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58 Cards in this Set
- Front
- Back
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What is closing capacity ?
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the volume at which small Airways begin to close in the dependent parts of the lungs
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Re: closing capacity, what happens when there is intrapulmonary shunting of deoxygenated blood ?
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this promotes hypoxemia
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how does closing capacity compared to frc ?
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it is usually well below frc
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how does closing capacity change with age
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it rises steadily with age
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how does closing capacity compare with frc at age 44?
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they are equal
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how does closing capacity compare with frc at age 66?
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it equals or exceeds frc in the upright position
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draw a picture of the respiratory waveform. Label the following:
1. Total lung capacity 2. Functional residual capacity 3. Closing volume 4. Residual volume 5. Closing capacity |
see picture 4 1
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what happens with closing capacity as you get older ? what will this look like on a respiratory waveform ?
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closing capacity rises as you get older. On a respiratory waveform, it will get taller than frc (whose upper limit is right at the bottom of normal relaxed breathing.)
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Which is higher, frc standing or supine ?
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standing. frc is less supine
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what is the bohr effect?
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it is the effect of PCO2 on the oxyhemoglobin dissociation curve
it refers to the shift in oxy hemoglobin to either an increase or a decrease in PCO2 |
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with the bohr effect, what happens to the oxy hemoglobin curve and the systemic circulation ? Why?
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in the systemic circulation, the oxy hemoglobin curve shifts right.
this is to facilitate the unloading of oxygen from the blood |
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with the bohr effect what happens to the oxy hemoglobin curve in the pulmonary circulation ? Why?
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it shifts to the left.
this is to facilitate the loading of oxygen into the blood |
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what happens to the oxygen dissociation curve with the bohr effect when oxygen content in the blood decreases ?
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it shifts to the right. This is to facilitate unloading. This is seen in the systemic circulation.
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What happens to the oxygen dissociation curve with the bohr effect when oxygen content in the blood increases ?
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it shifts to the left. It does this in order to grab more oxygen.
this occurs in the pulmonary circulation. |
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What does a Haldane effect describe?
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the effects of PO2 on the carbon dioxide dissociation curve.
it describes how a change in PO2 influences the CO2 dissociation curve |
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with the Haldane effect, what happens to the CO2 dissociation curve when PO2 increases ?
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it shifts down and to the right.
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With the Haldane a fact, what happens to the CO2 dissociation curve when PO2 decreases ?
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the curve shifts up and to the left
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what happens with the Haldane effect in the systemic circulation ?
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CO2 content is higher. The tissues are trying to get rid of CO2.
this allows for more CO2 to be taken up and gotten out |
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with the Haldane effect, PO2 is higher in the lungs and pulmonary circulation. What effect does this have on CO2 content and partial pressure of CO2 ?
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CO2 and PCO2 are lower
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with a Haldane effect, PO2 is lower in systemic circulation. What effect does this have on blood content and partial pressure of CO2 ?
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they are higher
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basically, how does pulse oximetry work ?
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there are two wavelengths of light, red and infrared.
it operates based on beer's law, where there is a relationship between the absorption of light and the properties of the material through which the light is traveling. |
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With pulse oximetry, what absorbs the red wavelength of light ?
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deoxyhemoglobin
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with pulse oximetry, what absorbs the infrared wavelength of light ?
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deoxyhemaglobin
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name 8 instances where pulse oximetry will not work
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1. When applied to the thumb
2. Vasoconstriction 3. Hypothermia 4. Hypotension 5. Methylene blue or indigo carmine 6. Anemia 7. Carbon monoxide poisoning 8.methemaoglobinemia |
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what is it called when CO2 in capnography is expressed as a number ?
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capnometry
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what is it called when CO2 is seen as a wave ?
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capnography
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basically describe the physics of capnography
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gas is sampled at 2 different infrared wavelengths
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where should we place the sampling line with capnography ?
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as close as possible to the alveolar gas (i.e. elbow of circuit)
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draw a normal capnography waveform. Label the following:
1. Begin expiration 2. Alveolar plateau 3. Actual alveolar end tidal CO2 4. Inspiratory limb 5. Fresh gas inhaled |
see picture 4 2
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draw an obstructive pattern capnography waveform
what 3 things could cause this ? |
see picture 4 3
kinked tube, COPD, bronchospasm |
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what does an apnea waveform look like ?
what could cause it? |
it is basically a normal waveform that goes flat
it could be either that the ventilator stops or the patient is disconnected |
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draw a picture of a rebreathing capnography waveform.
name 3 things that could cause this: |
see picture 4 2
faulty expiratory valve, exhausted CO2 absorber, channelling |
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draw increasing CO2 on the capnography waveform
name 2 things that could cause this |
see picture 4 3
MH (if the rise is rapid) hypoventilation (if the rise is gradual.) |
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Draw the start of spontaneous ventilation on a capnography waveform
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see picture 4 4
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draw hyperventilation on a capnography waveform
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see picture 4 5
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with blood gases, what is the basic goal of the body ?
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to compensate to a normal pH
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is compensation the same as correction ?
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no. Compensation is not synonymous with correction
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what is the formula to determine hydrogen ion concentration ?
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H+ (meq/L) X [PCO2/HCO3
] |
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what is the compensatory response to respiratory acidosis ?
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increase in HCO3 (metabolic alkalosis)
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what is the compensatory response to respiratory alkalosis ?
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decrease in HCO3 (metabolic acidosis)
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what is the compensatory response to metabolic acidosis ?
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decrease in PCO2 (respiratory alkalosis)
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what is the compensatory response to metabolic alkalosis ?
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increase in PCO2 (respiratory acidosis)
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Re: respiratory acidosis and respiratory alkalosis, what is the anticipated ratio of change between pH and PCO2 for acute ?
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0.008
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Re: respiratory acidosis and respiratory alkalosis, what is the anticipated ratio of change between pH and PCO2 for chronic ?
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0.003
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with compensatory response, which system response to metabolic disorders?
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respiratory system
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with compensatory response, which system provides the compensation for respiratory disorders, and how long does this take ?
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kidneys provide compensatory response for respiratory disorders
it begins in 6 to 12 hours and requires a few days to reach maximum compensation |
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what is the pneumonic for causes of metabolic acidosis with normal anion gap ?
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USED CARP:
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what is the pneumonic for causes of metabolic acidosis with high and I am gap ?
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MUDPILES:
methanol, uremia,DKA, Paraldehyde, iron or INH, lactic acid, ethanol, salicylates |
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what is normal venous pH ?
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7.31 to 7.41
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what is normal venous PCO2 ?
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five points higher than arterial
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what is normal venous PO2 ?
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35 to 40
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what is normal venous HCO3 ?
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the same all
around |
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if the pH and PCO2 change in the same direction, what type of disorder is this ?
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primary metabolic
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if the pH is abnormal but the PCO2 is normal, look at of disorders this ?
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primary metabolic
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if the pH is normal but the PCO2 is abnormal, what could this indicate ?
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a mixed metabolic respiratory disorder
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what is the pneumonic for causes of metabolic acidosis with normal anion gap ?
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USED CARP:
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what is the pneumonic for causes of metabolic acidosis with normal anion gap ?
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USED CARP:
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what is the pneumonic for causes of metabolic acidosis with normal anion gap ?
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USED CARP:
ureterostomy, small bowel fistula, extra chloride, diarrhea, carbonic anhydrase inhibitors (Diamox.), adrenal insufficiency, renal tubular acidosis, pancreatic fistula |
