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PFT Final Exam | 100% Correct Answers
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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
- Pulmonary Hypertension
- Accompanied by drastic SOB What is seen normally during exercise as VT increases and cardiac output increases promoting recruitment of vessels in the apices of the lungs? - ✔✔Decreased Deadspace What is the normal Alveolar Ventilation? - ✔✔ 4 - 5 L/min What is the ventilatory response to CO2 regarding ventilatory control tests? - ✔✔measurement of the increase or decrease in minute ventilation caused by breathing various concentrations of CO2 under normoxic conditions. When regarding Ventilatory Control tests response to CO2, the normal linear increases in MV of about - ✔✔3 L/min/mmHg, there will be a decrease response in COPD because an increased RAW leads to reduced ventilatory drive. What is the ventilatory response to O2 regarding ventilatory control tests? - ✔✔measurement of the increase or decrease in MV caused by breathing various concentrations of O2 under isocapnic conditions. What does isocapnic conditions mean? - ✔✔level of CO2 in the tissues that remains steady despite changes in levels of ventilation What does the occlusion pressure look at? - ✔✔ventilatory drive What is the HAST test? - ✔✔Evaluates a patients tolerance to hypoxia during air travel.
What is "work" defined as? - ✔✔-expressed in kpm
- 1 kpm= work of moving a 1kg mass a vertical distance of 1 m against force of gravity What is "power" defined as? - ✔✔-expressed in kpm/min or in watts
- 1 watt= 6.12 kpm What is "energy" defined as? - ✔✔-expressed by VO
- Oxygen consumption in L or mL/min in STPD or by metabolic equivalents What is a term used to describe the level of work performed during exercise or in relation to ADLs? - ✔✔MET 1 MET equals - ✔✔3.5 mL O2/min/kg A healthy person typically exercises at how many METS? - ✔✔ 7 How do you find the O2 consumption? - ✔✔divide the VO2 by 3. What are some events that would make you terminate a exercise test? - ✔✔-Failure of monitoring system
- Changes to EKG patterns
- PVCs esp if normal then throw PVCs
- Worsening chest pain
- Sweating and pallor
- Systolic greater than 250**
- Diastolic greater than 120**
- Failure of BP to rise or a fall in systolic BP
- Dizziness, confusion, or headache
- Cyanosis
- Nausea, vomiting, muscle cramps What are some contraindications to exercise testing? - ✔✔-Recent MI
- CHF
- PaO2 less than 40mmHg
- PaCO2 greater than 75mmHg What is the calculation for HRMax? - ✔✔ 220 - Age in years How do you know if your patient is giving you maximal effort during the exercise testing? - ✔✔reaches 85% of maxHR Minute Ventilation will increase as - ✔✔workload increases What is the best indicator of workload? - ✔✔Oxygen consumption and will increase over 5.0 L/min What are the normals for o2 uptakes? - ✔✔Normal at rest: 2.5-4.0 ml/o2/beat Strenuous exercise: 10-15 ml o2/beat Lactic Acid is buffered by - ✔✔HCO VD/VT will decrease as - ✔✔workload increases What are the normal VO2 at rest? - ✔✔250 ml/min What are the normal VCO2 at rest? - ✔✔200 ml/min If a patient has exercise induced Asthma, their PFTs will be - ✔✔normal
- GAW
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.
- Normal values: 10-30 ppb in Adults, 5-15ppb in children What is the forced oscillation technique? - ✔✔-Useful for measuring changes in the patients airways when he or she is unable to perform spirometry or body box.
- Used with adults and young children who have physical limitations that prevent tests requiring effort and coordination. How do you determine if a patient is at post op risk? - ✔✔-Preoperative PFTs
- Find their %predicted
- If % predicted is less than 50% increased risk
- If FVC is less than 1.5 L then High Risk
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
- Should fast for 12 hours (turn off feed tubes)
- Neutral thermal environment
- Drugs or substances that alter metabolism should be avoided What are some key points regarding indirect calorimetry in a patient that is on the Ventilator? - ✔✔- stable condition
- No leaks
- No suctioning during testing
- No vent changes within the last 1-2 hours
- O2 concentration to remain the same What are some key points regarding PFT testing with Children? - ✔✔-Maximal effort needed
- Age appropriate instructions
- Tests must be performed standing***
- Only one set of results are acceptable if you cannot get reproducible efforts. What are some water sealed volume displacement spirometers? - ✔✔Collins Stead wells Bellotypes (bell type spirometer**) What are some problems with water sealed spirometers? - ✔✔-Corrosion of bells
- Bacterial growth in water - required frequent replacement
- Leaks in tubing - cracks in bell
- Chance of false reading at high flow rates
- Friction between bell and water
- Frequent changing of water vapor and CO2 absorbers.
- Not portable - bulky- high maintenance The simplest type of flow sensing device is the turbine and commonly known to us called - ✔✔Wright Respirometer What are Advantages of flow-sensing spirometers? - ✔✔-Many are small and portable
- With appropriate circuits and analyzers, can perform all PF tests
- Microprocessor controlled - direct connection of analog signal to tracing devices/readouts
- Easily cleaned what are Disadvantages of flow-sensing spirometers? - ✔✔-Usually requires two flow sensors - one for low flows and one for high flows
- Require very precise time devices
- Electronic "drift" of flow sensors necessitates frequent calibration
- Affected by composition of gas being measured (density, viscosity) requiring special corrections and/or calibration What are common problems with breathing valves? - ✔✔failure to operate correctly When it comes to Oxygen Analyzers, the polargraphic electrodes and zirconium fuel cells do what? - ✔✔measure the partial pressures of oxygen Infrared Absorption is the - ✔✔Measurement of CO and CO2 continuously
- CO measurement for DLCO tests
- CO2 for capnography Emission Spectroscopy is - ✔✔-Geisler tube
- Analyses nitrogen (N2) for the nitrogen washout test
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
- Gives an accurate measurement of O2 saturation and COHb (for CO poisoning diagnosis) What is the extent to which measurement of a known quantity results in a value approximating that quantity? - ✔✔Accuracy What is the extent to which repeated measurements of the same quantity can be reproduced? - ✔✔Precision If a 3L of air is injected into a spirometer and the results are 2.8, 3.0, and 3.2; the "mean" value is 3.0 L. Then the - ✔✔equipment is accurate even though the individual measurements are not precise. If 3 L of air is injected into a spirometer and it consistently measures the volume as 2.5 L, the spirometer is - ✔✔considered precise but not accurate. Adjusting a device to perform within certain limits (ex. signal adjustments of transducers, sensitivity of recording devices, software correction or compensation) is called what? - ✔✔Calibration A test performed to determine the accuracy and/or precision of a device with a known standard or signal (after calibration has been performed) is called what? - ✔✔Quality Control The 3L syringe is used to - ✔✔calibrate the flow and volume on equipment Quality control happens after - ✔✔calibration What is the correction factor for calibration and quality control? - ✔✔expected volume / measured volume
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
