Respiratory Physiology and Pulmonary Symptoms Flashcards
Normal acid/base disturbance of pregnancy
Compensated respiratory alkalosis
How does oxygen consumption change during pregnancy?
Increased by 20 to30%.
How does carbon dioxide production change during pregnancy?
Increases 30 to 35%
How does tidal volume change during pregnancy? Why?
Increases slightly due to progesterone mediated increase in hypercapnic respiratory drive.
How does respiratory rate change during pregnancy? Minute vent?
Resp rate does not change but due to increased TV, MV is increased.
How does cardiac output change in pregnancy? Why?
Increased CO 2/2 increased HR and SV.
How does Valsalva maneuver affect DLCO testing?
Increased intrathoracic pressure leading to decreased pulmonary capillary flow with reduced DLCO.
How does exercised affect DLCO?
Increased pulmonary capillary blood flow, so increased DLCO
Volume of blood defining massive hemoptysis
100ml/hr or 500mls in 24hr
Fist step in stabilizing massive hemoptysis
Intubation and bronchoscopy
Which biologic for asthma is considered safe in pregnancy?
Omalizumab is safe but should not be started during pregnancy due to risk of anaphylaxis.
Which asthma meds are safe in pregnancy?
Inhaled SABA, Inhaled LABA, ICS, LRA, and omalizumab
Steroids given in first trimester of pregnancy increase risk of?
Cleft palate
Minimal usability criteria for spirometry
No cough or glottic closure in 1st second, back extrapolated volume <5% or 0.1L whichever is greater, no evidence of faulty zero flow setting
Repeatability criteria for spirometry
Difference between 2 largest FVCs and FEV1s be <0.15L
_____ is a rare condition affecting multiple organs and is characterized by non-Langerhans histiocytes most commonly presenting with sclerotic lesions of the long bones.
Erdheim-Chester Disease (about 50% have lung involvement with dyspnea and cough)
_____ is a mutation detected in more than half of patients with Erdheim Chester Disease.
BRAF V600
The _____ protein is usually positive in patient with LCH.
S100
Studies have confirmed that long term oxygen therapy for at least ___ hours a day is superior to no oxygen and LTOT for ___ hr/day was superior to ___hr/day.
15; 24; 12
Swimming induced pulmonary edema is caused by _____.
effect of hydrostatic forces acting on the heart and lungs
The treatment of swimming induced pulmonary edema is _______.
Supportive care (potentially NIPPV if needed)
Idiopathic pulmonary hemosiderosis presents with ____
DAH
