Respi conditions: oxygen, general concepts

Question 1

Initial recommended settings on BiPAP

• inspiratory & expiratory pressures
• backup breathing rate

Answer 1

IPAP = 10cm
EPAP = 5cm
Backup breathing rate: 15 breaths per min
Backup inspiration: expiration ratio 1:3

according to 2008 RCPhysicians guidelines

Question 2

Indicators for NIV (BiPAP)

Answer 2

1. COPD + respiratory acidosis
2. T2RF
3. Cardiogenic

Question 3

Where is the safe triangle for chest drain insertion

Answer 3

1. Latissimus dorsi
2. Pec major
3. 4th/5th intercostal space in the mid axillary line

Direct tube high and anteriorly

Question 4

How much oxygen to give in venturi in a COPD CO2 retainer

Answer 4

24percent oxygen

Question 5

Causes of fine crepitations

Answer 5

Fine creps:

• Pulmonary oedema
• Pulmonary fibrosis

Question 6

Causes of coarse crepitations

Answer 6

Coarse creps:

• Pneumonia
• COPD
• Bronchiectasis
• TB lung cavities/ lung abscess

Question 7

What patients are High Res CT (HRCT) used for

Answer 7

Suspected interstitial lung disease

Question 8

Normal ABG + lactate values

Answer 8

pH: 7.35 – 7.45

PaCO2: 4.7-6.0 kPa

PaO2: 11-13 kPa

HCO3-: 22-26 mEq/L

Base excess: -2 to +2 mmol/L

Lactate: 0.5-1 mmol/L

Question 9

Percentage oxygen for flow rate:
Nasal cannula
1L
2L
4L
5L

Answer 9

Nasal cannula
1L 0.24
2L 0.28
4L 0.36
5L 0.4

1L 0.24 +0.04 for every 1L thereafter

Question 10

Percentage oxygen for flow rate:
Venturi
2L
4L
8L
10L
15L

Answer 10

Venturi
2L 0.24
4L 0.28
8L 0.35
10L 0.4
15L 0.6

Question 11

percentage oxygen for flow rate:

NRB 15L

Answer 11

NRB

15L 0.85

Question 12

What pO2 levels indicate a need for LTOT in COPD patients

Answer 12

pO2 7.3 OR
pO2 7.3-8 with 2o polycythaemia/ peripheral oedema/ pulmonary hypertension

Should get 2 ABGs at least 3 weeks apart

Question 13

MoA of buproprion

Answer 13

Nicotinic receptor ANTAgonist
Norepinephrine and dopamine reuptake inhibitor

Used in smoking cessation

Question 14

MoA of varenicline

Answer 14

Nicotinic receptor partial AGONist

Question 15

Definition of pulmonary arterial hypertension

• at rest
• after exercise

Answer 15

PAH

> 25mmHg at rest
30mmHg after exercise