Mr. Rogers CD Final Exam

Which of the following can cause a profound decrease in the conc. of expired CO2? 1.) Pulmonary embolization 2.) Pulmonary Shunting 3.) Decreased minute ventilation 4.) Decreased cardiac output

1,4

Which of the following are causes of a normal anion gap in a subject with metabolic acidosis? 1.) Hyperventilation 2.) Uremia 3.) Pancreatic fistula 4.) Lactic Acidosis

1,3

What variables are needed to calculate shunt? 1.) CcO2 2.) Qt 3.) CO2 4.) CaO2

1,3,4

Which of the following anthropometric measurements are essential for pulmonary function testing? 1. Height 2. Percent body fat 3. Gender 4. Age

1,3,4

Which of the following correctly describes the measurement of FRC by the closed-circuit method? 1. The system volume of spirometer and circuitry must be calculated 2. The test is continued until the He changes by less than 2% in 30 seconds 3. A small amount of He is absorbed by blood and tissues. 4. A CO2 absorber is required

1,3,4

Which of the following pulmonary function tests are categories that fall under the forced vital capacity maneuver? 1. FVC 2. VTG 3. FEF 4. PEF

1,3,4

A subject in a plethysmograph has his Raw measured as 2.2 cm H2O/L/sec at a lung volume of 3.7 L. The calculated sGaw for this patient is which of the following?

0.12

By performing a combined Raw and VTG maneuver in a plethysmograph, a subject has the following values determined: Raw 2.00 VTG 3.00 This subject's sGaw (specific conductance) would be:

0.17

A subject has the following measurements obtained during pulmonary function testing: These findings are consistent with: FVC 3.90 L FEV1 1.10 L FRC (He) 3.62 L VTG (FRCpleth) 4.77 L

- Severe obstruction with air trapping

The Jones method of timing the breath hold for DLCOsb measures the interval from:

0.3 units of I time to the middle of the alveolar sample

In a healthy subject, what are the ATS-ERS recommended washout volume and sample volume?

0.75 - 1 for washout

According to the ATS-ERS recommendations, which of the following activities should be avoided before testing lung function? 1. Smoking within 1 hour of testing 2. Vigorous exercise 30 minutes before testing 3. Eating a large meal 2 hours before testing 4. Consuming alcohol within 24 hours of testing

1,2,3

In addition to a spirometer, which of the following pieces of equipment are needed to perform a closed-circuit FRC determination? 1. CO2 and H2O absorbers 2. An O2 source 3. A He analyzer 4. A N2 analyzer

1,2,3

What is of the following are considered disadvantages of DLCOrb (rebreathing)? 1. Complex calculations 2. Rapid responding analyzers required 3. Sensitive to COHb back-pressure 4. Slow responding analyzers required

1,2,3

Which of the following pulmonary function tests may be used to follow the effect of treatment for congestive heart failure? 1. Lung volumes 2. Arterial blood gases 3. Diffusing capacity 4. Maximal respiratory pressures

1,2,3

Which of the following variables are needed to calculate the alveolar air equation? 1.) Barometric pressure 2.) Fraction of inspired O2 3.) Partial pressure of CO2 4.) Temperature

1,2,3

1. What is of the following disorders would a reduction in DLCO be expected? 1. Sarcoidosis 2. Scleroderma 3. Pulmonary edema 4. Interstitial pulmonary fibrosis

1,2,4

According to the ATS-ERS general considerations guidelines, which of the following laboratory variables must be recorded? 1. Ambient temperature 2. Date and time of test 3. When the equipment was last cleaned 4. Barometric pressure

1,2,4

What is of the following are possible causes of sinus tachycardia? 1. Fever 2. Pain 3. Drowsy 4. Anxiety

1,2,4

What is of the following gases may be used as a tracer gas when performing the DLCO test? 1. Methane 2. Neon 3. Oxygen 4. Helium

1,2,4

Which of the following are indications for performing spirometry? 1. Assess the risk of lung resection. 2. Determine the response to bronchodilator therapy. 3. Assess the severity of restrictive lung disease. 4. Quantify the extent of COPD.

