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Diagnostics > Exam 3 Cardiac And Respiratory > Flashcards

Exam 3 Cardiac And Respiratory Flashcards

1
Q

What is the number one risk factor for COPD?

A

Tobacco

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2
Q

Name some risk factors for COPD

A 
Tobacco
Air pollution inside or outside
Noxious exposure such as paint
Older age
Female sex
Low socioeconomic status
Asthma as a child
chronic bronchitis
Infections
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3
Q

What is Alpha1 anti-trypsin?

A

Alpha-1 antitrypsin is a protein that protects the lungs

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4
Q

What does alpha-1 antitrypsin deficiency cause?

A

It is a genetic issue that can cause liver and lung problems

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5
Q

What is the modified British medical research Council questionnaire?

What does it measure?

A

It is a subjective measure assessment

It measures the severity of dyspnea

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6
Q

What is the goal diagnostic tool based on?

A

It is based on PFTs responsiveness to bronchodilators

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7
Q

What is a normal FEV1/FVC ratio?

A

70% or 0.7

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8
Q

If a patient does not have a response to a bronchodilator what does that mean?

A

They have COPD and not asthma

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9
Q

The American thoracic society guidelines are utilized for what group of patients?

A

For patients younger than 65

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10
Q

What medication do they use in a broncho provocation challenge?

A

Methacholine

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11
Q

What does methacholine do?

What challenges is it a part of?

A

It is a part of the bronchoprovocation challenge

It narrows airways and triggers an asthma attack

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12
Q

Does the bronchoprovocation challenge have better sensitivity or specificity?

A

It has better sensitivity and low specificity

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13
Q

The mannitol inhalation challenge Has what In regards to specificity and sensitivity?

A

It’s better specificity and lower sensitivity

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14
Q

What are some contraindications for spirometry test?

A

Any surgery within four weeks ago
MI within one week
Arrhythmias, heart failure, hypertension or uncontrolled hypertension, acute cor pulmonale, unstable pulmonary embolism, increase intraocular and intracranial pressure, cerebral aneurysm, recent concussion, increased sinus in middle ear pressure, Pneumothorax, thoracic or abdominal surgery, late term pregnancy, suspected transmissible respiratory or systemic infection, oral secretions that are bleeding

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15
Q

How long should patient’s avoid vaping and smoking or using a pipe before PFT?

A

One hour before

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16
Q

How long do you patients need to avoid alcohol before a pft?

A

Eight hours

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17
Q

Patient should avoid vigorous exercise for how long before a PFT?

A

One hour

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18
Q

What does FVC mean?

A

Forced vital capacity

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19
Q

What is FEV1 ?

A

Force expiratory volume in the first second of exhalation

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20
Q

What is TLC?

A

Total lung capacity

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21
Q

What is RV mean?

A

Residual volume

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22
Q

How do you do spirometry?

A

Begin with maximal inhalation, then do a blast of expiration which is FEV1, Continue complete expiration for a maximum of 15 seconds which is your FVC

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23
Q

How many times can you do you spirometry—What is the maximum and minimum attempts?

A

Repeat my maneuver for at least three times, maximum of eight attempts

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24
Q

What are the normal values for FEV1 and FVC alone?

A

Greater than 80%

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25
Q

The expected normal of the FEV1/FVC ratio is based off what 5 factors?

A

Sex, age, weight, height, ethnicity

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26
Q

FVC should be within How many liters of the FEV1 to determine reliability of test?

27
Q

What does a low FEV1/FVC ratio mean ?

A

Probably has an Obstructive disorders such as emphysema or bronchitis COPD asthma bronchiectasis

28
Q

What does a normal FEV1/FVC ratio, but low FVC mean?

A

Air trapping

Interstitial lung disease, luminary fibrosis, obesity, scoliosis, muscular dystrophy

29
Q

What is Maximum voluntary ventilation test?

A

Patient breathe in and out as quickly as possible for 12 seconds

30
Q

What does the maximum voluntary ventilation determine?

