finalquiz.pft Flashcards

1
Q

How do we measure indirect volumes?

A

Performing a SVC maneuver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

respirometers measure _______ & reports the results in ________

A

flow

volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peak flow meters measures flow & reports in _______.

A

Flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the 5 purposes for PFT testing?

A
Identification (detect disease)
quantification (evaluate need)
Epidemiological (identifies pulmonary abnormalities from environment or occupational risk screening
Post Op Risk
Pulmonary disability
Therapeutic Effectiveness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name 5 volumes that can be measured directly?

A

Vt, IRV, ERV, IC, VC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T or F: Tidal volume has great variation & may abnormal readings are always indicative of disease.

A

False, Vt is not indactative of disease due to great variance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is an average Vt?

A

500 - 700 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

This value is part of normal breathing, is consistent at resting, you would exhale maximally to obtain reading of this expiratory level?

A

ERV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If you tell a patient to take a maximal inspiration followed by a maximal exhalation without force you would be looking to get what type of measurement?

A

SVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The SVC will provide important volumes used to determine ________ disease.

A

Restrictive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Maximum volume of air inspired following normal inspiration but is not clinically significant, obtained from SVC

A

IRV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A normal exhalation, when you inhale maximally is describing:

A

IC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T or F: there is great variation with IC

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This value can be measured on inspiration or expiration?

A

VC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 5 things that can be provided with a VC maneuver

A

VT, IRV, ERV, IC, VC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

This evaluates lungs ability to move large volumes quickly?

A

Pulmonary Mechanics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The FVC will provide important flow rates used to determine ________ disease>

A

Obstructive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pulmonary Mechanics uses _____ maneuver to obtain results.

A

FVC maneuver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When an FVC is performed your exhalation needs to last longer than ______ seconds. If it cannot be completed in ______ seconds this indicates obstruction.

A

6 seconds, 3 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

FVC should equal _______.

A

SVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

FVC can measure what 5 items?

A

FVC, FEV1, PEFR, FEF 200-1200, FEF25-75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

This measurement is sometimes used to evaluate asthmatic patients pre & post bronchodilation, is seen on flow volume graph as the highest point.

A

PEFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a normal value for PEFR?

A

600 l/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T or F: PEFR may appear normal in abnormal patients & is also effort dependent?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Decreased values in this measurement is associated with large airway obstruction?

A

Forced expiratory flow 200-1200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

_______ is the best indicator of obstructive disease.

A

FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

T or F: Largest FEV1 is not always largest FVC

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

This measurement is associated with small airway obstruction?

A

Small airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

This value is the FEV for a given interval expressed as a % of a FVC

A

FEV/FVC ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A decreased ratio of FEV1/FVC is indicative of _______ disease.

A

Obstructive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A ratio of less than ______ % is indicative of obstructive disease.

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A ratio of greater than 70% is indicative of _______ or ______ lungs

A

Normal or restrictive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The flow volume loop measures _________ and _______ rates of FVC

A

Flow Volume Loop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Flow per time is measured on the ______ axis & volume is measured on the ________ axis on a flow volume curve.

A

Flow per time is measured on vertical axis & volume is measured on horizontal axis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

___________ is measured on top part of line & _________ is measured below the base line.

A

expiration;

inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

If you have a flow volume loop that is scooped out this may represent _______ disease; if you see a skinny and tall loop you may have ________ disease.

A

Obstructive

Restrictive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Fixed obstruction causes:
A. Decrease in inspiratory flow rates only
B. Decrease in expiratory flow rates only
C. Normal flow rates when measured directly
D. Equal decreases in both expiratory & inspiratory flow rates.

A

D. Equal decreases in both expiratory & inspiratory flow rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

If you have a flattened flow volume loop on the expiration side this would indicate what type of obstruction?

A

Intrathoracic variable large airway obstruction or fixed large airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

If you see a relatively normal expiratory flow curve but a small volume, flattened curve on inspiration you probably have what type of obstruction?

A

Extrathoracic variable large airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

If you have a flow volume loop that looks flattened & smaller on both inspiration & expiration you probably have?

A

Fixed large airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When you are testing for reversibility of an obstructive pattern you would need to see an increase of more than _______% following application of bronchodilator.

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

When a PFT test is performed how long should a patient refrain from using their bronchodilator before testing occurs?

A

8 hours prior to testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What test is used to look for a reactive airway? It is called _________ or __________

A

Bronchial provocation or methacholine challenge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What value should be seen in order to see a positive result in the methacholine challenge?

