Pulmonary Diagnostic Testing

Question 1

ABG: Too much Heparin

Answer 1

PaCO2 decreases towards 0
PaO2 increase/ decrease towards room air
pH decreases toward 7.0

(same as air bubbles in sample)

Question 2

A-a Gradient values

Answer 2

Normal - 25-65 torr on 100%
V/Q Mismatch - 66-300 torr
Shunting - >300 torr

Question 3

P/F Ratio values

Answer 3

Normal: 380 torr or more
ALI: <300 torr
ARDS: <200 torr

Question 4

Respiratory Acidosis with Hypoxemia Treatment

Answer 4

Initiate ventilation, increase RR

Question 5

Respiratory Alkalosis with Hypoxemia Treatment

Answer 5

Oxygen for hypoxemia

Question 6

Metabolic Acidosis

Answer 6

Administer Bicarbonate

Question 7

Hypoxemia with high PaCO2

Answer 7

Poor ventilation - increase ventilation (RR)

Question 8

Hypoxemia with normal or low PaCO2

Answer 8

V/Q Mismatch - Increase FiO2 up to 60%

Question 9

Hypoxemia with FiO2 60%+

Answer 9

Shunting, refractory hypoxemia, venous admixture - start/increase PEEP or CPAP

Question 10

Normal ABG values for Neonates

Answer 10

pH > 7.30
PaCO2 < 50 torr
PaO2 > 60 torr

Question 11

Spirometers measure

Answer 11

Volumes and flow rates

Question 12

Pneumotachometers measure

Answer 12

Flow (Wright respirometer)

Question 13

Typical Peak Flow Value

Answer 13

10 L/sec or 600 L/min

Question 14

Plethysmograph (Body Box)

Answer 14

Measures FRC in Obstructive patients and airway resistance

Question 15

Volume Calibrations done with

Answer 15

3.0 L syringe

Question 16

MIP

Answer 16

> -20 cmH20

< -20 cmH20 indicates muscle weakness

Question 17

MEP

Answer 17

> 40 cmH20

< indicates poor ability to clear secretions

Question 18

FVC

Answer 18

Decreased/decreased volumes = restrictive disease

best indicator of restrictive disease

Question 19

FEV1

Answer 19

Decreased/decreased flow = obstructive disease

good indicator of obstructive disease

Question 20

FEV1/FVC ratio

Answer 20

Decreased = obstructive

normal (70%) = not obstructive, but can be restrictive if FEV1 decrease

Question 21

FEV1 decreased, normal FEV1/FVC ratio =

Answer 21

Only restrictive disease

Question 22

Pre and Post Bronchodilator Testing

Answer 22

Minimum increase of 12% and 200 mL in FEV1

Question 23

Predicted Normal Values %

Answer 23

Normal - 80%-100%
Mild - 60%-79%
Moderate - 40%-59%
Severe - < 40%

Actual value/predicted value= % of predicted

Question 24

FVC Maneuver Best Test

Answer 24

Largest sum of FVC + FEV1

Question 25

MVV

Answer 25

Performed for 12-15 secs

Measures the muscular mechanics of breathing (muscle strength)

Decreased with obstructive disease, increased Raw, muscle weakness, decreased compliance, and poor patient effort

Question 26

Gas Diffusing Capacity (DLCO)

Answer 26

Normal = 25 mL

Measures all factors that affect the diffusion of gas across the A/C membrane

Emphysema only obstructive disease