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Spring 2020 - Physiology 1 > Pulmonary Function Tests - Quiz 7 > Flashcards

Pulmonary Function Tests - Quiz 7 Flashcards

1
Q

What is the FEV1 for High Risk Patients?

A

< 2 L

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2
Q

What is the FEV1/FVC for High Risk Patients?

A

< 0.5

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3
Q

What is the VC for High Risk Adults and Children?

A

Adult: <15 cc/kg

Child: < 10 cc/kg

or

VC < 40-50% than predicted

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4
Q

What is the PreOP Goal of PFTs?

A

Optimize Patient by treating Reversible Conditions

Important for Pts. w/ > 15% improvement after treatment

EX: Bronchodilators, Antibiotics, Diuretics

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5
Q

How do you manage the Ventilator Intraoperatively

A
  • Emphysema needs longer expiratory time (change I:E)
  • Monitor PIP
  • Keep EtCO2 near patient’s baseline
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6
Q

How do you manage Bronchospams Intraoperatively?

A

Neb Treatment

Avoid Histamine Releasing Drugs

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7
Q

What are some Histamine Releasing Drugs?

A

Pentothal (STP)

Morphine

Atracurium

Mivacurium

Neostigmine

ABX

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8
Q

How would an FEV1 > 50% predicted effect extubation?

A

Extubation will not be effected

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9
Q

How would an FEV1 of 25-50% + some hypoxemia & hypercarbia effect extubation?

A

Probable Prolonged Intubation

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10
Q

What considerations should you take for a patient with an FEV1 < 25% predicted?

A

Only perform Life-Saving Procedures

Regional Anesthesia

Long Term Vent

Poss. Trach

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11
Q

Extubation Criteria

A
  • VSS, Awake & Alert
  • 40% FiO2 = PaO2 > 70 & PaCO2 < 55
  • NIF < -20cm H2O
  • VC > 15 cc/kg
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12
Q

What criteria would be considered Respiratory Failure requiring Intubation?

A
  • RR > 35
  • PaCO2 > 55 mmHg
  • PaO2 < 70 on 40% FiO2
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13
Q

What A-a gradient would you consider Intubating?

A

A-a Gradient > 350 mmHg on 100% FiO2

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14
Q

At what Vital Capacity would you consider Intubating?

A

VC < 15 cc/kg

< 10 cc/kg for kids

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15
Q

At what ratio of Dead Space to Tidal Volume would you consider intubating?

A

Vd/Vt > 0.6

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16
Q

List A-I

(I is not Depicted)

A

A: Airway

B: Bone

C: Cardiac Silouette

D: Diaphragm

E & F: Equal Lung Fields

G: Gastric Bubble

H: Hilum (and Medastinum)

I: Invasive Lines (Not Shown)

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17
Q

Whats the most fundamental test of all PFTs?

A

Arterial Blood Gas

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18
Q

How soon much the blood ABG be measured after being drawn?

A

Within 15 min or glycolysis due to lacic acid

=

↓pH + ↑CO2

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19
Q

How long can you store an ABG for?

A

1-2 Hours on Ice

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20
Q

How does Heparin effect an ABG?

A

Lowers PCO2 by dilution

(Especially in Kids)

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21
Q

An increase in PCO2 by 10 mmHg would decrease in pH by ________

A

PCO2 increase by 10 = pH decrease of 0.8

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22
Q

What does the A-a Gradient measure?

A

A-a measures the difference b/t oxygen concentration in alveoli & arterial system

23
Q

How do you treat abnormal A-a gradients?

A

Treat Underlying Cause

O2, Adjust Ventilation, PEEP

24
Q

A decrease in Bicarb by 10 mmoles decreases pH by _________

A

Decrease of Bicarb by 10 decreases pH by 0.15

Replace Bicarb by half of deficit

25
Q

What can cause Respiratory Alkalosis?

A

Pregnancy

Artificial Ventilation

Hypoxic Respiration

Anxiety

Kidneys partially fix pH

26
Q

What can cause Metabolic Acidosis?

A

Low pH & Low HCO3-

Lactic Acidosis

DKA

ASA Ingestion

Diarrhea

27
Q

What can cause Metabolic Alkalosis?