A

It is a 20% decrease in FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

When given this test you would instruct the patient to breathe in & out as fast as possible until told to stop; normally performed in 12-15 seconds often in a panting maneuver?

A

Maximum voluntary ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What type of measurements is gold standard for diagnosing restrictive condition?

A

Lung Volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

If you needed to obtain a height on a person who is a double amputee how would you find it?

A

Measure finger to finger to approximate weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

PD20% represents:

A

A 20% decrease in FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

This measurement can gives us a picture of a patients muscular mechanics?

A

Max Voluntary ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What method of drug administration is used to administer the methacholine challenge?

A

Nebulizer or dosimeter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The largest volume & rate that can be breathed per minute by voluntary effort is _____________.

A

Maximum voluntary ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

The predicted values for evaluation of PFT is based on what 3 factors?

A

Age, height, sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

If you test positive on the PD20% which means you have a decrease of 20% in your fev1 you probably have ___________ airways.

A

Reactive airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Pulmonary mechanics is looking at ________ of a person.

A

Airflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are some reasons a person may have poor or decreased MVV measurements? 5 reasons

A
Obstructive disease
Airway resistance
muscle weakness
decreased compliance
poor patient effort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

The MVV measures the amount of air moved within _________ seconds.

A

12-15 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Name 3 things measured in PFT tests.

A

Lung volumes/capacities
Flow rates
Gas diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the scale used to interpret normal vs abnormal results? Measured in percentages

A

80-100% = normal pft
60-79% of predicted = mild disorder
40-59% of predicted = moderate disorder
40% of predicted = severe disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

If you have a patient with these values how would you diagnose him/her?
56 year old female
FVC = predicted (5.10); Observed (3.30); % predicted = 64.7%
FEV1 = Predicted (3.83); Observed (3.18); % predicted = 83%
FEV1/FVC % = Predicted 75%; Observed 96%

A

Volume (FVC) decreased 65% of predicted
FEV1 are normal (83% of predicted)
Since the FEV1 is normal no obstructive problem is identified but since FVC volume is decreased the patient appears to have a mild restrictive problem

DX: Mild Restrictive only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q
How would you diagnose this patient?
48 year old man:
FVC = 81.9% of predicted
FEV1= 44.6% of predicted
FEV1/FVC % = 41%
A
Volume (FVC) is normal when above 80% which would indicate no restrictive problem
The flows (FEV1) are decreased 44% of predicted so there appears to be a moderate obstructive problem

DX: Moderate obstructive only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

If a patient is testing for an obstructive condition what is the next study that should be done?

A

Post bronchodilator study to see if obstruction is reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

T or F: RV can be measured directly.

A

False; RV cannot be directly measured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

In order to obtain a measurement for FRC & TLC you also must measure ________

A

RV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Name 3 tests or ways you can measure FRC?

A

Helium dilution
Nitrogen Washout
Body Plethysmography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

The nitrogen washout method or N2 is a open/closed method of obtaining FRC?

A

Open Method

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How is FRC measured with the Nitrogen Washout method, explain the process & what other gases if any may be used.

A

FRC is washed out of the lung by having the patient inspire 100% O2; The washout FRC goes into a colleting spirometer & is measured to calculate the FRC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

A N2 washout of ________ minutes indicates normal lungs whereas a time that is greater than ________ indicates poor distribution.

A

2-3 minutes = normal

> 7 minutes = poor distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

If you have a leak in your system during the N2 or nitrogen washout test what happens to your FRC?

A

FRC is artificially raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q
When performing the \_\_\_\_\_\_\_\_\_\_\_ test for measuring FRC you are looking at the distribution of air trapping in the lungs.
A.  Nitrogen Washout
B.  He Dilution
C.  Body Plethysmography
D.  Calibration
A

A. Nitrogen Washout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

T or F: When you are calibrating a gas analyzer which is used to confirm standards of PFT testing you must calibrate analyzers on same gas that is used in the test?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

This is the resting volume left in the lungs when you do not inhale or exhale; it can be the volume left after a quiet exhale

A

FRC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

T or F: Weight never affects a predicted value in PFT testing

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

T or F: Lung size may change if a patient is profoundly obese due to the restrictive area left in the cavity.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is normal value for FEV1/FVC?

A

Our value is 72%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

T or F: The FEF 200-1200 is a vital component of the PFT testing for us to measure flow and thus obstruction.

