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Block 2; Week 8 > Floreani PFT > Flashcards

Floreani PFT Flashcards

1
Q

What are the contraindications for performing a PFT?

A

A patient who is uncooperative.

A patient who is not healthy enough to perform the test.

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2
Q

Why is a PFT important for pre-operative evaluation?

A

It helps you determine if the patient has sufficient pulmonary status to undergo their operation.
It helps you determine if you are about to take a lung tumor if the patient will still be able to function afterwards.

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3
Q

What are some of the uses of the pulmonary function test?

A 
Help diagnose & exclude diseases
Assess the severity of the disease
Monitor the course of the disease
Monitor response to therapy
Occupational & disability evaluations
pre-operative evaluation
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4
Q

When you measure the volume of air/time in a PFT…what values does this offer?

A

Inspiratory air flow
Expiratory air flow
FVC
FEV1

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5
Q

When you measure the volumes of air in the lungs…w/ a PFT…what values does this offer?

A

Lung Volumes

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6
Q

When you measure pressure in a PFT…what values does this offer?

A

Muscle Strength
Compliance
Lung Mechanics

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7
Q

When you measure gas conc’n & transfer in a PFT…what values does this offer?

A

diffusion capacity

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8
Q

What does diffusion capacity basically tell you?

A

whether you can get gas across the alveolar membrane…

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9
Q

What is another name for a body plethysmograph? What values does it give you?

A

Body Box

Lung volumes etc.

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10
Q

deltaV/Pel indicates what?

A

static compliance

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11
Q

delta Pel/V indicates what?

A

Elastance

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12
Q

delta F/Pel indicates what?

A

Resistance–important info for obstructive lung disease

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13
Q

delta Pel/F indicates what?

A

Conductance

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14
Q

What values does a spirometer help you get?

A

Inspiratory & expiratory air flows

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15
Q

What does it mean when you say that an asthmatic is hyper-responsive?

A

Their airways are twitchy.
They are abnormally sensitive to nonspecific stimuli (smoke, cold air etc)
they’re not allergic to these things, but they are sensitive.

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16
Q

What happens in a methacholine challenge test?

A

Methacholine is a nonspecific cholinergic agonist. It causes smooth muscle constriction in the airways. it doesn’t present a huge problem for normal people. It is a problem for asthmatics.

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17
Q

Exercise tests are an example of ______ tests for asthmatics. What happens with this test?

A

challenge test type
Bring up the heart rate of the patient. Compare the spirometry at different points.
**exercise can be a trigger for asthmatic symptoms.

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18
Q

Is exercise-induced asthma a real thing?

A

NO! It is a trigger for asthma. Sometimes the only discernible one…

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19
Q

What are 5 provocation or challenge tests for asthmatics?

A 
Methacholine
Exercise
Cold Air
Histamine
Adenosine 5 monophosphate.
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20
Q

What are some examples of cardiopulmonary exercise tests?

A

Treadmill Test
Stationary Bicycle
6 minute walk test

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21
Q

What are some factors that can affect the normal reference ranges for PFTs?

A 
Age
Sex
Height
Weight 
Race
Altitude & other physical factors
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22
Q

How do age & sex affect the normal PFT range?

A

As you age, the PF decreases

Males have a higher PF

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23
Q

After age _____ adults usu lose ____ of forced vital capacity.

A

25-30 years of age

20 cc

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24
Q

The primary signal in spirometers is either ____ or ____.

A

Volume or flow

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25
Q

Restrictive Abnormalities relate to _____ mechanics. They relate to changes in what factors?

A

Static mechanics
Compliance
**volumes, pressures

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26
Q

Obstructive Abnormalities relate to _____ mechanics. They relate to changes in what factors?

A

Dynamic Mechanics
Flow Rates
**volume/ time & airflow

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27
Q

Vascular Abnormalities relate to:

They relate to changes in what factors?

A

defects in gas exchange.
changes in arterial blood gas
**diffusion capacity

28
Q

What is the main type of spirometer that is used?

A

Flow sensing type. Pneumotachometers

29
Q

If you determine vital capacity thru spirometry thru a slow expiration maneuver what is it called?

A

SVC Slow Vital Capacity

30
Q

If you determine vital capacity thru spirometry thru a rapid expiration maneuver what is it called?

A

FVC forced vital capacity

31
Q

In a normal individual…their FEV1 will be ___% of their ____.

A

80% of their VC

32
Q

A decrease in what 3 values is a hallmark of an obstructive disease? What 2 diseases would fit this?

A

FEV1
FVC
Flow rate
Emphysema & Asthma

33
Q

What is FEF25-75%?

A

midflow rate termed in L/sec

**varies person to person, but helpful to look at a person’s progress?

34
Q

What is maximal voluntary ventilation? What does it indicate?

A

sustained maximal ventilation for 15 seconds

indicates muscle fatigue & endurance

35
Q

When you are making FEV1 & FVC measurements…how long must your exhalation take?

A

6-8 seconds

36
Q

What are the 2 types of body boxes?