1,2,4

Which of the following cause emphysema? 1. α1-Antitrypsin deficiency 2. Exposure to environmental pollutants 3. Radiation therapy 4. Cigarette smoking

1,2,4

What is of the following determines the shape of the "effort-independent" portion of the expiratory F-V curve?

1. Elastic recoil of the lung 2. Flow resistance in the small airways

What is of the following are possible causes of sinus bradycardia?

1. Increased ICP 2. Beta-blocker overdose

In diseases that cause obstruction of the small airways, the MEFV curve may assume a concave appearance because of

1. Loss of elastic recoil 2. Increased airway resistance

A patient produces the following spirometry results: These findings indicate that Actual FVC (L) 4.0 FEV1 (L) 2.0 Predicted FVC (L) 4.1 FEV1 (L) 3.3

1. Obstruction is present 2. MVV is underestimated

Before drawing a specimen of blood for gas analysis from the radial artery a modified allen's test is performed.Collateral circulation is adequate if the hand is re-perfused within?

10-15 sec

A Pt has following ABG: pH 7.41 CO2 38 PO2 77 Hb 10 O2Hb 94% What is the CaO2?

12.8 ml/dl

A 52-year-old female has a 30-pack-year history of cigarette smoking and has shortness of breath. Room temperature is 26°C (conversion factor = 1.068). Trial 1 FEV1 2.00 FVC 2.50 Trial 2 FEV1 1.98 FVC 3.01 Trial 3 FEV1 1.95 FVC 2.96 What is the subject's reportable FEV1 in BTPS conditions?

2.14 L

According to the 2005 ATS-ERS repeatability standards, of the three acceptable tracings, the two largest FVC values and the two largest FEV1 values in a subject with a vital capacity greater or equal to 1.0 L should be within how many milliliters?

150

In What is of the following situations would the DLCO be artificially increased?

1500 above sea level

A 62-year-old female complaining of shortness of breath has the following spirometry results. Ambient temperature is 26°C (conversion factor = 1.068). Trial 1 FEV1 2.10 FVC 2.65 Trial 2 FEV1 1.96 FVC 3.11 Trial 3 FEV1 1.99 FVC 2.99 What is the subject's reportable FEV1 in BTPS conditions?

2.24 L

A 66 yr old female pt was admitted to the ER with SOB and has the following blood gas on 21% FIO2: pH 7.48 PCO2 32 PO 52 SaO2 86 Hb 16 Calculate the arterial content

18.6

Which of the following correctly describes the measurement of FRC by the open-circuit method? 1. Alveolar N2 is assumed to be 65% at the beginning of the test. 2. The test is continued until alveolar N2 is reduced to 1%. 3. Some N2 is released from the blood and tissues. 4. A fast response CO2 analyzer is required.

2,3

Which of the following are characteristic of obstructive lung diseases when measured values are compared with predicted normals?1. VC is increased. 2. FRC is increased. 3. RV is increased. 4. RV/TLC ratio is increased.

2,3,4

Which of the following can cause inaccurate measurement in arterial blood gas testing? 1.) Protein contamination 2.) Inadequatte mixing of the sample 3.) Rupture of membranes 4.) Bicarb buffer mistakenly placed in the PCO2 electrode jacket

2

Which of the following statements is true concerning hyperventilation? 1.) The PaO2 is greater than 100 mmHg 2.) The pH is greater than 7.45 3.) The RR is greater than 25 breaths per minute 4.) The tidal volume is greater than 500 ml

2 only

A pt is admitted to the ER with smoke inhalation. The pt is SOB, bit his color is pink. A pulse ox finger probe is placed and reads 94% with a heart rate of 130. What is the technologists interpretation of the data? 1.) the subject is well oxygenated 2.) the unit is correctly reading functional O2 saturation 3.) An arterial blood gas should be obtained 4.) the unit is correctly reading fractinal O2 saturation

2,3

Which of the following correctly describes appropriate physical measurements before pulmonary function testing? 1. Actual body weight should be used to calculate predicted values. 2. Standing height should be measured when the patient is barefoot. 3. Arm span should be used instead of height for a patient with kyphosis. 4. Age should be recorded to the nearest decade (10 years).