A

False, Peak flow will tell us same thing so don’t really need; it is an indicator for large airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What measurement may be good for classification for pulmonary and/or occupational purposes?

A

FVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

During PFT testing what is the maximum parameter or time that can be measured during exhalation.

A

15 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

When performing PFT testing for SVC & VC the tests should start within _______ ml of each other.

A

.2mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

If you increase FRC what will happen to the alveoli in the lungs?

A

The alveoli will stay open longer period of time so the IC & Vt will lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

T or F: The values of RV & FRC cannot be manipulated or changed in lungs.

A

False, RV & FRC can be raised in certain lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What type of maneuver can be done to improve oxygenation?

A

Peep maneuver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What flow level must be met in order for an MDI to work effectively?

A

60 lpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Name the 6 characteristics or principles that must be applied to flow or volume equipment.

A
Capacity
Accuracy
Error
Linearity
Output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Name 3 examples of volume measuring devices.

A
  1. Water sealed spirometers/stead wells that measure volume & time (Stead Wells, Water Sealed Collins)
  2. Dry Rolling Seal (pistons with rolling diaphragm)
  3. Bellows spirometer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Flow measuring devices are known as _______.

A

Pneumotachometers

86
Q

Name 5 types of pneumotachometers or flow measuring devices.

A

Turbine device - Wright Respirometer (turbinometers);
Fleisch which measures pressure differential or resistance
Thermal- flow cooled
ultra sonic-signal disrupted by change
Peak Flow Meters

87
Q

What is the formula to find Vt if you have I time & flow?

A

Vt= Flow X I time

88
Q

T or F: Flow can be converted to volume when using some flow measuring equipment

A

True

89
Q

What is a normal value on the Peak Flow Meter

A

600 lpm

90
Q

When using _________ to measure flow repeatability is more important than accuracy and its reproducibility should be within 0.67 l/sec or 40 lpm

A

Peak Flow Meters

91
Q

What do you call a principle of pulmonary function testing in which the accuracy of the measurement exists over its entire range of measurement?

A

linearity

92
Q

A principle of PFT equipment that represents how much the equipment can measure?

A

Capacity

93
Q

Reliability of PFT equipment is called ______.

A

Precision

94
Q

The specific measurement made is called _____.

A

Output

95
Q

If you have only spirometry values to analyze as you do not have a complete PFT test but the FVC = SVC but you notice the values are low this would imply what type of condition?

A

Restrictive

96
Q

This is the gold standard of identifying obstructive conditions?

A

FEV1 values

97
Q

Name 2 types of problems you may experience when measuring for FRC?

A

Patient problem

Leaks or problem with equipment

98
Q

When measuring for FRC this type of test is done when the patient is panting against an open & closed shutter?

A

Body Box

99
Q

What must occur to obtain a valid measurement of FRC for helium or Nitrogen testing?

A

Equilibration

100
Q

When performing Plethysmography what gas law is used to determine total thoracic gas volume

A

Boyles Law

101
Q

Intrapulmonary volume is abbreviated as

A

VTG or TGV

102
Q

T or F: In normal patients VTG = FRC

A

True

103
Q

When using body box because air flow is not possible against a closed shutter mouth airway pressure = ___________.

A

Alveolar pressure change

104
Q

When using the body box or plethysmography a graph is created which shows ________ & ________ changes?

A

Pressure & Time changes

105
Q

T or F: When utilizing the plethysmograph the cabin the patients sits in must be pressurized & internal pressure is monitored & compared to external atm pressure

A

True

106
Q

What is Boyles Law?

A

P1V1=P2V2

107
Q

HE dilution for measuring FRC is considered an open or closed system?

A

Closed Method

108
Q

T or F: After equilibrium occurs the changed level of O2 is used to determine FRC once He is diluted & equilibrium occurs.

A

False; The change in He? is used to determine FRC because there is no helium in lungs normally; measurement occurs after equilibrium occurs

109
Q

T or F: Helium is an inert gas

A

True

110
Q

In order to have a valid test your extrapolated volume for flow rates should be less than _______.

A

Less than 5% or .150 l

111
Q

If your FVC , SVC your patient may have what type of condition?

A

Obstructive

112
Q

When you are measuring FEV1 the result is reported as __________ but is actually ________ value.

A

FEV1 reported as volume but is actually flow

113
Q

This is the volume exhaled before zero time point, no more than 5% of VC is allowed.

A

Extrapolated value

114
Q

T or F: The larges FEV1 will always lead to the largest FVC

A

FALSE; the largest FEV1 does not always = largest FVC

115
Q

This is the average air flow during mid portion of FVC.

