Resp Diseases

Question 1

If pt has URI, when should surgery be rescheduled for? Why?

Answer 1

6 weeks; it may take that long for airway hyperactivity to resolve

Question 2

Asthma is a disease of ______ airflow obstruction characterized by ____, ____, & ______

Answer 2

Reversible; bronchial hyperreactivity, bronchoconstriction, chronic airway inflammation

Question 3

the volume of air that can be forcefully exhaled in 1 sec. normal value?

Answer 3

FEV1; 80% - 120% of predicted value

Question 4

The volume of air that can be exhaled with maximum effort after a deep inhalation. Normal values?

Answer 4

FVC; F = 3.7L, M = 4.8L

Question 5

The volume of a substance (carbon monoxide) transferred across the alveoli into blood per min per unit of alveolar partial pressure. Normal value?

Answer 5

DLCO; 17-25 ml/min/mmHg

Question 6

_____ & _____ are the most common arterial blood gas findings in the presence of asthma

Answer 6

hypocarbia & respiratory alkalosis

Question 7

A disease of progressive loss of alveolar tissue and progressive airflow obstruction that is NOT reversible

Answer 7

COPD

Question 8

Signs & symptoms of COPD

Answer 8

DOE or at rest, chronic cough, & chronic sputum production

Question 9

When does a COPD pt need home oxygen?

Answer 9

if PaO2 < 55mmHg, Hct > 55%, or there is evidence of cor pulmonale

Question 10

How long preop do pts need to stop smoking?

Answer 10

at least 6 weeks

Question 11

Why should inter scalene block be avoided in pts with severe COPD?

Answer 11

it typically causes ipsilateral phrenic nerve palsy

Question 12

associated with irreversible airway dilation in pts with either focal or diffuse lung involvement by this disease

Answer 12

bronchiectasis

Question 13

How do you diagnose cystic fibrosis

Answer 13

sweat chloride concentration > 70 mEq/L

Question 14

What drugs should be avoided with cystic fibrosis? Why?

Answer 14

anticholinergics to maintain secretions in a less viscous state

Question 15

When does tracheal stenosis become symptomatic?

Answer 15

when the lumen of the adult trachea is decreased to < 5mm in diameter

Question 16

Hallmark of restrictive lung dz

Answer 16

inability to increase lung volume in proportion to an increase in pressure in the alveoli

Question 17

What is the “butterfly” fluid pattern more commonly seen with?

Answer 17

increased pressure more so than increased capillary permeability

Question 18

mainstay treatment for aspiration pneumonitis

Answer 18

supplemental oxygen & PEEP

Question 19

the 3 principal goals in the management of acute respiratory failure:

Answer 19

1. a patent upper airway
2. correction of hypoxemia
3. removal of excess carbon dioxide

Question 20

What should be considered when abrupt worsening of oxygenation occurs in the absence of hypotension?

Answer 20

migration of tracheal tube into the left or right main bronchus or development of mucus plug

Question 21

Tx for tension pneumothorax

Answer 21

immediate evacuation of gas through a needle or small-bore catheter placed into the second anterior intercostal space can be life saving

Question 22

important indicator of a neuromuscular dz on ventilation

Answer 22

vital capacity

Question 23

Breathing is maintained solely or predominantly by the diaphragm in quadriplegic pts with spinal cord injury where?

Answer 23

at or below C4

Question 24

How do you offset pressure from insulation (15mmHg)?

Answer 24

PEEP

Question 25

Involvement of sensory/motor levels above ____ can be a/w impairment of respiratory muscle activity needed to maintain acceptable ventilation

Answer 25

T10

Question 26

Which lung is removed in a single-lung transplant?

Answer 26

the one with worse perfusion

Question 27

What side would you place the IJ (central line) in a one-lung transplant pt?

Answer 27

on the side of the native lung

Question 28

When is peak improvement achieved in lung transplant?

Answer 28

within 3-6 months