2,3

An outpatient is referred for a shunt study. After 25 minutes of breathing 100% O2, the patient produces the following arterial blood gas values PO2 290 PCO2 40 Sats 100 Hb 10.2 If the barometric pressure is 750 and a content difference of 4.5 vol% is assumed, what is the subjects shunt?

20%, shunting equation is used for this

Compared with oxygen, how much more readily does carbon monoxide combine with hemoglobin?

210 times more

What is the P50 in the healthy adult?

27

1. Calculate the FRC from the closed-circuit method using the following data: He added to spirometer: 0.5 L % He initial: 9.1% (0.091) % He final: 5.5% (0.055) He absorption correction: 0.1 L Temperature: 24°C

3.77

What is the calculated bronchodilator response in this subject? Pre-Drug FVC 4.5 FEV 2.8 Post-Dilator FVC 4.8 FEV 3.9

39%

The following raw data are obtained from spirometry and a He-dilution FRC test (all values have been corrected to BTPS): VC 3.4 IC 2.1 ERV 1.3 FRC 3.9 Whats the pts TLC?

6L

Before bronchodilator studies, inhaled â-adrenergic agents should be withheld for how long?

4-12 hours for regular or long-acting preparations

What is the in a patient with the following arterial and mixed venous blood gases? ARTERIAL Hb: 15.1 Sat: 92% PO2: 73 MIXED VENOUS Hb: 15.1 Sat: 70% PO2: 39

4.55 vol %

The pressure gradient for the diffusion of CO in the lung is

45 mmHg

The rate of a sinus rhythm is

60-100 BPM

What are the most common wavelengths of light used in pulse oximetry?

660 and 940

A 47 yr old female pt was admitted to the ER after 5 days of flu-like symptoms and has the following blood gases obtained on an FIO2 of .21: pH 7.49 PCO2 42 PO2 92 HCO3 29.1 Classify this

Metabolic alkalosis

A patient with a pulm artery cath in place has the following blood gas results while breathing 100% O2 at a barometric pressure of 750 mmHg. ARTERIAL PO2 377 PCO2 40 Saturation 100 Hb 14.2 MIXED VENOUS PO2 44 PCO2 46 Saturation 76 Hb 14.2

8%

According to the 2005 ATS-ERS guidelines for diffusing capacity, what is the recommended breath-hold time?

8-12 seconds

What is the correct pant rate for measuring airway resistance or conductance?

90 - 120 bpm

A subject has the following results from spirometry and N2 washout FRC determination: What is of the following best explains these findings? Measured VC 4.6 FRCN2 8.2 TLC 10.2 RV/TLC% 55 Predicted VC 4.7 FRCN2 3.8 TLC 7.5 RV/TLC% 55 % Predicted VC 98 FRCN2 216 TLC 136 RV/TLC% -

A leak occurred during the FRC test

A patient is referred for arterial blood gas testing. She has an SpO2 of 84% by pulse oxumetry, but blood oximetry reveals an SaO2 of 94%. Which of the following best explains the difference between the results?

Pulse ox probes can be incorrect easily

A subject with an RV that is 60% of the predicted value and an RV/TLC ratio of approximately 20% would most likely have

A restriction disorder

Technologist-driven protocols allow a selection of tests related to the...

Clinical questions

A subject has spirometry repeated before and after inhaled bronchodilators. The following data are obtained: Predicted FVC 5.20 FEV1 4.10 PEF 9.20 Before Drug FVC 4.90 FEV1 3.10 PEF 7.77 After Drug FVC 5.30 FEV1 3.30 PEF 8.92 What is of the following statements best describes these findings?