A

FEF 25-75

116
Q

If you have a reduced value of FEF 200-1200 then you may have large or small airway obstruction.

A

Large airway obstruction

117
Q

This value is located on the highest point on volume flow graph & sometimes shows normal in abnormal patients.

A

PEFR

118
Q

When ______ value is decreased this is a symptom of small airway obstruction

A

PEF 25-75

119
Q

If you see an increased MVV value you have an increase in __________. If you see a decrease in MVV then you have _________ condition.

A

Increased Raw

Decreased = obstructive condition

120
Q

A method of measuring FRC (RV & TLC) in which gases are measured that are in communication with obstructed airways & does not take into account all airways.

A

He or Nitrogen washout

121
Q

When using the Nitrogen Washout method how do you remove the patients nitrogen?

A

Have them inspire 100% O2 for 2-5 minutes

122
Q

What happens to the patients Nitrogen once it is removed?
A. It is released into atmosphere as it is inert
B. It is recycled back to lungs after exhale
C. FRC washout goes to a collecting site to be measured
D. It is converted to a liquid for proper measurement

A

C. FRC washout goes to a collecting site to be measured

123
Q
This type of test for FRC can measure gases trapped.
A.  Helium Dilution
B.  Nitrogen Washout
C.  Body Plethysmography
D.  Both A & B
E.  All of the above
A

C. Body Plethysmography

124
Q

Besides measuring FRC another value that can be provided by use of body box includes?

A

Airway Resistance

125
Q

What is the scale of Severity of Raw

A

2.8 to 4.5 cmH2o/L/Sec = Mild
4.5 - 8 = moderate
> 8.0 = severe

126
Q

What is a normal resistance value?

A

0.6 - 2.8 cmH2O/l/Sec

127
Q

What test is used to find airway resistance?

A

Body Box test

128
Q

Compliance is found by _______ change per unit of _______ change

A

Volume change per unit of pressure change

129
Q

What two parameters must be calibrated in order to determine accuracy of body box?

A

Pressure & Flows

130
Q

_______ is determined by volume change per unit of pressure change?

A

Compliance

131
Q

________ is determined by measuring changes in pressure vs. flow.

A

Airway Resistance

132
Q

When calibrating the pressure of a body box what is used to verify pressure against?

A

Mercury or water manometer

133
Q

Flows are verified with what device?

A

Rotameter

134
Q

Name 3 advantages of using a body box? Name 3 disadvantages?

A

VTG not affected by lung ventilation
Test is quicker
Easily repeatable
Disadv: Patient may not be able to physically enter the body box, Claustrophobia, Patient may not be able to pant

135
Q

Name 3 methods of Calibration when analyzing a gas for FRC or D1CO & quality control?

A

Utilize known gas value
Mechanical lung analog
Test known subjects

136
Q

What is the name of a gas analyzer?

A

Clark Electrode (which is polargraphic) or galvanic fuel cell

137
Q

What is the name of the He analyzer?

A

Wheatstone bridge which measures thermal conductivity

138
Q

What is the name of the analyzer for N2?

A

Geisler tube ionizer

139
Q

What is the name of the analyzer for gases of stress testing?

A

Mass Spectrometer

140
Q

What analyzes for DLCO testing?

A

Chromatograph or infrared absorption

141
Q

Gas analyzers are calibrated by calibrating to zero and by adding a gas::
A. Running a gas that is a mixture of the gas that the device normally measures with an inert gas
B. A gas that is free of that particular gas the device tests for
C. Removing all gas & adding liquid
D. Adding O2 only as this is a major gas we have in lungs that must be tested for.

A

B. A gas that is free of that particular gas the device tests

142
Q

When measuring for airway resistance raw is calculated from two curves, what do they represent?

A

The first curve is produced when the shutter in the box is open and flow is plotted against box pressure which produces an S-Shaped curve.
The second curve is created after the shutter is closed that plots mouth pressure against box pressure

143
Q

When you see an increase in Raw during exhalation this is indicative of what type of abnormality?

A

Obstructive airways disease such as emphysema

144
Q

An increase in resistance is represented in what way on the s-curve?

A

The curve will change from a skinny narrow double line to showing a wide type on the expiration side of the graph.

145
Q

What 3 items must be calibrated on the Body Box?

