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Anaesthetic FRCA Primary - eLFH Data Interpretation > eLFH - Lung Function Tests > Flashcards

eLFH - Lung Function Tests Flashcards

1
Q

Lung function test examples

A

Peak expiratory flow rate

Spirometry

Diffusing capacity

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2
Q

Types of spirometry

A

Benedict Roth Spirometer

Vitalograph trace

Flow volume curves

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3
Q

Peak flow meter description

A

Telescopic tube with a piston that expands as gas is blown into it, with longitudinal gas escape slot

Best of 3 measurements are taken

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4
Q

Conditions which have reduced PEFR

A

Obstructive lung conditions:
- Asthma
- COPD

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5
Q

PEFR prediction tables description

A

Gives predicted PEFR based on height and gender

Needs correction for ethnic groups that are not Caucasian

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6
Q

Predicted PEFR correction in Afro-Caribbean population

A

Reduce values by 13%

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7
Q

Predicted PEFR correction in Asian population

A

Reduce values by 7%

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8
Q

Limitations of predicted FVC and FEV1 values

A

Less established for patients aged 70 years and older

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9
Q

Calculation for predicted FVC in females over 70 years old

A

FVC = (0.0443 x height in cm) - (0.026 x age) - 2.89

SD +/- 0.43 L

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10
Q

Calculation for predicted FEV1 in females over 70 years old

A

FEV1 = (0.0395 x height in cm) - (0.025 x age) - 2.60

SD +/- 0.38 L

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11
Q

Calculation for predicted FVC in males over 70 years old

A

FVC = (0.0576 x height in cm) - (0.026 x age) - 4.34

SD +/- 0.61 L

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12
Q

Calculation for predicted FEV1 in males over 70 years old

A

FEV1 = (0.043 x height in cm) - (0.029 x age) - 2.49

SD +/- 0.51 L

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13
Q

Benedict Roth Spirometer use

A

Measures static lung volumes

Measures Tidal volume and vital capacity

Can then calculate Inspiratory reserve volume and Expiratory reserve volume

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14
Q

Method to measure functional residual capacity

A

Helium dilution

or

Body plethysmography

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15
Q

Volumes which can be calculated from FRC + other spirometry

A

Residual volume

Total lung capacity

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16
Q

Tidal volume definition and volume

A

Volume of air inspired and expired with each breath

6-8 ml/kg

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17
Q

Inspiratory reserve volume definition

A

Additional volume of air that can be forcibly inhaled after normal tidal volume inspiration

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18
Q

Expiratory reserve volume definition

A

Additional volume of air that can be forcibly exhaled after normal tidal volume expiration

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19
Q

Vital capacity definition

A

Maximal volume of air that can be exhaled after maximal inspiration

VC = TV + IRV + ERV

20
Q

Residual volume definition

A

Volume of air remaining in lungs after maximal expiration

RV = FRC - ERV

21
Q

Functional residual capacity definition

A

Volume of air remaining in lungs at the end of normal expiration

FRC = RV + ERV

22
Q

Total lung capacity definition

A

Total volume of air in lungs after maximal inspiration

TLC = FRC + TV + IRV
or
TLC = VC + RV

23
Q

Spirometry volumes and capacities graph and which cannot be calculated from it

A

Residual volume (and therefore also FRC and TLC) cannot be calculated from graph as lungs cannot be fully emptied

24
Q

Vitalograph definition

A

Plots time on x axis against forces expiratory volume (FEV) on y axis

25
Q

FEV1 definition

A

Volume of air forcefully exhaled in first second

Reduced in obstructive lung disease

26
Q

Forced vital capacity definition

A

Volume of air that can be forcefully exhaled after maximal inspiration

Reduced in restrictive lung disease

27
Q

High risk factor for general anaesthesia from vitalograph

A

FEV1 < 1L

28
Q

Flow volume curve definition

A

Derived from pneumotachograph studies of whole respiratory cycle

Air flow is plotted against lung volume during forced inspiration and forced expiration

29
Q

Normal flow volume curve

A

On expiration - rapid rise to maximal expiratory flow, followed by steady decline

30
Q

Flow volume curve in obstructive lung disease

A

Expiration flow rate is low, with rapid decline after maximal flow giving scooped out appearance

31
Q

Flow volume curve in restrictive lung disease

A

Maximal flow rate reduced

32
Q

Flow volume curve with variable extra-thoracic obstruction e.g. goitre

A

Inspiratory part of curve is flattened, but expiratory part is preserved

33
Q

Flow volume curve with variable intra-thoracic obstruction e.g. tracheomalacia

A

Expiratory part of curve is flattened but inspiratory part is preserved

34
Q

Flow volume curve with fixed extra-thoracic obstruction

A

Flattening of curve in both inspiration and expiration

35
Q

Abnormal spirometry results by each measurement definition

A

Below are all considered abnormal results:
FEV1 < 80% predicted
FVC < 80% predicted
FEV1/FVC < 0.7

36
Q

Diagnosis of obstructive lung disease

A

FEV1 < 80%

and

FEV1/FVC < 0.7

37
Q

Differentiating between COPD and Asthma on spirometry

A

Reversibility with bronchodilators

38
Q

Diagnosis of restrictive lung disease on spirometry

A

FEV1 < 80%
FVC < 80%
FEV1/FVC > 0.7

39
Q

Spirometry findings obstructive vs restrictive lung disease

A
40
Q

Diffusing Capacity of Lung for Carbon Monoxide (DLCO) alternate name

A

Transfer factor

41
Q

Diffusing Capacity of Lung for Carbon Monoxide (DLCO) definition

A

Test of the integrity of the alveolar-capillary surface area for gas transfer

42
Q

Normal carbon monoxide transfer limiting factor

A

CO rapidly taken up by Hb in blood

Therefore transfer of CO mainly limited by diffusion and used to measure gas transfer

43
Q

Conditions where DLCO is reduced

A

COPD

Interstitial lung disease

Multiple PEs

Anaemia

44
Q

Normal partial pressure changes in pulmonary capillary blood for N2O, O2, and CO

A

N2O is perfusion limited
CO is diffusion limited
O2 can be perfusion limited or partially diffusion limited

45
Q

Pathogenesis of Cor pulmonale or P pulmonale

A

Lung disease results in hypoxic pulmonary vasoconstriction

Pulmonary hypertension results in right heart failure

Anaesthetic FRCA Primary - eLFH Data Interpretation (6 decks)

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