Midterm Flashcards
1
Q
What are anions and examples of jt
A
Negative charged ions
Cl, HCO3, OH
2
Q
What are cations and examples
A
Positive charged ions
Na, K, Ca, Mg
3
Q
What makes up the BMP
A
Na, k, cl, Hco3, BUN, Cr, and glucose
4
Q
How to calculate anion gap and what is normal anion gap
A
Na + K - (Cl + HCO3) or Na - (Cl + HCO3)
8-16 Normal
5
Q
What is normal PaCo2
A
35-45
6
Q
Normal range for k
A
3.5-4.5
7
Q
Normal range for Cl
A
80-100
8
Q
What does BMP stand for
A
Basic metabolic panel
9
Q
Normal Na
A
135-145
10
Q
Normal bicarbonate
A
22-26
11
Q
Normal BUN
A
7-20
12
Q
Normal creatine
A
.7-1.3
13
Q
Normal glucose
A
75-105
14
Q
Optimal placement for the end of an ETT on a CXR
A
2cm or 1 inch above the carina
15
Q
How does a poorly or less exposed film appear
A
White out or too dark
16
Q
Radiopaque definition
A
Absorb high density objects like bone and it appears whitish
17
Q
What would appear more radiolucent on a CXR
A
Air
18
Q
How would the heart appear on a CXR for a patient that has CHF
A
Big/ cardiomegaly
19
Q
What is the newest and greatest test for pulmonary embolism
A
CTPA
20
Q
What do hot spots on a PET scan mean
A
Areas of high flow
21
Q
What is a PET scan useful for
A
Early detection of malignant lesions, shows metabolic activity of tissues and organs
22
Q
What causes tracheal shift
A
Atelectasis sucks (towards)
Pneumothorax blows ( away)
23
Q
What are good indicators of a well exposed CXR
A
10-11 ribs, clavicle to diaphragm, and lung fields shown
24
Q
What is an AP CXR not helpful for
A
Assess the heart bc AP magnify the heart
25
What test should we be very careful about metal
MRI
26
Most appropriate protocol for CF patients
Bronchopulmonary hygiene therapy
27
What’s the likelihood of a child having CF if both parents carry the gene
25%
28
What is the type of genetic disorder found with cystic fibrosis
Autosomal recessive gene disorder
(Mutation in a pair of genes located on chromosome 7)
29
Gold standard for testing for CF
Sweat test aka sweat chlorine test
30
What is barrel chest a sign of
Emphysema
31
What is orthopnea
Short of breath while laying down
32
Hallmarks of emphysema
Permanent enlargement and destruction of airspace’s
33
Hallmarks of chronic bronchitis
Excessive mucus production, cough for 2 months every 2 years
34
Between emphysema and Chronic bronchitis which causes bullae
Emphysema
35
What 2 values do we look at first to categorize and diagnose the severity of an obstructive disease
FEV1/FVC ratio
36
What has the greatest influence on lung size predicted values
Height
37
What is a primary test that’s part of PFT that is common
Spirometry
38
Define tidal volume VT
Size of breath in normal breathing
39
FEV1 is compared to what to help us identify lung disorders
FEV1/ FVC less than 70% is obstructive
40
Obstructive diseases will affect a patients…
Flow
41
Restrictive disorders will affect a patients…
Volume
42
Normal FEV1/FVC ratio
80% or higher
43
What does DLCO test measure
Lung volume and diffusion capacity
44
What symptoms would be seen in patients having an asthma attack
Wheeze, short of breath, chest tightness and cough. Increase eosinophils
45
What are causes of extrinsic and instrinsic asthma
Extrinsic- dust mite, animal dandur, cockroach poop, fungi, mold and yeast
Instrinsic- Stress, GERD
46
What is FENO testing used for
Test for asthma, measures high levels of eosinophilic airway and inflammation
47
When is bronchial challenge test appropriate and what is it
Bronchial provocation test is useful when there’s limitation in airflow during assessment. Done with inhaled methacholine
Exercise induced bronchoconstriction(EIB)
Is confirmed by lung function test and BPT. Diagnose vocal cord dysfunction
48
What is pulsus paradoxus
Decreased blood pressure during inhalation
Increased blood pressure during exhalation
49
How does an asthmatics sputum appear
Whitish, contains eosinophils, charcot-leiden crystal and curschmanns spirals
50
What is the general management primary goals of asthma
Maintain control, maintain normal activity level, prevent asthma exacerbation, avoid adverse effects from meds, and maintain pulmonary function as normal as possible
51
What are some controller medication for asthma
Inhaled corticosteroids: advair, Ellipta
52
What are some rescue medication for asthma
Albuterol, levalbuterol
53
How much improvement on the FEV1 is needed to show reversibility of bronchospasm in asthma
