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6902- Cullen > pulmonary disease > Flashcards

pulmonary disease Flashcards

1
Q

Who’s at risk for pulmonary problems?

A

pre existing pulmonary dx, thoracic or upper abdominal surgery, smokers, obesity, age >60 years, anesthesia longer than 3 hours

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2
Q

5 pulmonary symptoms that ID a patient at risk for pulmonary complications?

A

cough, expectoration, hemoptysis, chest pain, wheezing

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3
Q

How do you calculate pack years?

A

length of time smoking x # of packages of cigs smoked

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4
Q

Malnourished patients are predisposed to what type of pulmonary complication?

A

pneumonia

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5
Q

Clubbing is often seen in what?

A

chronic lung disease and malignancy

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6
Q

RR greater than what is early sign of respiratory failure?

A

25

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7
Q

How is pursed lip breathing an adaptation for obstructive lung dx?

A

self PEEP

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8
Q

How could you identify severe dyspnea?

A

unable to complete normal sent wout pausing for breath

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9
Q

What is inspiratory paradox?

A

abdomen goes in and chest wall expands= dysfunction of diaphragm

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10
Q

Reduced pulm vascular markings in hyperinflated lung volumes can be seen how on a chest xray?

A

lungs seem more translucent

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11
Q

IC spaces mildly elevated so wider between ribs implies what on a chest xray?

A

use of accessory muscles for respiration so hyperinflation of lungs

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12
Q

Dome flattened out and is below ant angle of __ rib so implies emphysema?

A

7th

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13
Q

3 common ABG findings w pulmonary pathology?

A

PCO2>45, PaO2

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14
Q

2 EKG changes in pts with lung dx?

A

low voltage QRS (bc of hyperinflation of lungs and increases distance of skin where electrodes are and electrical activity of heart), right BBB

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15
Q

RBBB seen in what leads?

A

2ndary R wave in V1-3

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16
Q

Where can you see cor pulmonale and pulmonary hypertension?

A

chest xray

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17
Q

Examples of symptoms and signs of pulmonary dysfunction warranting PFTs?

A

symptoms- wheezing, CP, dyspnea, orthopnea, cough, phlegm; signs- diminished breath sounds, overinflation of chest, exp slowing observed as purse lip, chest/spine deformity, unexplained crackles

18
Q

IC is?

A

TV + IRV

19
Q

VC is?

A

ERV + IRV + TV

20
Q

TLC is?

A

IRV + ERV + TV + RV

21
Q

FRC is?

A

ERV + RV

22
Q

Maximal volume of air exhaled from end expiration?

A

ERV

23
Q

Maximal volume of air inhaled from end inspiration?

A

IRV

24
Q

Volume of air remaining in lungs after maximal exhalation?

A

RV

25
Q

Volume of air in the lungs at resting end expiration?

A

FRC

26
Q

Maximal volume of air that can be inhaled from the resting expiratory level?

A

IC

27
Q

Largest volume measured on complete exhalation after full inspiration?

A

VC

28
Q

Volume of air in lungs at maximal inflation?

A

TLC

29
Q

If the patient has obstructive disease, how is that manifested on a slow VC (not forced vital capacity in other words) spirometry?

A

slow VC generally higher than forced VC bc airways collapse under rapid exhalation

30
Q

Most widely used parameter to measure mechanical pressures of lung?

A

FEV1

31
Q

In normal people, FEV1 reflects what?

A

greatest part of exhaled vol and reflects mech probs of lungs and medium sized airways

32
Q

In obstructive airway dx how does that show up on FEV1/FVC?

A

FEV1 is reduced disproportionately to FVC. so ratio is

33
Q

In restrictive airway dx how does that show up on FEV1/FVC?

A

FEV1, forced VC and TLC are all reduced but FEV1/FVC ratio normal or sometimes elevated

34
Q

What is FEF 25-75%?

A

the midpoint of forced VC. so between 25 and 75 of expired vol is also called maximal midexp flow

35
Q

FEF 25-75% reflects what? And is it recommended to measure that?

A

small airway disease; no

36
Q

As a person ages, how do the lungs change?

A

less elasticity, smaller lung volumes, smaller capacities

37
Q

4 variables which affect lung volumes/capacities?

A

age, gender, height, race

38
Q

What does the volume time curve look like in obstructive lung dx?

A
39
Q

What does the volume time curve look like in restrictive lung dx?

A

reduced FVC, reduced FEV1, normal ratio, but lower lung volumes so under the normal curve

40
Q

Patients with obstructive dx need what 2 parameters? And what vent setting do they do better on?

A

PEEP and longer expiratory time, may do better on pressure support or pressure generated volume

41
Q

When ventilating a person with restrictive dx, what do you want to do?

A

have smaller lung capacity so want to generally bring down volumes we use and increase the rate

6902- Cullen (10 decks)

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