Investigations of the Respiratory System Flashcards
why do we need investigations?
-confirm diagnosis
-establish severity/extent of disease/prognosis
-asess fitness for treatment
what is a high resolution CT good for?
very good for looking at lung parenchyma, but not great for looking at tumours/mediastinum.
what is a staging CT with contrast good for?
lymph nodes or other mediastinal tissue.
what is a staging Ct with contrast?
inject contrast - goes through, highlights blood vessels away from other mediastinal structures such as lymph nodes or other mediastinal tissue.
what is a CT pulmonary angiography?
has contrast again, with timing such that it hits the arterial phase, allowing you to visualise the pulmonary arteries to see if there are any clots. Quality of image may not be as good as high resolution CT. Visualising lymph nodes and soft tissue may not be as good as well.
what is a CT pulmonary angiography?
pulmonary arteries
what is a thorascopy?
make an incision between the ribs to get between the pleura
what are some ward tests we can do?
- Sputum, urine, faeces
- Blood venous/arterial
what is a bronchoscopy used for?
- Bronchial secretions
- Broncho-alveolar lavage (BAL)
- Endobronchial biopsies
- Transbronchial biopsies
- Transbronchial needle aspiration +/- ultrasound (EBUS)
what are some pulmonary function tests?
spirometry
arterial blood gas
progressive exercise test
sleep studies
how would we investigate for lung cancer?
CT scanning
bronchoscopy
end-bronchial tumour and biopsy
CT guided biopsy
FDG-PET scan
lymph node sampling
spirometry
progressive exercise test
arterial blood gas
interpreting arterial blood gases
what does a spirometry allow you to investigate?
lung function - eg if we remove part if the lung can the patient survive
what is a progressive exercise test?
With some patients, you don’t want to underestimate their fitness. You might test their fitness and perhaps prescribe some rehab to improve it before carrying out any further treatment.
what labs would be consistent with a COPD diagnosis?
PaCO2 7.5 (56)
PaO2 7.7 (57)
H+ 44
pH 7.36
HCO3- 36
what are the normal reference ranges?
PaCO2 4.5-6.0kPa (32-45mmHg)
PaO2 11-14kPa (78-105mmHg)
H+ 35-45nmol/L
pH 7.35-7.45
HCO3- 22-28mmol/L