Mild obstruction without significant change after bronchodilators

Lou Gehrig, a famous New York Yankee baseball player, is often associated with which neuromuscular disease?

ALS

A subject has an FVC of 1.8 L (39% of predicted). The same individual has a slow VC of 2.7 L. What is of the following might explain these findings?

Airway compression in obstructive lung disease

What is answer is consistent with the flow-volume curve shown?

Airway obstruction

What is answer is consistent with the following flow-volume curve?

Airways obstruction

A subject has these lung volumes measured using a body plethysmograph: Measured VC 4.4 FRCpleth 3.9 RV 2.2 TLC 6.3 Predicted VC 4.4 FRCpleth 3.7 RV 2.1 TLC 6.5 These values are consistent with an obstructive pattern such as emphysema.

Normal lung values

A subject has the following lung volumes measured using a body plethysmograph: Measured VC 4.91 FRC 4.66 RV 3.80 TLC 8.71 Predicted VC 5.20 FRC 3.90 RV 2.10 TLC 7.30

An obstructive pattern such as emphysema

Blood gas analysis is used with patients with COPD to do which of the following?

Assess the need for supplemental O2

An adult patient complains of chest tightness and cough whenever he jogs in cold weather. These symptoms are consistent with which of the following?

Asthma

What disease processes are potential causes of a restrictive pattern?

Asthma

The single-breath diffusing capacity test was first described by August and Marie Krogh

August and Marie Krogh

The reported value for VTG (FRCpleth) should be

Averaged from 3 acceptable maneuvers

A patient with emphysema has his FRC measured with the closed-circuit method and plethysmography. He produces the following results: FRC (He dilution): 4.1 L VTG (FRCpleth): 4.6 L FRC (Predicted): 3.6 L What is of the following best explains these results?

Normal pattern for the patient's diagnosis

Vocal cord dysfunction will typically affect the flow-volume loop in what way?

Blunt inspiratory portion of curve

List three significant signs and/or symptoms that, if observed with a sinus bradycardia, would require management of this dysrhythmia.

Clinical signs and symptoms of hemodynamic compromise can include: - acute changes in mental status - chest pain or discomfort - cold, clammy skin - fall in urine output - heart failure - low blood pressure - pulmonary congestion - shock - shortness of breath

To measure FRC in a body plethysmograph, the VTG should be measured by

Closing shutter at end expiration

How should an infrared analyzer used for capnography be calibrated?

Calibration with air and 5% CO2 in most circumstances

A subject with an FEV1/FVC ratio of 37% performs a 7-minute N2 washout test. After 7 minutes, the alveolar N2 concentration is 5.7%. This is consistent with What is of the following?

Chronic bronchitis

A 67 year old pt complaining of shortness of breath has the following blood gases obtained on an FIO2 of .21: pH 7.38 PCO2 63 PO2 58 HCO3 32 O2Hb 92% Describe his acid-base status

Compensated resp acidosis w/mild hypoxemia

A pt complaining of SOB has the following blood gases obtained on an FIO2 of .21: pH 7.42 PCO2 28 PO2 50 HCO3 18 O2Hb 86%

Compensated resp alkalosis w/ hypoxemia

A blood gas syringe is prepared using liquid heparin. A volume of .5 ml of heparin solution is left in the syringe, and a 1.5 ml specimen is obtained. Which of the following problems will occur with this specimen?

Contaminated sample PCO2 will be lower because of dilutent

A subject has the following spirometry results: Trial 1 FVC 1.48 FEV1 1.18 Trial 2 FVC 1.67 FEV1 1.38 Trial 3 FVC 1.42 FEV1 1.22 Trial 4 FVC 1.38 FEV1 1.18 What do the results most likely represent?

Variable effort

Which of the following statements concerning tumors in the upper airway is true?

