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34 Cards in this Set
- Front
- Back
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Indications for PFTs
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Early detection of Pulm-diz; monitor progress of Pulm-diz; pre-surgical assessment; D/Dx of Dyspnea; worker's comp claims
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Fxns of Spirometer
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To measure Lung Capacities, Vol & flow rates
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Lung Volumes
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The air that lungs can hold in diff compartments
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Lung capacities
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Combination of 2 or more lung vols
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Tidal Volume(Vt)
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The amt of air a person breaths in/out during quiet/normal breathing
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Inspiratory Reserve Vol (IRV)
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The additional amt of air, after the VT, a person can inhale is IRV; ERV is opposite to it
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Residual Vol (RV)
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The air left in lungs after the maximum exhalation; RV=TLC-VC
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Total Lung Capacity/TLC
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Total amt of air lungs can contain
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Vital capacity/VC
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The maximum amt of air a person can breathe in/out; VC=TLC-RV
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Functional Residual Capacity/FRC
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Total amt of air left in lungs @the end of a normal exhaltion; FRC=ERV+RV
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What are 6 parts of PFTs
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Air flows; Lung vols; Flow-Vol loop; MVV (maximum voluntary ventilation); diffusion of CO; ABG;
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Components of Air Flows
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FEV1; FVC; Ratio of FEV1/FVC;
The KEY to detect obstruction is FEV1/FVC<=75% |
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Max voluntary ventilation/MVV
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Pt's ability to breath in/out as hard & fast as possible for 10 secs(L/Min); it should be 40 x FEV1
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How to measure TLC or RV?
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Done via Helium Dilution technique or Body Plethysmography; TLC is the KEY lung vol; TLC>120% of predicted value=Hyperinflation; Increased RV & RV/TLC ratio suggest Airtrapping
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Diffusion Capacity
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Ability of inhaled CO to diffuse into Pulm-circulation; depends on functional Alveolar-capillary membrane surface & RBCs
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Flow-Vol loop
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Suggests upper airway obstructions & restrictions
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Peak expiratory Flow (PEF) meters
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Establish peak flow variability; quantify asthma severity; provide objective measurements on which to base TX decisions
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Hypoxia
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Reduced o2 pressure in the alveoli or low PAO2
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Hypoxemia
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Reduced o2 in blood or low PaO2
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Explaining ABGs
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Check for pH, ie. Acedemic/Alkalemic; Check for PaCo2/Hco3, ie. Resp/Met; Check for PaO2, ie. Hypoxemia/normal
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Oxygenation
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PaO2>65mmHg=normal
60-65 is mild hypoxemia 50-59 is mod hypoxemia <50 is severe hypoxemia |
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Fxns of A-a gradient=PAO2-PaO2
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Useful in Dx the source of hypoxemia, ie. diffusion or ventilation problem;
Hypoxemia w/ normal A-a gradient=ventilation problem; Hypoxemia w/ increased A-a gradient=diffusion problem (V/Q mismatch, R-L shunt, DLCO) |
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Principles of PFTs
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Pulmonary function tests measure the lungs' capacity to hold air, to move air in and out, and to exchange oxygen and carbon dioxide.
In other word they measure Perfusion, diffusion & ventilation of lungs |
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Indications for Eye & Ear cultures
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Eye: Bacterial Conjuctivitis (S. pneumoniae, S. aureus, H. influenzae)
Ear: Discharge in outer ear canal |
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Indications for Throat culture
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Strep throat; Diptheria (throat/nasal); Thrush; Viral pharyngitis
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Indication for Nasopharyngeal Swabs
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RSV; Parainfluenza virus; B. pertusis done w/ calcium-alginate-tipped swab via nose & throat
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WBC for bacterial pneumonia
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Neutrophils>25000; Klebsiella produces "currant jelly sputum"
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Dx tests in Bronchitis
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O2sat; CBC if possible infection; Gr stain & C-XRY for severe/prolonged; ABG for COPD
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Dx tests for Asthma
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O2 sat; Eosinophil count; Peak flow/Spirometry to see FEV1/FVC ratio; C-XRY for infections
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Dx test for Pneumonia
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O2 sat; CXR; CBC; CMP; blood culture & Gr stain
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Dx test for COPD
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O2 sat; ABG; PFT; ECG to check Heart fxn & r/o heart diz; CXR to look for lung changes;
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DX test for Pulm Embolism
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ABG, CBC, CMP, CXR, D-Dimer, EKG (sinus tach & non specific ST changes); Helical CT pulm angiogram
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What is Fluorescein Staining of an Eye
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Dx of Corneal Abraison under cobalt-blue filtered light p/ the application of Fluorescein stain; the abraison appears green w/ it
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Alveolar-Air Equation
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PAO2=FiO2(P atm-P h2o)Paco2/RQ
PAO2=0.21(760-47)36/0.8=107mmHg |
