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Respiratory Physiology > pulm function tests > Flashcards

pulm function tests Flashcards

1
Q

PFT is usually

A

spirometry

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2
Q

pt’s at risk for post op pulm complications

A

significant hx of pulm disease, thoracic or abdomical surgery, obesity, long term smoker, elderly >70

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3
Q

normal FEV1 is 5, patient should be able to get __% of that which is

A

80, 4

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4
Q

high risk result for FEV1

A

<2 L

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5
Q

high risk result for FEV1/FVC

A

<0.5

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6
Q

normal FEV1/FVC

A

80%

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7
Q

high risk VC in adult

A

<15cc/kg

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8
Q

high risk VC in child

A

<10cc/kg

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9
Q

why PFT pre-op

A

good to know pulm reserve so you can plan

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10
Q

bronchodilators are most important pre-op for patients with

A

> 15% improvement in FEV1 after treatment

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11
Q

normal I:E

A

1:2

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12
Q

severe emphysema requires longer

A

expiratory times 1:3

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13
Q

rapid correction in EtCO2 leads to

A

metabolic alkalosis.

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14
Q

the body handles acidosis or alkalosis better?

A

acidosis

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15
Q

with bronchospasm you should aviod

A

histamine releasing drugs

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16
Q

why does your patient become light when you treat with nebulized albuterol?

A

because it takes 10L of oxygen so youre diluting your gas

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17
Q

in terms of extubation, if FEV1 is ____ predicted, then extubation prob wont be effected

A

> 50%

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18
Q

if FEV1 is ___ predicted, only do life saving procedures under general

A

<25%

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19
Q

if FEV1 is between 25-50% with some hypoxemia and hypercarbia..

A

prolonged intubation probable

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20
Q

to extubate, RR should be less than

A

30

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21
Q

to extubate, ABG of 40% should show

A

PaO2 >70 and PACO2 <55

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22
Q

to extubate, NIF should be

Negative Inspiratory Force

A

more negative then -20 cm H20

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23
Q

to extubate, vital capacity should be

A

> 15cc/kg

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24
Q

to intubate resp rate is

A

> 35

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25
Q

to intubate VC is

A

<15cc/kg in adult or <10cc/kg in child

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26
Q

intubate if NIF is less negative than

A

-20cm H2O

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27
Q

intubate if PaO2 is

A

<70 on FiO2 of 40%

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28
Q

intubate if A-a gradient is

A

> 350 mmHg on 100% O2

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29
Q

intubate if PaCO2 is

A

> 55

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30
Q

intubate if vd/vt is

A

> 0.6

dead space to tidal volume ratio

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31
Q

intubate if clinically

A

airway burn, chemical burn, epiglottis, ams, rapidly deteriorating pulm status, fatigue

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32
Q

if youre worried about pneumothorax, get an X-ray on

A

exhalation

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33
Q

ABG must be measured within __ or what happens

A

15min , glycolysis will occur with lactic acid production, ↓ pH and ↑ PCO2

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34
Q

ABG can be stored on ice for

A

1-2h

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35
Q

heparin may significantly lower PCO2 by

A

dilution, esp in children

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36
Q

buffer

A

substance that can absorb or donate H+

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37
Q

examples of buffers

A

bicarb (HCO3), hb, serum proteins, phosphate (HPO4)

38
Q

normal ph

A

7.35-7.45

39
Q

normal PCO2

A

35-45

40
Q

normal PaO2

A

75-105

41
Q

normal bicarb

A

20-26

42
Q

normal base excess

A

-3 to +3

43
Q

blood gas machine assumes the person is breathing

A

Room air

44
Q

an increase in PaCO2 by 10mmhg causes a ____ in ph by ___

A

decrease 0.08

45
Q

an decrease PCO2 by 10 will ___ ph by ___

A

increase 0.08

46
Q

hypoxemia is PaO2

A

<75

47
Q

A-a gradient measures

A

efficiency of lung, how well is oxygen making it from your lungs to your normal blood supply

