiltration (lymphoma, alveolar cell carcinoma)
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7
Q

What are the differences between consolidation and collapse on CXR?

A

Consolidation > Collapse

Normal volume > Reduced volume
No shift of structures > Shift towards collapse
Vascular markings obscured > Vascular markings present and close together
Air bronchogram (black airway visible against white lung field) > No air bronchogram

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8
Q

Causes of pneumothorax?

A
  • Stab wound
  • Mechanical ventilation high pressures
  • Spontaneous rupture subpleural bleb
  • Misplacement subclavian line
  • Chest trauma and # ribs
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9
Q

What is a pneumothorax?

A

Air in the pleural cavity

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10
Q

Pleural effusion

A

Fluid in the pleural space.

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11
Q

What will pleural effusion look like on CXR?

A
  • Blunting of costophrenic angle
  • White opacity (gravity dependent)
  • No loss of volume
  • Fluid line observed in erect position
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12
Q

What would you expect to see on a COPD CXR?

A
  • Bullae

- Hyperinflation

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13
Q

What are some causes of pulmonary oedema?

A
  • Left ventricular failure
  • Renal failure
  • IV fluid overload
  • Drug abuse
  • Neurological events
  • ARDS
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14
Q

What is ventilation?

What is perfusion?

A 
Ventilation = Air that reaches the lungs 
Perfusion = Blood that reaches the lungs
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15
Q

Where does optimal V/Q matching occur?

A

Dependent region (lower 1/3 of the lungs)

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16
Q

What happens when there is poor ventilation?

A

Shunt. Perfused area of lung but not ventilated

17
Q

What happens if there is poor perfusion?

A

Physiological dead space. Ventilated lung but not perfused, does not participate in gas exchange.

18
Q

98.5% of O2 is transported where?

Where is the rest?

A

Binded to haemoglobin on RBC’s.

Dissolved in plasma.

19
Q

Where is 60-70% of CO2 transported?

A

In a dissolved state as bicarbonate.

20
Q

What are two methods of monitoring blood gases?

A
  1. Non-invasive (clip on/external attachment eg. pulse oximeter)
  2. Invasive (via inserted attachment, eg. IV or arterial line)
21
Q

What are some common insertion locations for arterial lines?

A
  • Radial artery
  • Brachial artery
  • Femoral artery
22
Q

What are the two key buffer systems for maintaining the bodies acid-base balance?
How long do these systems take to respond?

A
  1. Respiratory (mins-hours)

2. Renal (days)

23
Q

pH measure ____ concentration which is kept in balance by maintaining _____ and _____ in a constant ratio.

A

H+
Bicarbonate ions (basic)
PaCO2 (acidic)

24
Q

What are normal values for the following:

  • pH
  • PaCO2
  • PaO2
  • HCO3
A 
pH = 7.35 - 7.45
PaCO2 = 35-45mmHg
PaO2 = 80-100mmHg
HCO3 = 22-26mmHg
25
Q

What is Type I respiratory failure?

A

PaO2>60mmHg

Hypoxemia

26
Q

What is Type II respiratory failure?

A

PaCO2>50mmHg + PaO2<60mmHg

Hypercapnia + Hypoxemia

27
Q

Signs of hypoxia?

A
  • Cyanosis
  • Mild hypertension
  • Increased HR
  • Peripheral vasoconstriction
    OR
  • Parasympathetic response (bradycardia & hypotension)
28
Q

Signs of hypercapnia?

A
  • Vasodilation
    OR
  • Sympathetic response (hypertension, increase HR, sweating)
29
Q

Symptoms of hypoxia?

A
  • Loss of judgement
  • Paranoia
  • Restlessness
  • Agitation & confusion
  • Dizziness
30
Q

Symptoms of hypercapnia?

A
  • Headache
  • Drowsy
  • Unresponsive/ unconscious
  • Coma
31
Q

ABGs for respiratory acidosis?

A

pH low <7.35
PaCO2 high
HCO3- normal

32
Q

ABG’s for respiratory alkalosis?

A

ph high > 7.45
PaCO2 low
HCO3- normal

Acute Care (6 decks)

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