Family Medicine

Front 1

What is the most useful for diagnosing presence of Obstrutive lung disease?

Back 1

Spirometry

Front 2

What is FVC?

Back 2

MAxium volume of gas that can be exhaled forcefully after a maximum inspiration

Front 3

What is FEV1?

Back 3

volume of gas exhaled during the first second of an FVC maneuver

Front 4

What is the range of Abnormal FEV1?

Back 4

<80% AND WHEN THE RATIO of FEV1/FVC is <0.7

Front 5

What is FEF 25-75%?

Back 5

measured in the middle one-half of forced expiration, represents flow thorugh small airway.

Front 6

What is abnormal FEF 25-75?

Back 6

<50% of that predicted, consider obstruction disease if the FEV1/FVC is also decreased despite a normal FEV1

Front 7

What is Total lung capacity?

Back 7

Volume of lungs at maximum inspiration-

Front 8

What is decreased TLC?

Back 8

restrictive pattern

Front 9

What is Residual volume?

Back 9

Volume left in the lungs after maximal expiration

Front 10

What indicates air trapping?

Back 10

increased RV

Front 11

What is Tidal VOlume?

Back 11

volume of air inspired and expired during normal breathing

Front 12

What is DLCO?

Back 12

Diffusing capacity of the lung for CArbon monooxide, measures the diffusion of CO across the alveolar surface.

Front 13

DLCO is decreased (<80% of normal) caused by what?

Back 13

intersitial thinckening, decrease in alveolar surface area (emphysema, PNA) inflammation(pnemonitis, bronchiolitis) CO poisoing

Front 14

What if DLCO is increased >140% of normal?

Back 14

significant pulmonary hemorrhage, obesity, polycythemia, large lung volumes, left to right shunt and astham

Front 15

Restricitivedisorders are suggested by what?

Back 15

decrease in both FEV1 and FVC, but with FEV1/FVC ratio of >.7.

Front 16

Restrictive disease is defined by what ?

Back 16

Decrease in TLC

Front 17

Differntial diagnosis for Restictive diseases?

Back 17

Emphysema, chornic bronchitis, asthma

Front 18

What is the normal ranges of Vital capacity of male and females?

Back 18

Women: (21.78-.101x age in yrs)x ht in cm
Men: (27.63-.112xage in yr)x ht in cm

Front 19

What is the normal tidal volume for adutls and children

Back 19

children: 7.5ml/kg
women: 6.6 ml/kg
men: 7.8ml/kg

Front 20

Define Respiratory Failure?

Back 20

inability of the lungs to meet the metabolic demands of the body.

Front 21

Acute respiratory failure should be suspected when a patient breathing room air has?

Back 21

PO2 <60 torr or PCO2 >50 torr with pH of <7.3

Front 22

What is the flow rate and % ox delivered with Nasal cannula?

Back 22

.25-8 L/min delivering 22-45

Front 23

What percent of O2 can simple mask at 6-10 L/min flowrate give?

Back 23

35-55percent

Front 24

What is the minmum flow rate that can be used for simple mask?

Back 24

5lpm

Front 25

What is the flowrate and oxygen percentage of Venturi Mask?

Back 25

4-12 wth 21-100 O2

Front 26

What can cause a decrease in respiratory drive?

Back 26

CO2 retention (hypercapnia/acidosis)
pts with chronic hypoxemia, whohave resp. drive based on hypoxia (COPD)

Front 27

What should be the base line for premissive Hypercapina of O2 concentration?

Back 27

PO2 >55 to 60 torr (88%-90% SATS) treat hypercapnia with ventilaroy support as indicated

Front 28

What is Volume cycled ventilation?

Back 28

tidal vollume is set and the specified volume of gas is delivered.

Front 29

Examples of Volume cycled ventilation is?

Back 29

controlled mandatory ventilation(fixed rate and volume,Assist control, and volume support

Front 30

In volume cycled ventilation, how is it used?

Back 30

MV is guaranteed, but the airway pressures are variable, allwoing for generation of high airway pressures and increased risk of barotrauma

Front 31

Descrive Pressure cycled ventialtion?

Back 31

Inspriatory pressure is set with Vt dependent on pressure and patient compliance: Vt acturally varies from breath to breath

Front 32

Exampes of pressure cycled ventilation?

Back 32

PC and PSV

Front 33

What are some disease that the patient may benefit from using pressure cycled ventilation?

Back 33

PNA or ARDS

Front 34

Whatis the one thing that can determine CPAP/BIPAP vs Intubating?

Back 34

Cooperatition of the patient

Front 35

What is the starting ranges of CPAP?

Back 35

8-12 cmH2O for Inspiratory and 3-5cmH2O for expiratory pressures

Front 36

What is the rule of thumb when you Oxygenate a patient?

Back 36

intiate MechVentilation with an FIO2 of 100%, then taper 10% every 10-15 minutes to find the lowest Fio2 necessary to maintain adequate oxygentation.

Front 37

What is the intial Vt levels for patients?

Back 37

8-10ml/kg of body weight.

Front 38

What percent of FIO2 for over 24 hours has been associated with lung injury?

Back 38

>60%

Front 39

How can you calcuate MV?

Back 39

Tidal volume x RR

Front 40

INcrease in MV with do what to the CO2 levels?

Back 40

Decrease PCO2

Front 41

What is permissive hypercapnia?

Back 41

Lower tidal volumes may lead to hypoventilation, and the PCO2 will rise. in certain situations like ARDZS

Front 42

What is PEEP?

Back 42

postitive end expiratory pressure, may increase compliance of the lung and decrease the work of breathing by recruitiing alveolar units, thus preventing atlectasis and decreasing shunting

Front 43

What is the starting levels of PEEP?

Back 43

3-5 cmH20 and increase in small increments

Front 44

If high levels of PEEP are achieved, what is the possible end product?

Back 44

decreased venous return and severe hemodynamic compromise.

Front 45

What is Peak airway pressure?

Back 45

reflects the pressure required to overcome airway resistance and is the peak pressure during th einspiratory cycle.

Front 46

What PIP would be alarming for a patient?

Back 46

>35cmh2o

Front 47

What should you consider if PIP are high?

Back 47

obstruction in the ET, bronchspasm, decreased lung compliance, or a pneumothroax form barotrauma

Front 48

What are some ideal parameters of weaning patient off the ventilator?

Back 48

PO2>60torr with <40%fio2, PCO2 and pH in acceptable range, PEEP <5cmH2O MV <10ml/mil

Front 49

For weaning, what would an acceptable NIP?

Back 49

>-20cmH2O

Front 50

When should you discontiune attemtps of weaning?

Back 50

pH <7.3, PCO2 >50torr, or PO2 <60torr.
patient becomes anxious, fatigued, demostrates increasing respiratory distress, or develops signigicant arrhythmias or hemodynamic deterioration

Front 51

What are some methods of weaning from ventilator?

Back 51

Pressure support method or T-piece.

Front 52

Describe how PS ventilation works for patients?

Back 52

Switch from an asisted mode of breathing to pressure support. setting pressures to generate tidal volumes similar to the assisted volumes with a ventilation rate <20.
Gradually decrease the inspiratory pressure until 8 to 10cmH2O above expiratory pressure.