Resp Function Tests Flashcards

1
Q

Spirometry Aim

A

Diagnostic tool to assess lung disease, quantify lung impairment, monitor the effects of occupational/environmental exposure + determine effects of medications

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2
Q

Spirometry Description

A

Measure expired + inspired air
Volume, time and flow
Measure FEV1 and VC

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3
Q

Hering-Breuer Reflex

A

Reflex triggered to prevent over-inflation of the lung

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4
Q

Obstructive defect

A

FEV1 more reduced than VC
FEV1/VC <75%
Asthma
COPD

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5
Q

Restrictive defect

A

FEV1 reduced no more than VC
FEV1/VC ratio >75% and may be 100%
VC reduced

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6
Q

Peak flow measurement

A

Only valid if done at TLC and with max effort

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7
Q

Peak flow reduction

A

Large airway obstruction
Upper airway obstruction
Asthma

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8
Q

Peak flow less affected in

A

COPD

Small airway disease

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9
Q

Interpreting Spirometry data

A

In adults, age, height, sex + race main determinants

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10
Q

Reduced inspiratory limb flow with normal expiratory flow

flow vol loop

A

Extra-thoracic obstruction

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11
Q

Equal reduction in both flows

flow vol loop

A

Intrathoracic obstruction

e.g. retrosternal goitre

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12
Q

Obstructive Flow vol loop

A

Shifts to left
Scoop in top bit, and smaller top bit
Same bottom bit

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13
Q

Restrictive flow vol loop

A

Shifts to right

Exact same shape as normal but smaller

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14
Q

FEV1/FVC ratio

A

Ratio of Forced Expiratory volume in 1 sec + forced vital capacity

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15
Q

FEV1/FVC ratio incorrect in

A

Asian communities

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16
Q

Total lung capacity measurement

A

Inspiration of gas mixture which includes helium, with rebreathing and VC manoeuvre for mixing
Dilution of helium + decrease in concentration x VC gives TLC

17
Q

Alveolar volume + gas transfer calculation

A

Single large breath of air + CO + helium

Hold breath for 10 seconds

18
Q

TLCO equation

19
Q

Decreased TLCO

A

Decrease perfusion
Decrease ventilation
V/Q mismatch
Anaemia

20
Q

Increased TLCO

A

Increased CO
Polycythaemia
Alveolar haemorrhage

21
Q

The Fick principle

A

the volume of gas per unit time which diffuses across a tissue sheet is proportional to:

  • proportional to area of sheet
  • inversely proportional to thickness
  • proportional to difference in pressure on 2 sides
  • dependent upon permeability coefficient for that gas
22
Q

Fick equation

A

Volume/time = area/thickness x pressure (P2-P1) x diffusion constant

23
Q

Diffusion constant

A

Dependent on solubility + molecular weight of gas

More soluble, easier to pass

24
Q

Graham’s law

A

Rate of diffusion of a gas is inversely proportional to the square root of molecular weight
Bigger things diffuse more slowly

25
Gas transfer reduced with
Reduced SA Increased thickness of membrane Reduced O2 conc. Inadequate time
26
DLCO/TLCO
Measures how efficient lungs are at exchanging gases | Ability of lungs to transfer gas from inhaled air to RBCs
27
Haemoglobin binding
CO>O2 (200-250x)
28
DLCO
Lung SA available for gas exchange (Va) x rate of capillary blood CO uptake (Kco)
29
DLCO/TLCO
Quantity of CO transferred per min from alveolar gas to red blood cells (mL/min/mmHg)
30
DLCO/TLCO normal
>75%
31
Increased DLCO
Exercise Supine Pulmonary haemorrhage Polycythemia Obesity Left to right shunt- atrial septal defect Muller manoeuvre- inspiration against closed mouth + nose after expiration
32
Decrease DLCO
``` Post exercise Standing Valsava manoeuvre Lung resection Pulmonary emphysema Interstitial lung disease ```
33
ILD
Decreased DLCO due to decreased Kco (fibrosis of interstitium) Useful for early ILD detection