Variable or fixed obstruction

The following data are obtained from a subject complaining of shortness of breath: Predicted TLC 4.29 RV 1.97 FVC 3.42 FEV1 2.73 FEV1/FVC 79.9 DLCO 22.7 VA 5.16 Measured % TLC 5.63 RV 2.22 FVC 3.48 FEV1 2.66 FEV1/FVC 76.5 DLCO 16 VA 6.62 Predicted TLC 104 RV 113 FVC 102 FEV1 98 FEV1/FVC DLCO 70 VA 128 What is of the following statements would be most correct regarding the data?

DLCO data should be questioned because the VA is significantly larger than the TLC

What is of the following DLCO methods is deemed to provide the most accurate measurement of diffusion?

DLCO rebreathing

Which of the following tests may be helpful in distinguishing between emphysema and chronic bronchitis?

DLCO test

In addition to explaining the procedure for each pulmonary function test to the patient, the pulmonary function technologist should do what of the following?

Demonstration

A subject performs the following two DLCO maneuvers: Trial 1 DLCO 24 DLCO/VA 3.5 BHT 11.4 Trial 2 DLCO 26 DLCO/VA 3.6 BHT 12.5 What should the technologist do next?

Do another trial

When the pH falls from 7.40 to 7.10 with no change in the PCO2, the conc. of H+ has ?

Doubled or two fold

What is answer is consistent with the following three superimposed flow-volume loops?

Fixed extra thoracic obstruction

A subject has a DLCOsb of 8.3 mL CO/min/mm Hg STPD, What is is 38% of his predicted value. His calculated DL/VA ratio is 1.1. These values are most consistent with What is of the following?

Emphysema

A subject who complains of shortness of breath has an FVC of 2.57 L, but her VC is 2.99 L. These findings suggest What is of the following?

Emphysema

What is of the following is an advantage of continuous analysis of expired gas during a DLCOsb test?

Exhaled alveolar gas concentrations

The rate of sinus tachycardia is beats/min

Faster than 100

If the He and CO analyzers used for a DLCOsb test are linear with respect to each other, the fractional concentration of CO at the beginning of the breath hold (FACO0) is equal to...

FAHe

Back extrapolation is the method used to determine "time zero" when measuring What is of the following parameters?

FEV1

What is of the following parameters has to be corrected to BTPS?

FEV1/FVC ratio

The following raw data are obtained from spirometry and a He-dilution FRC test (all values have been corrected to BTPS): VC 3.4 IC 2.1 ERV 1.3 FRC 3.9 Whats the pts RV?

FRC - ERV = RV, so RV = 2.6

The following data are obtained during a closed-circuit FRC determination: What is of the following is the FRC? He added: 0.5 L % He initial: 9.0% % He final: 7.1% Temperature: 24°C He absorption correction: 0.1 L

FRC equals 1.60 L BTPS

A patient with pulmonary fibrosis has lung volumes measured using the open-circuit method and by plethysmography with the following results: FRC (N2 washout) 2.21 VTG 2.34 LFRC (predicted) 3.67 L What is of the following best explains these results

FRC is typically decreased in restrictive diseases, as seen in interstitial diseases associated with fibrosis.

A patient with cystic fibrosis may present with an increase in...

FRC, RV/TLC ratio

The FEF25%-75% depends on What is of the following?

FVC

What is of the following maneuvers is used for the measurement of an FEF25%-75%?

FVC

What are the recommended dosages for assessing bronchodilator response, according to the ATS-ERS spirometry guidelines?

Four doses of Albuterol (100) or ipratropium bromide (40)

Who first popularized spirometry for the evaluation of pulmonary function?

Hutchinson

Who is credited with first describing the flow-volume curve?

Hyatt

What is of the following may cause a sinus bradycardia?

Hypothermia

DLCO measurements may be indicated to evaluate gas exchange abnormality in which of the following?

ILD

Management of a patient with a sinus tachycardia might include...

Identification and treatment of the underlying cause

Diffusing capacity is reduced in emphysema because of What is of the following?