A

Loss of H+ from Vomiting/NGT Suctioning

Giving too much Bicarb

28
Q

What is Tidal Volume?

A

Volume Inspired/Expired w/ each normal breath

500 mL

29
Q

What is Inspiratory Reserve Volume?

A

Extra Volume inspired above normal breathing.

3000 mL

30
Q

What is Expiratory Reserve Volume?

A

The extra volume after normal expiration

1100 mL

31
Q

What is Residual Volume?

A

Volume of air remaining after max expiration.

1200 mL

32
Q

What is the Inspiratory Capacity

A

The maximum amount of air that a person can breathe in.

Tidal Volume + Inspiratory Volume Reserve

3500 mL

33
Q

What is Functional Residual Capacity?

A

The air in the lungs after normal expiration

Expiratory Reserve Volume + Residual Volume

2300 mL

34
Q

What is Vital Capacity?

A

The max amount of air a person can blow out after taking the biggest breath they can.

Inspiratory Reserve Volume + Tidal Volume + Expiratory Reserve Volume

4600 mL

35
Q

What is Total Lung Capacity?

A

The max volume of air the a person can breath in

Vital Capacity + Residual Volume

5800 mL

36
Q

Normally, how much is the FRC in comparison to the TLC?

A

40% of TLC

37
Q

What are the techniques used to measure FRC and which is the most accurate?

A
  • Helium Dilution
  • Nitrogen Washout
  • Body Plethysmography - sit in a sealed box and try to inhale through closed mouthpiece - more accurate
38
Q

What is Forced Vital Capacity (FVC)?

A

The max amount of air a person can forcibly blow out after taking the biggest breath they can.

39
Q

What is FEV1?

A

Volume of air forcibly exhaled in the first second.

3-5 L

40
Q

What is FEV1%?

A

Ratio of FEV1 to FVC

Normal: > 75%

41
Q

How does Airway Obstruction and Constricted Lungs compare to normal Flow Volumes?

A
  • Both have reduced Total Lung Capacity & Residual Volume
  • Airway Obstruction - harder to get air out
42
Q

How are FVC’s different between a healthy person and a person with lung disease?

A

Total Volumes are not much different.

Major difference Amount of air each person can expire per second

43
Q

What is the most important clinical tool in assessing the Severity of Obstructive Airway Disease?

A

FEV1

44
Q

What is the approximate FEV1% for a person with serious airway obstruction?

A

47%

Acute Asthma: < 20%

45
Q

An abnormal FEV1 can indicate ______ disease, while an abnormal FVC can indicate ________ disease

A

Abnormal FEV1 = Obstructive

Abnormal FVC = Restrictive

46
Q

Degree of risk in Obstructive Lung Disease

A

FEV1/FVC

Normal: > 75%

Mild: 60-75%

Moderate 45-60%

Severe 35-45%

Extreme < 35%

47
Q

What helps distinguish b/t upper airway obstruction (extrathoracic) and generalized pulmonary disease (intrathoracic)?

A

Flow-Volume Loops

48
Q

Extrathoracic obstruction decreases _______ flow, while Intrathoracic obstruction decreases ________ flow

A

Extrathoractic decreases inspiratory flow

Intrathoracic decreases expiratory flow

49
Q

Which type of lung disease when FEV1 < FVC and the FEV1/FVC ratio is decreased?

A

Obstructive Lung Disease

50
Q

Which type of lung disease when FVC < FEV1 and the FEV1/FVC ratio is increased?

A

Restrictive Lung Disease

51
Q

What is FEF25-75%?

A

Forced Expiratory Flow
or
Mid-Expiratory Flow Rate

  • Effort Dependent = Highly Variable
  • Indicator of Early Airway Obstruction
52
Q

What is the “Will to Live” test?

A

Max Voluntary Ventilation or Max Breathing Capacity

Patient breathes as hard and fast as possible x 12 seconds

Extremely Effort Dependent

53
Q

What does the Max Voluntary Ventilation (MVV) test for?

A

Breathing Motivation, Mechanics, Strength, and Endurance

Low MVV = ↑Morbidty & ↑Mortality for thoracic Sx

Spring 2020 - Physiology 1 (24 decks)

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