A

Constant Volume, Variable Pressure Type

Flow or Variable Volume Type

37
Q

What do body boxes measure?

A

Measurements of volumes in the lungs.
Thoracic Gas Volume
Changes in airway resistance & conductance

38
Q

What are 2 things that body boxes measure?

A

utilize pneumotachometers

utilize mouth pressure transducers

39
Q

What lung volume value do you especially need to think about w/ patients on mechanical ventilation?

A

Functional Residual Capacity

40
Q

___ ______ in people with asthma or other lung conditions increase what 2 values?

A

air trapping

Increases functional residual capacity & residual volume

41
Q

What does diffusion capacity (DLCO) measure?

A

the transfer of gas across the alveolocapillary membranes

integrity of the alveoli, capillary bed, & the membranes

42
Q

What are some conditions that impair DLCO?

A

Emphysema
Cystic Lung Disease
Fibrotic Lung Disease
Pulmonary Vascular Disease

43
Q

What does emphysema reduce DLCO?

A

b/c it distorts the bronchoalveolar structures & compromises the supporting structures in the interstitium & alveoli…

44
Q

T/F Emphysema decreases DLCO & RV.

A

False. It decreases DLCO. It increases RV & FRC b/c of air trapping.

45
Q

The DLCO measurement is not ____, but is ____.

A

DLCO measurement is not specific, but it is sensitive.

46
Q

How do you take the DLCO?

A

Gas Mixture of 0.3% CO & 21% oxygen, some nitrogen & some helium, neon or methane…
**uses single breath hold maneuver

47
Q 
What does obstruction do to:
FVC
FEV1
FEF25-75
MVV
FRC
RV
TLC
A 
FVC: stays the same or decreases
FEV1: decreases
FEF25-75: decreases
MVV: decreases
FRC: increases
RV: increases
TLC: increases
48
Q 
What does restriction do to: 
FVC
FEV1
FEF25-75
MVV
FRC
RV
TLC
A 
FVC: decreases
FEV1: stays the same or decreases
FEF25-75: stays the same or decreases
MVV: stays the same or decreases
FRC: decreases
RV: decreases
TLC: decreases
49
Q

What causes a volume & flow decrease?

A

Mild Obstructive Lung Disease

50
Q

What causes normal inspiration & changed expiration?

A

Variable Intrathoracic Upper Airway Obstruction

51
Q

What causes limited inspiration, but normal expiration?

A

Variable Extrathoracic Upper Airway Obstruction

**dynamic truncation of the inspiratory limb

52
Q

What causes limited inspiration & expiration?

A

Fixed Intrathoracic or Extrathoracic Upper Airway Obstruction

53
Q

What causes a decreased volume of inspiration?

A

Restriction, such as pulmonary fibrosis

54
Q

What are 3 things that can cause a variable extra thoracic upper airway obstruction?

A

tracheomalacia: a trachea that collapses upon inspiration
laryngomalacia: a larynx that collapses upon inspiration
vocal cord dysfunction: it adducts(closes) when it should abduct.

55
Q

A variable intrathoracic obstruction is a dynamic truncation of _______. What are 5 things that can cause this?

A 
the expiratory limb
tracheal lesions
intrathoracic tracheomalacia
Tracheal Stenosis
Lymphadenopathy
Bronchogenic cysts
56
Q

What are some things that can cause a fixed airway obstruction? What does this limit?

A

This limits the inspiratory & expiratory limbs.
Extraluminal Obstructive Lesions: bulky mediastinal adenopathy, invasive thymoma, large thyroid cancers
Bronchial Mainstem Lesions: usu cancers

57
Q

What is considered a significant pulmonary function change w/ the addition of bronchodilators?

A

12%

58
Q

What are 3 hallmarks of asthma?

A

inflammation
hyper-responsiveness
airway obstruction

59
Q

What happens to FEV1 & FEV1/FVC with asthmatics?

A

FEV1 decreases
FVC decreases
FEV1/FVC ratio decreases

60
Q

What does idiopathic pulmonary fibrosis cause?

A

a restriction of volume

there is no known treatment

61
Q

In restrictive lung disease, which values are decreased? What treatment is NOT appropriate?

A

Total Lung Capacity decreases
Inspiratory Capacity decreases
Diffusion Capacity decreases
Bronchodilators are NOT helpful with this…

62
Q

What are some things that can cause hypoxemia or problems with diffusion?

A

Pulmonary Edema
Diffuse Pneumonitis
Fibrosis
Emphysema

63
Q

Pulmonary HTN is a type of _______.

A

pulmonary vascular disease

64
Q

What are some conditions that can cause reduced diffusion capacity?

A

Emphysema
Cystic Lung Disease
Fibrotic Lung Disease
Pulmonary Vascular Disease

65
Q

What is an example of interstitial lung disease?

A

Pulmonary Fibrosis

66
Q

What are some things that cardiopulmonary stress testing captures?

A

VO2, VCO2, Vd/Vt, End tidal CO2

Block 2; Week 8 (6 decks)

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