48
Q

normal A-a is approx

A

age/3

49
Q

how does anesthesia affect A-a

A

widens

50
Q

A-a is ___ with hypoventilation or low FiO2

A

normal

51
Q

A-a is ____ with intrinsic lung disease - PTX,PE,Shunt, v/q mismatch, diffusion problems

A

widened

52
Q

a decrease in bicarb by 10 ___ the pH by ___

A

decreases 0.15

53
Q

bicarb and ph are ___ , PCO2 and ph are ___

A

direct, indirect

54
Q

an increase in bicarb by 10 ___ the ph by

A

increases 0.15

55
Q

** total body bicarb deficit =

A

base deficit x weight in kg x 0.4

56
Q

usually replace ___ of total body bicarb deficit

A

half

57
Q

resp acidosis caused by ____ventilation and ____carbia

A

hypoventilation , hyper

58
Q

resp acidosis is ___ ph and ___ Paco2

A

low ph high PACO2

59
Q

resp acidosis causes ___ FRC

A

decreased

60
Q

causes of resp acidosis

A

sleep apnea, obesity, trauma drugs CNS depression, upper or lower airway obstruction, asthma, pulm fibrosis

61
Q

after __ days of resp acidosis, renal compensation occurs

A

1-2 days

62
Q

how do the kidneys compensate for resp acidosis

A

H+ is excreted by the kidney and HCO3 is reabsorbed into blood to partially correct pH

63
Q

resp alkalosis is __ph and __ paCO2

A

high, low

64
Q

resp alkalosis is caused by ___ventilation and ___carbia

A

hyperventilation, hypocarbia

65
Q

resp alka is caused by

A

hypoxic respiration (mtn climbing), CNS disease, encephalitis, anxiety, narcotic withdrawal, *pregnancy, artificial ventilation

66
Q

how do the kidneys compensate for resp alkalosis

A

decreased secretion of H+ and increased excretion of HCO3, which partially corrects pH

67
Q

meta acidosis is ___ph and ___HCO3

A

low low

68
Q

causes of metabolic acidosis

A

lactic acidosis* from hypo perfusion, DKA,renal dz with bicarb loss (anion gap and k+), *diarrhea, ASA ingestion, high protein intake

69
Q

metabolic acidosis compensation

A

resp compensation(central chemoreceptors) with hypocarbia, more rapid than renal compensation, partial correction

70
Q

metabolic acidosis kidneys..

A

may increase H+ excretion

71
Q

metabolic alkalosis ph and hco3

A

high ph and high hco3

72
Q

causes of metabolic alkalosis

A

bicarb infusion,metabolism of lactate or citrate, loss of H+ from vomiting or excessive NGT suctioning

73
Q

resp compensation for met alka

A

limited hypoventilation due to eventual hypoxic drive, partial correction (cant slow respirations down enough)

74
Q

metabolic alka kidneys

A

may increase bicarb excretion in urine

75
Q

FRC is

A

ERV +RV

76
Q

what decreases FRC

A

obesity, full belly,pregnant, trendelenberg

77
Q

what is the most important clinical tool in assessing the severity of airway obstructive disease

A

FEV-1second

78
Q

FEV -1 second definition

A

after max inspiration, the volume of air that can be forcefully expelled in one second

79
Q

whats a normal FEV-1

A

3-5L

80
Q

FEV1/FVC

A

> 75%

81
Q

FEV1/FVC can tell you

A

how severe their obstructive lung disease is

82
Q

mild risk

A

60-75

83
Q

moderate risk

A

45-60

84
Q

severe risk

A

35-45

85
Q

extreme risk

A

<35

86
Q

FEF 25-75 is effort ____

A

independent

87
Q

FEF 25-75 reflects

A

collapse of small airways, peripheral airways. sensitive indicator early airway obstruction

88
Q

MVV or MBC

A

maximal breathing capacity- “will to live” test

89
Q

MVV is effort ___

A

dependent , non-specific

90
Q

extrathoracic obstruction decreases ___ flow

upper airway obstruction

A

inspiratory

91
Q

intrathoracic obstruction decreases ___ flow

generalized pulmonary disease

A

expiratory

92
Q

the downward slope on pressure volume loop is

A

FEV1

Respiratory Physiology (11 decks)

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