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Cardiopulmonary Diagnostic (PFTs) > Mid-Term > Flashcards

Mid-Term Flashcards

1
Q

What are some indications For PFTs

A
  • Diagnosis
  • Screening (pre-op)
  • Monitoring
  • Effects of chemicals and toxic medications
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2
Q

What is the Gold standard for diagnosing obstructive diseases

A

Spirometry

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3
Q

What 3 tests are involved in PFT

A
  • Spirometry
  • Lung volumes
  • DLCO
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4
Q

What do we use to diagnose Restrictive diseases

A

Lung volumes

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5
Q

What do we use to diagnose gas exchange?

A

DLCO

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6
Q

For obstruction, DLCO is used to determine the (2)

A
  • severity of the obstruction
  • ruling out Emphseyma
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7
Q

Predicated values come from a national data base based on 4 demographics. What are they?

A

HGAR
- Height
- Gender
- Age
- Race

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8
Q

FEF 50% is the

A

most accurate measure used to determine pt effort

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9
Q

FEF 25%- 75% reflects

A

abnormalities in the small airway

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10
Q

When is FEV1 measured

A

during the FVC

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11
Q

FEV1 is called

A

Forced Expiratory Volume over 1 second

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12
Q

FEV1/FVC ratio defines

A

the obstruction

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13
Q

FEV1 defines the

A

degree/severity of the obstruction or restriction

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14
Q

If FEV1/ FVC ratio is less than ___% what does that indicate?

A

75%;
obstruction disease (CBABE)

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15
Q

If FVC is _______/high ( ____%) you have an…

A

normal;
80%
obstruction only

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16
Q

If FVC is low <80% you may have a

A

restrictive component or mixed

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17
Q

FEV1 <80% to determine if its

A

mild, moderate moderately severe, severe, or very severe

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18
Q

Mild is

A

70- 79%

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19
Q

Moderate is

A

60- 69%

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20
Q

Moderately severe is

A

50- 59%

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21
Q

Severe is

A

35- 49%

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22
Q

Very severe is

A

<35

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23
Q

Define Peakflow

A

A maximal inspiration, followed by a maximal forced exhalation

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24
Q

What are the predicated values based on for peak flow?

A

HAG
- Height
- Age
- Gender

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25
Q

If you do not have FEV1/ FVC which do you look at first and why?

A

RV for air trapping

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26
Q

If RV is high what do you do?

A

Look at the TLC

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27
Q

If FVC is low (<80%) it is considered

A

mixed

28
Q

If FVC is normal or high then you have an

A

Obstruction only

29
Q

How do we measure a pt’s height

A

W/o shoes

30
Q

What are some contraindications for Spirometry testing?

A
  • Myocardial infarction within the past month
  • Chest abdominal, facial, or oral pain
  • Stress incontinence
  • Dementia, confusion
  • Hemoptysis
  • Recent cataract surgery (extra pressure)
  • Recent abdominal or thoracic surgery
31
Q

If you want a good effort then what must you do?

A

Coach pt

32
Q

How do we know if test is valid?

A

If it is acceptable and replicable

33
Q

HE measures (2)

A

FRC and estimate lung volumes

34
Q

How long do we perform HE

A

until equilibrium is reached

35
Q

For HE test how long do you have to wait until you can retest

A

5 minutes

36
Q

Where do we measure alveolar pressure?

A

At the mouth when the shutter is clsoed

37
Q

What can cause the DLCO to decrease? (7)

A
  • Asthma
  • Emphysema
  • PNA
  • Pulmonary edema
  • OSA
  • COPD Exacerbation
  • Radiation
38
Q

What can cause the DLCO to increase (3)

A
  • Polycythemia (increased RBC)
  • Increase in pulmonary blood flow (e.g Exercise)
  • Alveolar hemorrhage
39
Q

Would radiation increase or decrease DLCO?

A

Decrease

40
Q

The jones method measures

A

breath hold from 0.3 of the inspiratory time to the midpoint of the alveolar sample

41
Q

Minute ventilation equation

A

VE= VT x RR

42
Q

Respiratory Exchange Ratio (RER) is the ratio between the

A

volume of carbon dioxide produced (VCO2) divided by the volume of O2 consumed (VO2)

43
Q

Minute volume must be correlated w/

A

blood gas values to determine adequacy of ventilation

44
Q

What is the normal minute volume in healthy adults

A

5 to 10 L/min

45
Q

Low VE does not necessarily mean __________________ and high VE does not necessarily mean ________________ b/c not all breaths are created __________

A

hypoventilation;
hyperventilation;
equal

46
Q

In the case of CO2 retention, Hyperventilation is not determined until….

A

ventilation is greater than what is needed to adequately remove excess CO2

47
Q

Why must VE be correlated w/ blood gases

A

VE does not determine Hypo/hyperventilation (Remember the body will compensate for an increased or decreased CO2)

48
Q

What is the criteria for hypoventilation?

A
  • pH <7.35
  • PCO2 > 45
49
Q

What is the criteria for hyperventilation

A
  • pH >7.45
  • PCO2 <35
50
Q

What are the 2 types of deadspace?

A

Anatomic
Alveolar

51
Q

Air in the upper airways that does not participate in gas exchange is

A

Anatomic deadspace

52
Q

Lung volumes that are ventilated but not perfused by capillary blood flow. Air trapped in the small airways (alveoli) that cannot participate in gas exchange

A

Alveolar deadpsace

53
Q

The combination of the 2 deadspaces are called

A

Respiratory or Physiological Deadspace

54
Q

How do we measure dead space?

A

Exhaled gas is collected over a specified interval and measured

55
Q

What is Bohr’s equation

A

VD= (Paco-Peco2)/Paco2 x VT

56
Q

Anatomic dead-space can be calculated as

A

1ml per pound or 2ml/kg of IBW

57
Q

When can alveolar deadspace be calculated

A

During measurements of volumes

58
Q

Alveolar ventilation is the part of ventilation that participates in

A

gas exchange at the alveolar level

59
Q

What is the equation for VA

A

VA= (VT-VD) x RR

60
Q

Dead space (VD) is considered equal to

A

anatomic dead space
(1 ml/lb or 2ml/kg of IBW)

61
Q

_________ is the pressure generated at the ________ during the _______ 100 milliseconds of an _____________ effort against an _____________ airway

A

P100 (Occlusion pressure);
mouth;
first;
inspiratory;
occluded

62
Q

What is the normal range for P100?

A

1.5 to 5 cm H2O

63
Q

P100 is helpful in determining the effects of..

A

treatment in pts w/ abnormal vent responses

64
Q

What is P100 measured with?

A

Closed-circuit

65
Q

Tidal volume is defined as the volume of

A

air inspired or expired during a normal respiratory cycle

66
Q

What is the equation the Vt?

A

Vt=VE/RR

67
Q

If a pt is hypoxic but they have a good DLCO, what could cause that?

A

Hypoventilation

Cardiopulmonary Diagnostic (PFTs) (6 decks)

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