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A comprehensive review of pulmonary function testing (pft) concepts, including spirometry calibration, ventilatory control tests, cardiac output calculations, dead space ratios, alveolar ventilation, and exercise testing protocols. It covers various conditions affecting respiratory function, such as pulmonary emboli, hypertension, and asthma, and includes key points on bronchoprovocation testing, mip/mep measurements, exhaled nitric oxide tests, and indirect calorimetry. The material is presented in a question-and-answer format, making it useful for exam preparation and quick reference. It is designed to help students and professionals understand the principles and applications of pfts in clinical practice, covering topics from basic calculations to advanced diagnostic procedures. The document also addresses contraindications and termination criteria for exercise testing, as well as the interpretation of pft results in various respiratory conditions.
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You are calibrating a spirometer with a super syringe, and after injecting 3L of air for three consecutive calibrations; the results are 2.8L, 3.0L, and 3.2L. Based on these results, the spirometer is considered: - ✔✔Accurate Which of the following test is used as an indicator of ventilatory inspiratory muscle strength? - ✔✔MIP Individuals with a resting SaO2 less than ____ at sea level are recommended to have a HAST prior to air travel. - ✔✔92% The ventilatory control tests for CO2 and O2 assess the - ✔✔central (Co2) and peripheral (O2) chemoreceptors What is the calculation for Cardiac Output? - ✔✔HR x SV What is the calculation for Stroke Volume? - ✔✔End Systolic Volume - End Diastolic Volume What is the Dead Space ratio? - ✔✔VD/VT What is the calculation for deadspace? - ✔✔PaCO2-PeCO2 divided by PaCO What is the calculation for Alveolar Ventilation? - ✔✔(VCO2/PaCO2) X 0. What is the normal minute ventilation? - ✔✔ 5 - 10 L/min What does the Wright Respirometer give you when referring to PFTs? - ✔✔Slow Vital Capacity
What is Respiratory Dead space? - ✔✔Lung volume that is ventilating but not perfused by the pulmonary capillary blood flow. Made up by Anatomical and Alveolar VD. Also known as Physiological What conditions would give you a quick increase in dead space? - ✔✔-Pulmonary Emboli
What is "work" defined as? - ✔✔-expressed in kpm
What is the calculation for the %decrease during Bronch.Prov. Testing? - ✔✔Control - Current / Control If a patient comes in for Broncho Prov Testing, and is having symptoms, what do you do? - ✔✔Reschedule the test A postive Broncho Prov test is indicated by - ✔✔a decrease in FEV1 of 20% During the Broncho Prov test, the baseline PFT FEV1 must be greater than - ✔✔80% What gives the patient exact amounts of med during the Broncho Prov test? - ✔✔Dosimeter How long do you wait after administering methacholine to get your FVC? - ✔✔ 30 - 90 seconds After a 20% decrease in FEV1 is established after a methacholine test is performed, what do you need to immediately do? - ✔✔give a bronchodilator to assure patient is back to normal What is a side effect of doing a broncho provo test with histamine? - ✔✔can cause flushing, hot flash sensation and headache, and you must warn your patient about this. During the exercise challenge should be a vigorous exercise at ____ percent of max HR - ✔✔ 80 - 90 During exercise challenge, the bronchospasm usually occurs - ✔✔ 5 - 10 minutes AFTER and a positive test is a 10-15% drop in FEV During Eucapnic Voluntary Ventilation, the MVV will be - ✔✔ 30 - 70% as target rate and depth
What is the most negative pressure developed during a forceful inspiration from RV against an occluded airway, evaluates inspiratory muscle strength and the normals for woman and men are between - 50 to - 75 cmh20? - ✔✔MIP What is the largest pressure generated during a forceful exhalation from TLC against an occluded airway, evaluates expiratory muscle strength and elastic recoil of lungs and thorax and the normal value is greater than +80 to +100 cmh20 - ✔✔MEP What is the technique of MEP and MIP and what is a main characteristic of the test? - ✔✔Forceful inspiration and expiration effect against occluded airway for 1-3 seconds. This test is very patient effort dependent What is MIP often used for? - ✔✔to assess strength training of respiratory muscles and in determining the need for mechanical ventilation, kinda like NIF What is MEP often used for? - ✔✔to determine inability to cough effectively which results in patients with excessive mucus production. Decreased in neuromuscular patients What are some key points regarding Exhaled Nitric Oxide test? - ✔✔-Uses sensitive chemoluminescent analzyler to obtained exhaled NO percentages from airways.
If RQ is closer to 1 then think the patient is in - ✔✔lipogenesis or non-steady state hyperventilation Carbs With a patient on a ventilator what are some key points regarding performing indirect calorimetry? - ✔✔-need to be recumbent or supine for 20-30 minutes
What determines the concentration of each type of hemoglobin by measuring the light absorbed by each type: oxyhemoglobin (O2Hb), carboxyhemoglobin (COHb), methemoglobin (METHb), sulfhemoglobin, reduced Hb, & total Hb? - ✔✔-Hemoximetry or a Co-oximetry
What is the %error for quality control? - ✔✔(expected - measured) / expected What is the minimal expected error for quality control? - ✔✔3.5% or 65mL Sine wave rotary pumps are used for - ✔✔MVV and Body Box When doing a leak check for quality control and you are losing volume this means - ✔✔there is a leak What are common problems associated with gas analyzers? - ✔✔leaks and water vapor what does multiple point calibration for the DLCO gas analyzer do - ✔✔establishes linearity when 3 or more points are employed What is calibrated on the body box? - ✔✔Mouth transducer Box pressure transducer Flow transducer What are the two buffer ranges with calibrating PH - ✔✔6.840 - 7. What is an example of an electrode being in control? - ✔✔All values values vary between +/-2SD but in a regular manner What is an example of a out of control electrode? - ✔✔values increase or decrease +/- 2SD What is an example of a trend electrode - ✔✔situation that is not good as its moving away from the mean, its going to be out of control soon What is an example of a random error when it comes to electrodes? - ✔✔1 out of 11 points fall outside of the standard deviation