Loss of alveolar surface area

During an SBN2 test, an increased slope of phase III is

Indicative of uneven distribution of gas within the lungs

In sinus arrhythmia, a gradual increasing of the heart rate is usually associated with

Inspiration

There are three essential components to an FVC maneuver. Which of the following is the first phase of the maneuver?

Inspire the maximum amount possible

Why is CO an ideal gas for measuring diffusing capacity of the lungs?

It is taken up by the Hb in a manner similar to O2

What is of the following methods does the ATS-ERS recommend to calculate breath-hold time?

Jones method

If a patient has a fever of 40C, the pH, as measured by an automated blood gas analyzer, will be which of the following?

Lower than measured at 37 degrees Celsius

A 48-year-old female complaining of cough has the following spirometry results: Pre-Drug FVC 3.32 FEV1 2.34 FEV1/FVC 70.4 % Predicted FVC 94 FEV1 79 FEV1/FVC Post-Dilator FVC 3.58 FEV1 2.75 FEV1/FVC 76.7 How would you interpret her spirometry results? - Mild obstruction with a positive response to bronchodilation

Mild obstruction with a positive response to bronchodilation

A subject performed four acceptable FVC maneuvers. Predicted FEV 1 4.80 Maneuver 1 FEV 1 4.83 Maneuver 2 FEV 1 4.60 Maneuver 3 FEV 1 4.23 Maneuver 4 FEV 1 4.03 What do the results most likely represent?

Maneuver-induced bronchospasm

What is of the following would be considered key components of the FVC maneuver?

Maximal inspiration, blast of expiration, and complete exhalation

What is of the following determines the fractional concentration of CO after 10 seconds of breath holding (FACOT)?

Measurement of CO from an alveolar sample

What does the abbreviation DM represent?

Membrane conductance

The following data are obtained from a 19-year-old female subject complaining of shortness of breath: Predicted TLC 4.59 RV 0.92 FVC 3.67 FEV1 3.36 FEV1/FVC 91 DLCO 26.3 VA 4.51 Measured TLC 2.98 RV 1.70 FVC 1.21 FEV1 0.71 FEV1/FVC 58.9 DLCO 8.2 VA 1.93 %Predicted TLC 65 RV 184 FVC 33 FEV1 21 FEV1/FVC DLCO 31 VA 43 What is of the following interpretations is most consistent with the data?

Mixed pattern of obstructive and restrictive

A 47-year-old man with a history of cough has the following spirometry results: Measured FVC (L BTPS) 3.85 FEV1 (L BTPS) 2.14 Predicted FVC (L BTPS) 4.01 FEV1 (L BTPS) 3.33 These findings show the presence of What is of the following?

Moderate obstructive disease

A patient being evaluated for disability has the following spirometry results: Measured FVC (L) 4.00 FEV1 (L) 2.00 MVV (L/min) 105 Predicted FVC (L) 4.10 FEV1 (L) 3.30 MVV (L/min) 110 What do these findings indicate?

Moderate obstructive disease

A 69-year-old female complaining of cough and shortness of breath has the following pulmonary function results: Measured FVC 1.54 FEV1 1.22 FEV1/FVC 79.2 % Predicted FVC 58 FEV1 57 FEV1/FVC These findings are consistent with:

Moderate restriction with no evidence of obstruction

A pt is connected to a 12 lead ecg monitor and pulse ox before an exercise test. The HR displayed by ECG monitor is 97; the pulse ox reads HR 141 with an SPO2 of 85%.Which of the following would be the most appropriate action?

Move the pulse oximetery sensor to an alternate site

The following data are obtained from a subject complaining of shortness of breath: Predicted TLCpl 6.59 RVpl 2.43 FVC 4.16 FEV1 3.16 FEV1/FVC 76 MEP +190 MIP ?2-101 Found TLCpl 4.12 RVpl 3.01 FVC 1.14 FEV1 1.16 FEV1/FVC 99 MEP 63 MIP ?2-56 % Pred TLCpl 63 RVpl 124 FVC 28 FEV1 37 FEV1/FVC MEP 33 MIP 55 These data are most consistent with What is disease entity?

