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FM boards > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

The air in the lung at max expiration

A

Residual Volume (RV)

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2
Q

The air in the lung that can be exhaled after normal expiration

A

Expiratory reserve volume (ERV)

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3
Q

Air entering and exiting the lungs during normal expiration

A

Tidal volume (TV)

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4
Q

Air in excess of tidal volume entering the lungs at full inspiration

A

Inspiratory reserve volume (IRV)

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5
Q

RV + ERV: the volume of air in the lungs at the end of passive expiration

A

Functional reserve capacity

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6
Q

RV + ERV + TV + IRV: The volume of the lungs at max inspiration

A

Total lung capacity (TLC)

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7
Q

What are lung volume assessments useful for?

A

Evaluating restrictive lung disease, looking for evidence of hyperinflation 2/2 obstructive lung disease and interpreting DLco

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8
Q

Name the components of PFTs

A

Spirometry
Lung volume measurements
Quantitation of diffusing capacity

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9
Q

What are PFTs useful for?

A

Eval of pts w/ risk factors (i.e. smoking)
Eval of chronic persistent cough, wheezing, dyspnea or exertional cough/chest pain
Assess bronchodilator therapy
Eval work exposure
Assess surgical risk
Assess impairment/disability

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10
Q

Use this test to screen smokers >45 yo for COPD

A

Spirometry

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11
Q

This test reveals stridor over the neck or unexplained dyspnea, and is used to dx variable airway obstruction (vocal cord paralysis or dysfunction)

A

Forced inspiratory maneuvers

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12
Q

Use this test when obstruction is seen on spirometry, or when asthma is suspected

A

Postbronchodilator spirometry, repeat test 10 min after bronchodilator administration

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13
Q

This test may be used to diagnose interstitial lung disease

A

Lung volumes

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14
Q

This test differentiates restrictive vs obstructive lung disease

A

DLco

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15
Q

What test result on postbronchodilator spirometry indicates bronchodilator responsiveness?

A

FVC increase of 12% & at least 0.2 L

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16
Q

Low DLco indicates what condition?

A

Emphysema

17
Q

Normal DLco indicates what?

A

Bronchitis

18
Q

Normal to high DLco indicates what?

A

Asthma

19
Q

What disease causes:
Normal/low FEV1/FVC
Normal TLC
Normal/High DLco

A

Asthma

20
Q

What disease causes:
Low FEV1/FVC
High/normal TLC
Normal/high DLco

A

COPD

21
Q

What disease causes:
Normal/low FEV1/FVC
Low TLC
Low DLco

A

Fibrotic disease

22
Q

What disease causes:
Normal FEV1/FVC
Low TLC
Normal DLco

A

Extrathoracic restriction

23
Q

What PaO2 level is considered hypoxemia?

A

PaO2 <80 (80-100 is normal)

24
Q

What is the most common cause of hypoxia?

A

Hypoxemia

25
Q

Most common cause of hypoventilation?

A

Medications

26
Q

PE, PFO and PDAs are the most common cause of this type of shunt.

A

Right to Left

27
Q

An increase in the A-a gradient in combination with low PaCO2 that does not improve with O2 supplementation is suggestive of this type of shunt?

A

Right to Left

28
Q

An increase in the A-a gradient with hypoxemia that improves with supplemental O2 suggests what?

A

V/Q (ventilation/perfusion) mismatch

29
Q

PE, asthma, COPD and pneumonia may all cause what pulmonary dysfunction?

A

V/Q (ventilation/perfusion) mismatch

30
Q

ILD or parenchymal disease show what test results?

A

Very low DLco, increased A-a gradient and improvement with supplemental O2

31
Q

Normal A-a gradient with hypoxemia that responds to supplemental O2 is suggestive of what causes?

A

High altitudes, closed space rescues, structural fires

32
Q

A patient presenting with agitation, headache, somnolence, coma and possibly seizures suggests what condition?

A

Hypoxemia

33
Q

What tests should be ordered for a patient presenting with agitation, headache, somnolence, coma and possibly seizures?

A

ABG, CXR, Pulse Ox may not be useful. Calculate A-a gradient.

34
Q

Formula A-a gradient

A

PiO2 - (PaO2 - PaCO2/8)

PiO2 = FiO2

FM boards (2 decks)

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