A

Mouth pressure transducer
Flow transducer
Cabinet pressure transducer

146
Q

T or F: Biological testing is a common component of quality control

A

True

147
Q

When measuring gas distribution on the single breath N2 elimination test two things are measured, what are they?

A

Evenness of distribution of inspired gas

Closing volume/closing capacity

148
Q

When you are using an O2 analyzer which side of equipment should be used if an aerosol is provided?

A

Always calibrate from dry side

149
Q

The gold standard in calibration is to analyze where?

A

As close to patient as possible

150
Q

What is the name of a pH analyzer?

A

Sans

151
Q

This describes what test: Patient first exhales to RV & then inspired 100% O2; The patient then exhales this gas slowly; exhaled gas passes through a N2 analyzer (geisler tube ionizer) to record changes in N2% & the volume of gas is exhaled into a spirometer

A

Single breath N2 elimination

152
Q

What are the 4 phases of the SB N2 elimination?

A

Phase I = Deadspace, 100% O2, no N2
Phase II= combination of deadspace & alveolar gases–N2 begins to increase
Phase III= alveolar gas; evenness of gas distribution is shown by how flat the mid-portion of the test is (poor distribution slants up more)
Phase IV: Shows the sudden rise of N2% & occurs during airway closure, called the closing volume when airway closure occurs

153
Q

When you add the closing volume to RV you have ________ ___________.

A

Closing capacity

154
Q

The sudden rise of N2% that occurs at airway closure is?

A

Closing volume

155
Q

What causes closure of the airways?

A

Compression of lower airways

156
Q

Name 2 other test methods besides the SBN2 elimination method used to measure gas distribution?

A

7 minute N2 washout test

Ventilation scans that can also measure distribution of gases

157
Q
With the onset of obstructive disease what measurement shows initially, often before symptoms experienced?
A.  Spirometry
B.  FEV1
C.  Peak Flow
D.  Closing volume
A

D. Closing volume may show up before spirometry changes in obstructive conditions

158
Q

What happens to the value of closing volume during obstructive disease?
2 things

A

Closing volume is elevated

Slope of Phase III is increased

159
Q
DLCO will measure the diffusion of \_\_\_\_\_\_\_\_\_\_\_ (gas) across the Alveolar capillary membrane.
A.  Carbon Monoxide
B.  CO2
C.  O2
D.  N2
A

A. Carbon Monoxide

160
Q

Which gas has an affinity with Hgb that is 210x greater than O2 & diffuses rapidly into pulmonary blood?

A

Carbon monoxide

161
Q

When performing a Single breath DLCO test the patient inhales a VC of gas from RV containing a known amount of?

A

0.3& CO, 10% He, and air

162
Q

The DLCO test requires a breath hold of _____ seconds?

A

10 seconds

163
Q

What is a normal value for DLCO and what is it measured from?

A

Normal DLco = 25 mL/min/mmHg in STPD

164
Q

Name 5 factors that affect Dlco?

A
HB, HCT
Body position
Breath holding time
Lung volume
Smoking
165
Q

What conditions may cause a decreased DLco value?

A

Pulmonary fibrosis
Sarcoidosis
Ards
Edema

166
Q

When might you expect to see an increase in DLCO?

A
Polycythemia
Exercise
Asthma
Obesity
Intralveolar hemorrhage, left to right intracardiac shunts
167
Q

If you see a reduction in DLCO you can have normal lungs if it is caused by what?

A

Small lungs, a pure reduction in DLCO can represent small lungs

168
Q

When evaluating alveolar capillary membrane abnormalities which arise from decreased DLCO you must compare DLCO to _______ ______.

A

alveolar volume

169
Q

A minimum of ______ procedures must be performed to meet ATS standards.

A

3 acceptable tests

170
Q

When evaluating patient performance standards against ATS guidelines name some important rules to identify if you have good results (4)

A

No false starts
Test should not differ by more than 5%
The “best test” should be determined & used
Best test means = highest FVC & FEV1

171
Q

What are 4 measurement principles you must evaluate?

A

Specificity
Sensitivity
Validity
Reliability

172
Q

To comply with standards of infection control is it necessary to routinely clean interior?

A

No, you do not have to routinely clean the interior; A clean mouthpiece & tubing is required & low resistance bacteria filter

173
Q

There is a direct/inverse relationship with volume & compliance

A

Direct

174
Q

When you see a reduced diffusion capacity this implies what abnormality?

A

Loss of pulmonary vascular bed/or parenchyma

175
Q

This principle of equipment measurement looks at ratio of all patients & looks at positive test results.