Myasthenia Gravis (MG)

The following data are obtained from an 80-year-old male subject complaining of shortness of breath: Predicted TLC 6.28 RV 2.52 FVC 3.77 FEV1 2.86 FEV1/FVC 75.9 DLCO 22.7 Measured % TLC 8.26 RV 4.14 FVC 3.44 FEV1 1.07 FEV1/FVC 31.1 DLCO 10.2 Predicted TLC 132 RV 164 FVC 91 FEV1 37 FEV1/FVC DLCO 45 What is of the following interpretations is most consistent with the data?

Obstructive lung disease like emphysema

A 63-year-old male complaining of shortness of breath and muscle weakness has the following pulmonary function result: Measured FVC 4.27 FEV1 3.29 FEV1/FVC 77.1 % Predicted FVC 96 FEV1 93 FEV1/FVC

Normal

A 50 yr old subject has the following arterial blood gases: pH 7.38 PCO2 42 PO2 65 HCO3 24 These results describe what?

Normal blood gas with moderate hypoxemia

A subject has her DLCOsb measured as 10.1 mL CO/min/mm Hg (STPD); her diffusing capacity measured by the DLCOrb is 9.1 mL CO/min/mm Hg (STPD). These findings are consistent with

Normal differences in a subject with a restrictive disease

What is of the following diagnoses is consistent with the following flow-volume curve?

Normal expiratory and inspiratory flows

A 50-year-old woman with dyspnea has the following spirometry results: Measured FVC (L BTPS) 3.99 FEV1 (L BTPS) 3.44 Predicted FVC (L BTPS) 4.10 FEV1 (L BTPS) 3.33 These findings are consistent with What is of the following?

Normal lung function

A subject produces the following simple spirometry results: These findings are consistent with... Measured FVC (L, BTPS) 4.5 FEV1 (L, BTPS) 3.6 Predicted FVC (L,BTPS) 4.0 FEV1 (L, BTPS) 3.2

Normal lung function

A subject referred for pulmonary function tests because of shortness of breath has an FEV1 of 98%. This finding is suggestive of

Normal lung function

What is of the following correctly reflects the ECG criteria for a sinus rhythm?

P waves that look alike and upright in lead II, one before each QRS complex

In addition to the FEV1 and FVC, What is of the following is useful in gauging subject effort during spirometry?

PEF

Why should all values from a series of peak flow measurements be reported?

PEF may decrease with repeated efforts

To measure accurately the VTG (FRCpleth), the patient should be instructed to do What is of the following?

Pant about once per second

A 55 yr old male with a history of diabetes complainging of shortness of breath has the following blood gases obtained on an FIO2 of .21: pH 7.28 PCO2 30 PO2 102 HCO3 10 O2hb 96% Describe this acid base status

Partially compensated metabolic acidosis

A subject being tested for possible environmental exposure to asbestos produces the following spirometry results: Measured FVC (L) 4.00 FEV1 (L) 3.44 MVV (L/min) 52 Predicted FVC (L) 4.07 FEV1 (L) 3.37 MVV (L/min) 135 The pulmonary function technologist may conclude that

Patient did not make a good effort on the MVV

The following data are obtained from a 40-year-old male with an FVC of 4.70 L and an FEV1 of 3.46 L: Trial 1 DLCO 26.3 VA4.73 IVC 3.75 DLCO/VA 5.6 Trial 2 DLCO 25.4 VA 4.89 IVC 3.88 DLCO/VA 5.4 What should the technologist do next?

Perform another maneuver because the IVC is low

A 22-year-old patient with dyspnea performs three spirometry trials. Trial 1 FVC (L BTPS) 4.21 FEV1 (L BTPS) 3.88 Trial 2 FVC (L BTPS) 4.49 FEV1 (L BTPS) 3.91 Trial 3 FVC (L BTPS) 4.65 FEV1 (L BTPS) 3.93 The pulmonary function technologist should do What is of the following?

