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Ch. 5 - Diffusing Capacity Tests (PFT)

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show transfer factor  
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what is DLCO used to assess?   show
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what is the most common DLCO method and most standardized method?   show
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what does DLCO measure?   show
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show mL of CO/min/mm of mercury at 0 degree C, 760 mmHg, dry  
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show 210  
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show status of the alveolocapillary membranes  
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what are the 2 components that the process of conductance across the membranes can be divided into?   show
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show process of diffusion across alveolocapillary membrane; reaction rate/pulm capillary blood vol  
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show factors that change the membrane component, alterations in Hb, capillary blood volume  
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show alveolar pressure  
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what is the equation that all methods of DLCO are based on?   show
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what does the pt do in the single-breath technique?   show
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what does the diffusion mixture usually contain?   show
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what is usually the tracer gas?   show
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what are used to detect changes in CO?   show
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how much should the pt ideally inhale of the VC?   show
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after inspiring the VC breath, how long does the pt hold the breath at TLC?   show
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after a suitable ________ _______ (750-1000 mL) has been discarded, a sample of _________ ____ is collected in a small bag or by continually aspirating a sample of the exhaled gas.   show
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what is the sample analyzed to obtain?   show
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show breath hold  
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what does the change in the tracer gas concentration reflect?   show
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what is this change used to determine?   show
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what are the two times the dilution of the tracer gas is used?   show
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show diffusion of gas thru the alveolocapillary membrane  
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show full scale; zero  
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if the analyzers have a linear response to each other, the fractional concentration of the tracer gas in the alveolar sample is equal to the ______.   show
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systems that use the same detector for both CO and the tracer gas also need to provide _______ _______. the linearity of the system should be within ____% of full scale.   show
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show multigas analysis; methane  
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show CO and CH4 (methane) are measured rapidly and continuously  
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what tracer gas is used for gas chromatography? carrier gas?   show
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gas chromatography is slow (60-90 secs), but is extremely __________.   show
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what should the resistance of the breathing circuit be?   show
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show demand valve; <10 cmH2O  
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the ______ method of timing the breath hold hsould be used. what does this method measure?   show
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show 2.2 mL/kg IBW  
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show 350  
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what is anatomic and instrument VD subtracted from before the alveolar vol is calculated?   show
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all gas volumes must be corrected from _____ to _____ for DLCO calculations.   show
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show 3.5%; 8  
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what is absorption of CO2 usually accomplished with?   show
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show anhydrous CaSO4; selectively permeable tubing  
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show after pt has been seated for 5 minutes  
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show exercise increases CO (increases DLCO)  
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show usually 6 secs or less; rapid but not forced  
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show 85%; 4  
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show instantaneous filling of the lung  
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what should the pt avoid excessiveness of?   show
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what might the valsalva/muller maneuver cause the DLCO to do?   show
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show 4; 3  
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how long should the breath-hold time, measured using the hones method be?   show
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what is one of the most common problems encountered when performing the DLCOsb maneuver?   show
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to obtain an alveolar sample, _____ _____ gas needs to be washed out. what is usually a sufficient washout time? what about with small VCs?   show
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show 0.5-1.0 L  
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show alveolar plateau  
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show two; 3; 10%  
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why should no more than 5 repeated maneuvers be performed?   show
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show 4-minute  
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the predicted DLCO should be corrected so that it reflects the DLCO at an Hb value of ____g% for adult and adolescent males, and to an Hb value of ____g% for women/children of either sex younger than 15.   show
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what does DLCO vary inversely with?   show
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show rebreathes from a reservoir containing 0.3% CO, tracer gas, and air; 30-60 secs at 30 breaths/min  
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the rebreathing method can be used during ________.   show
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what happens during the slow exhalation single-breath-intrabreath method?   show
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what does the pt do during this method?   show
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____ is used as the tracer gas because it can be rapidly measured using an infrared analyzer.   show
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the _________ _______ can also be used during exercise.   show
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show pt performs 2 DLCOsb tests, each at a different level of alveolar PO2  
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show distinguish resistance caused by alveolocapillary membrane from resistance caused by RBC membrane/Hb reaction rate  
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show nitric oxide  
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what is DLNO a direct measure of?   show
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show 280  
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DLNO reflects the ________ __________ to gas diffusion in the lungs.   show
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show 25  
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DLCO is often decreased in _________ lung disorders, particularly pulmonary fibrosis.   show
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what are other causes of decreased DLCO?   show
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show early stage - normal or increased; most times decreased  
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what is an exception to the extent of reduction being directly proportional to the vol of lung removed?   show
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DLCO is commonly used to monitor _____ ________.   show
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show hepatopulmonary  
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decreases in DLCO are termed _________ _______.   show
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show breath a gas mixture of 0.1%-0.2% CO in air for 5-6 mins; last 2 mins expired gas collected in bag/balloon; ABG drawn  
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what is exhaled volume measure and analyzed for?   show
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show DLCOss= VCO/PACO  
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DLCO may be decreased in both acute and chronic ____________ lung disease, like __________.   show
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DLCO measurements at rest have been suggested to estimate the probability of ___ ___________ during exercise.   show
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what is DLCO directly related to in healthy individuals?   show
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show whether a decrease is due to loss of lung volume (restriction) or from uneven V/Q (obstruction)  
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show 4-5  
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how is VA measured?   show
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show not requiring a breath hold at TLC  
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what indicates a restrictive cause of decreased DLCO? obstructive cause?   show
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what are 7 other physiologic factors that can influence the observed DLCO?   show
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what are the 3 methods to measure breath-hold time?   show
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a ______-_________ _______ has been proposed that uses separate equations for the three phases of the maneuver.   show
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