A

Sensitivity

176
Q

Deals with equipment results that are truly negative?

A

Specificity

177
Q

When you have airtrapping what type of change if any will it have on your FRC & RV

A

both will increase from hyperinflation or obstructive conditions

178
Q

This measurement is very good for looking at purely restrictive condition but with combined problem this value may not change at all?

A

TLC

179
Q

If you have poor distribution like in the case of COPD what happens when looking at distribution of gas?

A

The closing volume will be different

180
Q

During emphysema what normally happens to your DLCO value?

A

It will decrease due to loss of integrity of surface area; it becomes so loose it looses its ability to transfer

181
Q

When measuring DLCO you are given a ____________ ___________ measurement but it must be converted to __________ __________.

A

Absolute value;

Relative value

182
Q

Name a restrictive condition that does not cause a decrease in DLCO?

A

ALS

Neuromuscular

183
Q

Exhaled nitric evaluates the activity of ___________ activity which is an indictor of reactive airway.

A

Eosonophils

184
Q

What type of condition may cause problems with PFT testing and prevent equilibration or cause pain.

A

Ear infection

185
Q

When assessing abnormal lung conditions, when you are looking at obstructive conditions you are looking at _______; with restrictive you are looking at _______.

A

Obstructive - flows

restrictive- volumes

186
Q

Normal PFT machines allow for exhalation of up to _____ seconds; Patient should have _______ seconds of exhale.

A

15 seconds

6 seconds

187
Q

T or F: PFT tests can be used to diagnose conditions such as COPD or asthma?

A

False they can only show patterns such as obstruction or restriction

188
Q

Name two things which are vital to accurate PFT tests?

A

Patient cooperation, good instructions from RT

189
Q

When you measure your VC is this a direct or indirect measurement?

A

Direct

190
Q

What can a FVC imply if results are abnormal?

A

It would be used to determine if obstructive condition present

191
Q

In a normal lung what 2 values should match: If they do not match what could the patient have?

A

SVC = FVC; airway obstruction

192
Q

When we refer to pulmonary mechanics this is speaking to ______ of air/

A

Flow of air; airflow

193
Q

Two major things that can affect outcomes when measuring FRC are ______ & _________.

A

Obstruction or leaks

194
Q

T or F: a restrictive disease always shows a decrease of DlCO

A

False, some restrictive diseases do not affect or cause a decrease in DLCO

195
Q

What is normally given for pulmonary hypertension?

A

Nitrics

196
Q

T or F: the number of patients with CF is under estimated?

A

True

197
Q

T or F: it’s unusual for post surgery patients to experience decreased lung volumes which mimick restrictive conditions

A

False

198
Q

Name a couple of conditions causing decreased lung volumes?

A
Inflammatory diseases
Cardiac disease
Neurological neuromuscular
Pleural disease
Thoracic deformities
Fibrotic disease
199
Q

These types of abnormalities are characterized by decreased compliance, decreased thoracic compliance?

A

Restrictive disease

200
Q

T or F: Increased volume = decreased compliance

A

F; direct relationship exists

201
Q

Name some common causes of obstruction (6)?

A
Bronchoconstriction
excessive swelling
tumors
bronchiole collapse
increased Raw & decreased flow
202
Q

If you have a FEV1 value decreased or 44% of predicted how would you classify this patient with no other data?

A

Obstructive only, moderate

203
Q

If you patient has an FEV1 of 81? how would they be classified?

A

Normal

204
Q

When evaluating pulmonary function test analysis they are based on _________.

A

Predicted normal values

205
Q

In order to meet ATS qualifications for acceptable performance standards when performing more than 1 tests they should not differ by more than ______%.

A

5%

206
Q

What type of equipment may be used to validate other PFT equipment & it uses volume & time measurements.

A

Water Sealed Collins

207
Q

The gold standard of rotor spirometers which measures air flow as it passes through a motor or turbine?

A

Wrights respirometer

208
Q

In order to calibrate volume what do you do?

A

Measure against a 3.0 syringe

209
Q

When a patient exhales to RV and then inspires 100% O2 they are probably receiving what type of test?

A

SB N2

210
Q

What are some factors that may give false results when looking at DLCO? 6 total

A
Alcohol measurements will decrease DlCO
HB, HCT
Body position
Breath hold time, will increase if not held long enough
Patients lung volumes
Smoking
211
Q

When performing tests for DLCO a patient who is a smoker should be instructed not to smoke _________ hrs before the testing.

A

24 hours