A

Used to determine if patient has a neuromuscular weakness or upper airway obstruction

31
Q

What is a marked response for the airway responsiveness test—bronchodilator response?

Usually for asthma

A

An increase of 200 mls and 12% of the FVC or FEV1

32
Q

What are two lung volume measurements?

A

Inert gas solution and nitrogen washout

33
Q

For a lung volume measurement, in utilizing the inert gas dilution what does it involve?

A

They calculate the volumes after patient breathes gas (usually helium) in and out until equilibrium is reached

34
Q

For long volume measurement, the nitrogen washout involves?

A

Patient breathing 100% of oxygen in the amount of nitrogen is released as what they measure

35
Q

What is DLCO?

A

Diffusing capacity of long for carbon monoxide

36
Q

What does DLCO measure?

A

Measures gas transfer from the air and into the alveolar sacs

How oxygen can get to your tissues

37
Q

What can throw the test off for DLCO?

38
Q

What is an acute cough time length?

A

Acute was less than three weeks

39
Q

What is the subacute cough time span?

A

3 to 8 weeks

40
Q

Chronic cough is how many weeks?

A

Eight weeks

41
Q

How do assess an hepatojugular reflex?

A

Apply pressure on right upper quadrant for 60 seconds and watch for increase and jugular venous pressure greater than 1 cm positive test

42
Q

What disease can cause hepatosplenomegaly?

A

Mononucleosis because it can cause liver and spleen enlargement

43
Q

What is the normal time for a EKG Holter monitor?

A

24 to 48 hour monitoring

44
Q

What are ambulatory event monitors?

A

They are longer than holter monitors.

a loop recorder and planted can be up to two years.

They can be triggered or automatic recording with abnormalities

45
Q

A troponins will rise after how many hours has occurred?

A

2 to 3 hours

46
Q

If a troponins elevated but they are no EKG changes, what would be the diagnosis?

A

Non-ST elevation myocardial infarction or an NSTEMi

47
Q

What are some contra indications for stress testing?

A

Congestive heart failure, and controlled arrhythmias, aortic stenosis, angina, myocardial infarction,, pulmonary embolism, severe pulmonary hypertension, aortic dissection.

48
Q

How long does the patient need to be NPO for a stress test?

A

Four hours

49
Q

If a patient has a positive stress,

What would be the next diagnostic?

A

Heart catheterization

50
Q

A left heart Catherization looks at what?

A

Looks at vessels, mitral valve, aortic valve, left ventricular ejection fraction, used to insert stents and balloons.

Used mostly for heart disease patients

51
Q

A right heart catheterization looks at what?

A

Looks at pressures in the heart, blood flow, valvular disease, can diagnose pulmonary hypertension.

52
Q

Whats the purpose a stress echo cardiogram?

A

It can show problems with blood flow that is invisible and resting

53
Q

What can a bubble or contrast echo confirm?

A

It can confirm atrial septal defect

54
Q

Transthoracic echocardiogram

A

done through the chest wall

Looks like the inside of the heart, non-invasive. Done with Doppler and ultrasound. Does not diagnose cardiovascular disease. Recommended for long-standing hypertension. uses it continues EKG at the same time. Can be two or three dimensional.

55
Q

Transesophageal echocardiogram

A

Done with a probe in the throat
Can get better visualization

Shows vegetation or infection better

recommended for patients who have had sepsis and can also look for embolic source (a fib)

56
Q

What is the normal ejection fraction?

57
Q

Low pulse pressure is associated with what?

A

Is associated with aortic stenosis

58
Q

What is the normal anion gap?

59
Q

Kawasaki disease clinical findings

A

Rash, or pharyngeal mucous membrane changes, conjunctival injection, extremity changes, lymphadenopathy, and

fever five days or more

Elevated to C-reactive proteins, elevated ESR

60
Q

When a rhythm is below the iso electric line what is that mean?

61
Q

Inversion of a T wave means what?

A

Previous MI occurred

62
Q

What does a Q wave mean?

A

Someone had an MI in the past

This never goes away

63
Q

The right arm is always what?

64
Q

The left leg is always what?

Diagnostics (3 decks)

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