January 25, 2016 - SG7 - Dyspnea III

Question 1

Atopy and Asthma

Answer 1

Often associated.

Question 2

Common Side Effects of ACEi

Answer 2

Nocturnal cough.

If this happens, patients can be switched onto ARBs.

Question 3

Vascular Redistribution

Answer 3

When the vessels stretch all the way to the edge of the lungs.

Can often be seen in heart failure.

Question 4

Methacholine Challenge

Answer 4

Observe what concentration of methylcholine is needed to cause a 20% drop in FEV1.

<4mg = asthma

4-16mg = indeterminate / mild asthma

>16mg = not asthma

Question 5

Obstructive Airway Disorder

Answer 5

Less than 70% the expected value for FEV1/FVC

Question 6

Asthma Diagnostics on Spirometry

Answer 6

Less than 70% FEV1/FVC

Increase of >12% in FEV1 with bronchodilator and >200mL

Question 7

DLCO

Answer 7

Diffusing capacity.

Can help distinguish interstitial lung disease if it is low.

Question 8

Pathologic Q-Waves

Answer 8

Evidence of a previous MI.

A pronounced Q-wave with a drop and width of >1 little square.

Question 9

SABA

Answer 9

“Reliever” medication.

Question 10

LABA / ICS

Answer 10

“Controller” medication

Question 11

Oxygen Saturation and Asthma

Answer 11

Should show normal oxygen saturation.

Asthma is an expiratory problem, not an inspiratory one. Can’t blow off CO₂ but O₂ can still be dissolved.

Question 12

Rising CO₂ in Asthmatic Patients

Answer 12

This is BAD.

If carbon dioxide starts off low on the ABG and starts to rise without a marked improvement in symptoms, this indicates that the patient is failing therapy and may need to be intubated.

Even if the new CO₂ is within the normal range.