Greater or equal to 12 % after administration of a bronchodilator
54
What is the major reason that hospitals are reluctant to enact therapist driven protocols
Staff feels that RT don’t have the ability to assess and correctly do protocols
55
What is considered part of the airway clearance therapy protocol ( 11)
Increased fluid intake, cough and deep breathe, cough assist- hospital or home, chest physical therapy, suctioning( invasive), IPV-secretion removal and atelectasis, TheraPEP- pushes secretion into main bronchi, aerobika-secretion removal, bronchoscopy assist, mucolytic and bland aerosol
56
What type of patient would benefit from oxygen therapy protocol only
Hypoxic patients
57
A patient has post op atelectasis and hypoxemia what protocols would benefit them the most
Lung expansion/hyperinflation, and o2 therapy
58
What are the 4 types of hypoxia
Hypoxemic, circulatory (stagnant), anemic, histotoxic hypoxia
59
What causes hypoxic hypoxic: low pao2 and low co
Increased altitude, hypoventilation, pneumoconiosis, v/q mismatch, pulmonary shunting, diffusion impairment
60
What causes anemic hypoxia: low hemoglobin
Decreased hemoglobin, anemia, sickle cell, hemorrhage, abnormal hemoglobin, carboxyhemglobin, methemoglobin
61
What causes circulatory (stagnant) hypoxia: low blood pressure
Hypotension, slow flow or pooling of blood, arterial venous shunts, drop in cardiac output
62
What causes histotoxic hypoxia
Cyanide poisoning, increased lactic acid
63
What are some things that can cause cyanosis of the oral mucosa
Severe hypoxemia
64
What’s the P/F ratio
PaO2/ Fio2
65
If a patient was exposed to carbon monoxide what would best assess their oxygenation status
ABG or CO-OX
66
What is normal PaO2
80-100 mmHg
67
What would cause a left shift in the oxyhemoglobin disassociation curve
Left- decreased temp, pco2, 2 3 DPG, increase in pH, CO poisoning snd methemoglobinemia
68
What would cause a right shift in oxyhemoglobin disassociation curve
Increased temp, 2 3 DPG, pco2 and decrease pH
69
What is the C( a-v) O2
Difference between cao2 (arterial blood) and Cvo2 (venous blood)
70
Hypoxemia vs hypoxia
Hypoxemia- low arterial o2 tension( pao2) [low o2 in blood]
Hypoxia- low o2 for aerobic cellular metabolism (tissue level) [low o2 in tissue]
71
What are types of objective data
HR, RR, BP, CXR, ABG
72
What does SoAP mean
Subjective, objective assessment, plan
73
What are components of the physical exam
Inspection, palpation, percussion, and auscultation
74
What is indicated by nasal flaring
Increased WOB and pain
75
What term describes a drooping eyelid
Ptosis
76
What term describes double vision
Diplopia
77
Scoliosis
Sideways curvature of the spine
78
Kyphosis
Excessive outward curvature of spine ( back is rounded/hump)
79
Kyphoscoliosis
Combination of scoliosis and kyphosis
80
Lordosis
Excessive inward curve of spine
81
What causes a barrel chest
Hyperinflation secondary to emphysema
82
What’s retraction
Visible chest moving inwards, increase work of breathing
83
What does accessory muscle use indicate
SOB and WOB
84
What would increase vocal fremitus
Atelectasis, pulmonary edema, lung tumor, pulmonary fibrosis, and thin chest wall
85
What would decrease vocal fremitus
COPD, pneumothorax, and asthma
86
What percussion note would a pneumothorax have
Hyper resonance
87
What are the classic vital signs
Body temp, pulse, respiration, blood pressure, spo2
88
Why is it important to know a patients Level of consciousness
It indicates neurological function and can signal serious medial problems
89
Define fever
Body temp above normal range- Pyrexia
97-99 normal
90
Normal pulse
60-100
91
What is tachycardia
Increased heart rate above 100
92
Why do we care about tachycardia in our patients with lung disease
Can indicate hypoxemia
93
What characteristics of a patients pulse should the RT notate
Rhythm, rate, force, and equality
94
Define pulsus paradoxus
Systolic blood pressure more than 10 mmHg lower on inspiration than expiration
95
Define kussmauls breathing and what causes it
Increased rate and depth caused by diabetic ketoacidosis
96
Define orthostatic hypotension
Blood pressure drops quickly when standing up
97
Best way to assess perfusion to extremities
Skin temp, CT, MRI
98
What are some cardiac biomarkers
BNP- diagnose CHF
CK-MB: heart specific isoenzyme that distinguishes myocardial from muscle damage
Troponin 1- single best marker for diagnosis of acute coronary syndrome
