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Diag Pro Unit 1
SPC Diagnostic Procedures Unit 1 Exam 1
Question | Answer |
---|---|
What is spirometry? | Measures the volume and flow a patient is capable of producing. |
What are the 4 Primary Volume Measuring (PVM) Spirometers? | 1. Water Sealed 2. Dry Sealed 3. Bellows 4. Turbine/Wright |
What is significant of Water Sealed Spirometers? | "GOLD STANDARD" Rugged, dependable, and too large to move |
What is significant of Dry Sealed Spirometers? | More Portable and easier to maintain but resistance by dry seal is a source for measurement error |
What is significant of Bellow Spirometers? | Large bellows expanded horizontally and are accurate but crack and tear |
What is significant of Turbine/Wright Spirometers? | Only PVM that allows air to pass through device Best for bedside, small and easy |
What are the 3 Primary Flow Measuring (PFM) Spirometers? | 1. Differential Pressure Pneumotach 2. Thermal 3. Ultrasonic |
What is significant of Differential Spirometers? | Very accurate and widely used but not used with heliox |
What is significant of Thermal Spirometers? | Used difference in temperature caused by air flows to measure flows |
What is significant of Ultrasonic Spirometers? | Used ultrasonic crystals to measure flow |
How often should spirometers be calibrated? | Daily |
ATS (American Thoracic Society states calibration can be off by what? | 3% or 50ml |
What is an alternative to using a super syringe for calibration? | Rotometer or rotary pump |
What is ATPS? | Air in the spirometer is at ambient temperature, pressure saturated (ATPS) which is cooler than the air in the body and takes less volume in the spirometer. |
What is BTPS? | Air in the human body is at body temperature pressure saturated (BTPS) and takes up more volume in the spirometer. |
Should results be reported in ATPS or BTPS | The conversion is performed by the spirometer but it's important to understand that all spirometer results must be reported at BTPS. |
Indications for Spirometry? | 1. Detects Presence or absence of lung disease 2. Quantifies extent of known disease 3. Measures effects of occupational and environmental exposures 4. Evaluate effects of therapy 5. Assess risk for surgery 6. Evaluate degree of disability |
Predicted values are based on what characteristics? | 1. Height 2. Age 3. Weight 4. Gender 5. Race |
What is VC? | Amount of gas exhaled after a maximal inspiration All the way in, All the way out |
5 important facts about VC? | 1. Vary as much as 20% between efforts 2. Vary with body position and time of day 3. Increase to age 20 then decreases 4. Taller patient larger VC 5. VC can differ with race |
What is FVC? | Forced Vital Capacity- Air blown out fast as possible |
What is SVC? | Slow Vital Capacity- Air blown slowly |
Significant of FVC vs. SVC? | Will be equal in individuals without lung disease |
How many times must patient complete test to insure accuracy? | x3 |
What does the Black, Red, and Blue graph means on a volume time curve? | Black- Normal Lung Red- Restricted Lung Blue- Obstructed Lung |
What type of diseases are restrictive? | All cancers and the "osis" diseases (except Cystic fibrosis) |
What time of diseases are obstructive? | CBABE Cystic Fibrosis--Bronchitis--Asthma--Bronchiectasis--Emphysema |
If the actual FVC is less than 80% of the predicted FVC then the patient has? | Restricted Lung Disease |
How do you know if there is an obstructed lung disease? | Divide actual FEV1 by the actual FVC. FEV1/FVC is less than 80% they are obstructed |
If all numbers are above 80% then what? | Normal Spirometry |
FVC actual/FVC predicted = 80-100% | Normal |
FVC actual/FVC predicted = 60-80% | Mild |
FVC actual/FVC predicted = 40-60% | Moderate |
FVC actual/FVC predicted = <40% | Severe |
What is Pseudo restrictions? | When a patient is so obstructed the appear restricted. |
3 ways to tell if there is pseudo restriction? | 1. Patient is more obstructed (severe) than restricted (mild) 2. Air trapping like emphysema of hyperinflation 3. Patient history indicated obstructive but no restrictive such as asthma |
What is FEV1? | Volume exhaled during 1st second of a FVC. |
What significant of FEV1? | Expressed as a percentage of VC and is the standard index for assessing & quantifying airflow limitation, obstruction, and bronchoconstriction. |
What is back Extrapolation? | Performed by the computer to correct for a patients late start on a Volume Time Curve Loop |
Extrapolation may not exceed more than what of the FVC? | 5% or 150ml |
What is FEF 200-1200? | Flow that occurs between 200-1200ml of patients expiration. |
The 1st 200ml of expiration is considered what? | Deadspace |
What is FEF 25%-75%? | Measures expiratory flow in the MIDDLE of the FVC and shows flow from medium and small airways. |
FEF 25%-75% may decrease in early stages of what? | obstructive lung disease as well as restrictive lung disease. |
Both FEF 25%-75% & FEF 200-1200 are dependent on what? | Patient effort |
How to use a Peak Flow Meter? | Take a deep breath, Blow out hard and fast, record the reading on the meter |
What is MVV (Maximum Volume Ventilation)? | Largest volume of air that can be breathed in and out in one minute. Patient must cooperate |
RR for 1 min MVV test should be what? | 70-120 breaths |
Formula for percentage of change in FEV1 after a bronchodilator is given? | (Post FEV1-Pre FEV1)/Pre FEV1 |
If there is a 12% or > increase post bronchodilator that indicated what? | Positive response |
What is Bronchoprovocation? | Bronchoprovocation studies are used to determine if a patient has hyper reactive airways and is usually ordered for patients who have normal spirometry results with a history of wheezing or shortness of breath. |
A Reduction of greater than 20% in FEV1 with Bronchoprovocation means what? | A positive test |
What is inhaled with a Bronchoprovocation Study? | Methacholine or Histamine |
What is Elastic Recoil Pressure? | Patient must swallow esophageal ballon which will measure changes in pressure via transducer outside the body. Reflect changes in pleural pressure |
What is Impulse Oscillometry? | Non-invasive and fast way to detect airflow obstructions in who can not perform spirometry. Uses sound waves to measure FEV1, Peak, and resistance. |
Advantages of Plethysmography? | For patients who have air spaces within the lung who do not communicate with the bronchial tree. |