Respiratory Flashcards
What has the most significant contribution to airflow resistance?
Radius
Will the PNS cause bronchoconstriction of bronchodilation?
Bronchoconstriction
Will mas cells and non-cholinergic PNS cause bronchoconstriction of bronchodilation?
Bronchoconstriction
Will the non-cholinergic PNS (nitric oxide) cause bronchoconstriction of bronchodilation?
Bronchodilation
Will the SNS cause bronchoconstriction of bronchodilation?
Bronchodilation
Stimulation of the vagus nerve will stimulate what type of receptor to produce bronchoconstriciton
M3 Receptor
What class of drugs are these?
-albuterol
-metaproerenol
-salmeterol
Beta-2 agonists
Volume of air that can be exhaled after a maximal inhalation in ONE second
FEV1
Volume of air that can be exhaled after a maximal inhalation
FVC
Compares volumes of air expired in 1 second and total volume of air expired
FEV1/FVC
Measures airflow in the middle of FEV
MMEF
Most sensitive indicator of small airway disease?
MMEF
Maximum volume of air that can be inhaled and exhaled over the course of one minute
MMV
What is the best test of endurance?
MMV
Volume of carbon monoxide that can traverse the alveolocapillary membrane per a given alveolar partial pressure of carbon monoxide
DLCO
Lab value that can be predictive of postop pulmonary complications?
Albumin <3.5
How many hours after smoking cessation will P50 improve?
12 hours
Half life of carbon monoxide
4-6 hours
How can you reduce PREOP risk of PPC? (4)
- Treat exp outflow obstruction (bronchodilators & corticosteroids)
- Treat active inflammation with antibiotics
- Instruct patient on pulmonary recruitment measures
- Treat RV failure
How can you reduce risk of INTRAOP PPC?
- Regional anesthesia over general
- Minimally invasive surgical approaches
- Avoid procurers longer than 3 hours
How can you reduce the risk of PPCs POSTOP? (2)
- Analgesia
- Pulm recruitment maneuvers
Acute, reversible airway obstruction accompanied by chronic airway inflammation and bronchial hyper reactivity
Asthma
The condition of being “hyper-allergic”
Atopy
Greatest risk factor for developing asthma
Atopy
What test is reduced in asthma but can improve following bronchodilator therapy?
FEV1
FEV1/FVC
FEF 25-75%
S/S asthma (6)
- Wheezing
- Dypsnea
- Chest discomfort/tightness
- Productive or nonproductive cough
- Prolonged expiratory phase
- Eosinophilia
Drugs that may produce s/s asthma? (4)
- ASA
- NSAIDS
- Beta antagonists
- Sulfites
Most common ABG finding in asthma
Respiratory ALKalosis w/ hypocarbia
Elevated PaCO2 suggests
Air trapping
Asthma EKG shows (2)
- RV strain
- Right axis deviation (during severe attack)
Are PFTs predicative of PPC?
No
Deep or awake extubation for asthma
Deep
Ventilator goals for asthma
- LIMIT inspiratory time
- Prolong expiratory time
- Tolerate moderate permissive hypercapnia
What piece of equipment may benefit patients with exercise-induced asthma?
HME —> retains airway humidity
Which VA reduces airway resistance
All of them
IV induction agent that causes bronchodilation
Ketamine
Dose of lidocaine that reduces airway reflexes at extubation
1-1.5 mg/kg, 1-3 minutes before extubation
Avoid histamine releasing drugs in asthma, especially (4)
- Sux
- Meperidine
- Morphine
- Atracurium
What is the best beta blocker for asthma?
Esmolol