Respiratory Flashcards
When interpreting spirometry how do we determine obstructive vs restrictive pattern?
Look at the FEV1/FVC ratio of the best value
less than 70 % obstructive
greater than 70 % restrictive
When interpreting spirometry how do we quantify severity?
Look at the FEV1 percent predicted Based on the gold guidelines GOLD 1 Mild >= 80 GOLD 2 Moderate 50-79% GOLD 3 Severe 30-49% GOLD 4 Very Severe < 30%
On a chest x ray what does radiolucent mean?
Air, absorbs less radiation, easily penetrated BLACK
On a chest X ray what does radiodense mean?
Bone, absorbs more radiation, less penetration WHITE
Systematic approach to looking at a CXR.
Abdomen Thorax Mediastnum Lungs individually Lungs (comparing both sides) Look from area of least importance to most important
Which CXR view better identifies lesions or effusions?
Lateral view
Which CXR view is used to evaluate vertebral fractures?
Swimmers view
In what view will the heart appear enlarged, even if its really not?
Anterior Posterior View
Best way to take a CXR
Erect
PA and Lateral view
Inspiratory film
How do you detect air trapping with a CXR?
Expiratory Film
What do you see in oblique view?
localize lesions
assess free fluid
fluid will move with position change
What defines reversible air flow on a PFT?
Post bronchodilator 15% or more and 200ml increase in FEV1 or FVC= reversible flow
Usually indicates asthma, sometimes COPD
Do NOT use the FVC1/FVC ratio to determine reversibility
Oxygen testing and qualification
Arterial blood gas room air rest
PO2<55% or SAO2 88% or below
In the presence of CHF/Cor Pulmonale with DOCUMENTED EDEMA
PO2 55% or below or SAO2 89% or below
Room air pulse ox 88% or below or if CHF/Cor Pulmonale with DOCUMENTED EDEMA 89% or below
Rest
Exertion
Continuous nocturnal pulse ox recording
Total of 5 minutes or more NON CONSECUTIVE with pox 88% or below or 89% or below for CHF as above.
