Pulmonary

Question 1

what is the clinical indicator of ventilation?

Answer 1

PaCO2

Question 2

what is minute ventilation? What is the norm?

Answer 2

tidal volume x respiratory rate

normal: ~4L/minute

Question 3

what is the normal ventilation/perfusion ratio?

Answer 3

0.8 ratio,
4L ventilation/min //
(over/divided by)
5L perfusion/minute (V/Q)

Question 4

normal SvO2?

Answer 4

60-75%

Question 5

What conditions shift the oxyhemoglobin-dissociation curve to the left?

Answer 5

Alkalosis (low H+)
Low PaCO2
Hypothermia
Low 2,3-DPG

left is alllllllkolosis

Question 6

What conditions shift the oxyhemoglobin-dissociation curve to the right?

Answer 6

Acidosis (high H+)
High PaCO2
Fever
High 2,3-DPG

Question 7

Pro and Con to oxyhemoglobin-dissociation curve shift to the left:

Answer 7

Good: higher SaO2
Con: tissues do not get needed O2 as readily

aLkaLosis, coLd, Low, bad for patient, SaO2 high but O2 stuck to Hgb

Question 8

Pro and Con to oxyhemoglobin-dissociation curve shift to the right:

Answer 8

Good: tissues receive O2 more readily
Con: SaO2 is low

Question 9

what is the treatments for carbon monoxide poisioning?

Answer 9

100% FiO2 until symptoms resolve and carboxyhemoglobin level is <10%

Hyperbaric O2 chamber if available, generally within 30 minutes

Question 10

Normal for anion gap:

Answer 10

5-15 mEq/L

Question 11

What peak flow rate (PFR) is severe?

Answer 11

50% (admit to hospital if <70%)

Question 12

What are the 3 ventilator managements of status asthmaticus?

Answer 12

• Use low rate to increase exhalation time
• Use low tidal volumes to prevent auto-PEEP
• Increase inspiration/expiration (I/E) ratio (often greater than 1:3-4) to allow time for optimal exhalation and prevent auto-PEEP

(short inspiratory, long expiratory)

Question 13

norm for pulmonary artery mean pressure

Answer 13

~20 mmHg

Question 14

PAP and PAOP in pulmonary hypertension

Answer 14

PAP: >25 at rest

PAOP <16 mmHg at rest with secondary right heart failure

Question 15

PF ratio in acute lung injury vs ARDS

Answer 15

ALI: P/F 201-300
ARDS: P/F <200

Question 16

Define AC vent mode

Answer 16

Every breath (machine or self triggered) has same tidal volume

Question 17

Define SIMV vent mode

Answer 17

Pt gets tidal volume at set breath rate, every extra breath above the set rate are spontaneous at the pt’s own tidal volume

Question 18

Normal tidal volume? how about in ARDS?

Answer 18

norm: 8-10 mL/kg
ARDS: 4-6 mL/kg (in order to prevent volutrauma)

Question 19

what is a normal plateau pressure?

what si a normal peak inspiratory pressure?

Answer 19

plateau pressure (i think less than 30)
dunno yet

Question 20

dynamic vs static compliance

Answer 20

dynamic is airway compliance

static is lung compliance

Question 21

If the PAOP is high…… then what condition do you have?

Answer 21

pulmonary edema, most likely cardiac origin

Question 22

electrolyte imbalances can cause what ABG

Answer 22

metabolic alkalosis

Question 23

which vent setting helps “blow off” CO2?

Answer 23

PPV positive pressure ventilation