Pulmonary Outcome Measures & Diagnostics Flashcards
what is the modified MRC dyspnea scale used for?
measure degree of breathlessness in patients with a pulmonary diagnosis or have primary functional limitations from shortness of breath
the modified MRC dyspnea scale is used more for ______ and not as useful for ______
exertion dyspnea –> SOB with exertion
dyspnea at rest –> SOB at rest
your patient is experiencing stage 4 heart failure and is complaining most of SOB. does the dyspnea scale apply to this patient?
yes, even though they are a CV pt - their primary functional limitation is SOB
Modified MRC dyspnea scale grades:
– 0
– 1
– 2
– 3
– 4
– breathless only w/ strenuous exercise
– SOB w/ hurrying or walking up slight hill
– walk slower than equivalent aged people because of breathlessness or stop for breath when walking self-paced
– stop for breath after walking 100 m or after a few minutes
– too breathless to leave the house or breathless when dressing/undressing
who is the BORG dyspnea scale mostly used for?
pts with resting dyspnea - but can use with exertional dyspnea
how should you deliver the BORG dyspnea scale to your patient to differentiate between RPE scale?
“how hard is your breathing right now on a scale of 0-10?”
where does the VT2 fall on the BORG scale?
where should you keep your pts at on the BORG scale?
5-7
4-6 (with pathology)
6 minute walk test w/ pt with COPD:
– avg distance:
– distance predictive of hospitalization or mortality
– MCID
– 380 m
– < 200 m
– 54 m (same as HF)
Gait speed cutoff scores w/ pt with COPD:
– slow =
– normal =
– MCID in pulmonary rehab:
– < 0.8 m/s
– >/= 0.8 m/s
– 0.08 - 0.11 m/s
what is the ST. George’s Respiratory Questionnaire? (SGRQ)
instrument designed to measure impact on overall health, daily life, and perceived well-being in patients with obstructive airway disease
SGRQ combines ____ and _____ of symptoms with activities that are limited by breathlessness
frequency and severity
SGRQ:
– scored out of:
– high score =
– MCID:
– 100
– more limitations
– 4 for minimal improvement, 8 mod improvement, 12 high improvement
what does a chest x ray show?
air [black]
fat, fluid, bone and other tissue [variations of gray to white]
views of chest x ray:
anterior-posterior [frontal plane]
lateral [sagittal plane]
chest x ray is the first line of imaging for:
any respiratory distress
suspicion for pulmonary pathology
post line or device placement
post intubation or extubation
what is the costophrenic angle?
– sharp angle of ____ deg
junction of the costal and diaphragmatic pleural surfaces
– 30 deg (made of diaphragm and edge of rib cage)
what is a CT used to identify?
– more or less detailed?
structural defects of the lungs or pulmonary vasculature
– more detailed than chest X ray
indications for CT:
lung cancer
ARDS/COVID
any bleeding
structural details
what is a CTA? (CT angiogram)
radiopaque IV contrast injected prior to CT scan
shows vascular abnormalities or perfusion deficits
CTA is the first line of imaging used to diagnose:
pulmonary embolism
indications for CTA:
PE
ARDS
IPF
vascular obstruction
filling defects
impairments in flow rate
what is a PET scan?
nuclear imaging that can detect glucose uptake, blood flow, and pulmonary metabolism
used to assess for _______ most often
lung tumor metastasis in the thoracic cavity
cons of PET scan:
not as accessible as other scans
expensive
requires equipment