Perform at least one more maneuver

A nonsmoking subject performs two DLCOsb maneuvers, and the following results are obtained: Test 1: 24.3 mL CO/min/mm Hg Test 2: 18.7 mL CO/min/mm Hg What is of the following is appropriate?

Performing an additional maneuver

The membrane diffusion coefficient (resistance to diffusion by the alveolocapillary membrane) is estimated by

Performing the DLCOsb at two different levels of PAO2

A patient has the following blood gas results performed on room air. These are best described as: pH 7.45 PCO2 35 PO2 109 Hb 15 O2Hb 97%

Physiologically impossible

What is of the following statements is correct regarding DLCO adjustments?

Polycythemia will increase DLCO

The following FRCpleth values are obtained with a body plethysmograph: Maneuver 1: 2.35 L Maneuver 2: 2.30 L Maneuver 3: 2.15 L According to the ATS-ERS standards, what should the technologist's next step be?

Preform another manuver

The following data are obtained from a subject complaining of shortness of breath: Predicted TLCpl 5.76 RVpl 2.38 FVC 3.38 FEV1 2.63 FEV1/FVC 78 DLCO 23.1 Found TLCpl 3.18 RVpl 1.18 FVC 2.10 FEV1 1.88 FEV1/FVC 89 DLCO 6.0 % Pred TLCpl 55 RVpl 50 FVC 62 FEV1 71 FEV1/FVC DLCO 26 These data are most consistent with What is disease entity?

Pulmonary fibrosis (TLC, RV reduce)

A subject has a DLCOsb of 10.2 mL CO/min/mm Hg (STPD), What is is 51% of her predicted value. Her DL/VA ratio is 4.1. What is of the following diagnoses is most consistent with these values?

Pulmonary resection

Which measurement is used to detect disorders that affect metabolism in critically ill patients?

REE (resting energy expansure)

DLCO is characteristically decreased by What is of the following?

Radiation therapy of lung

Differences in the calculation of the DLCOsb because of the timing of the breath-hold period may be minimized by

Rapid inspiration

Alveolar pressure is measured in the body plethysmograph by

Recording mouth pressure when the shutter is closed

What is of the following combinations are characteristic of a restrictive pattern?

Reduced VC, reduced TLC, normal RV/TLC

The following data are obtained from a 25-year-old male with an FVC of 6.50 L and an FEV1 of 3.46 L: Trial 1 DLCO 45.3 IVC 5.62 Trial 2 DLCO 41.5 IVC 5.88 What should the technician do?

Report mean of two trials

The following data were obtained while performing a spirometry test on a 43-year-old patient. Trial 1 FVC 3.90 FEV1 3.25 Trial 2 FVC 4.15 FEV1 3.60 Trial 3 FVC 4.30 FEV1 3.50 What should the technologist do next?

Report the FVC from trial 3 and the FEV1 from trial 2

A 17-year-old patient with asthma performs three spirometry trials: Trial 1 FVC (L BTPS) 3.21 FEV1 (L BTPS) 2.88 Trial 2 FVC (L BTPS) 3.44 FEV1 (L BTPS) 2.91 Trial 3 FVC (L BTPS) 3.49 FEV1 (L BTPS) 2.93 The pulmonary function technologist should do What is of the following?

Report the values from trial 3

The following DLCO data (reported in mL CO/min/mm Hg) are obtained from a subject: Trial 1 DLCO 18 IVC 2.5 Trial 2 DLCO 25 IVC 3.5 Trial 3 DLCO 27 IVC 3.6 What should the technologist do next?

Report two that are closet and report the mean

What is of the following is the most common application of the DLCO testing method 1/Dm + 1/èVc (membrane diffusing capacity)?

Research with limited clinical applications

A 28 yr old lethargic female is admitted to the ER and has the following blood gases obtained on an FIO2 of .21: pH 7.24 PCO2 60 PO2 70 HCO3 25.9 BE 1.1 O2Hb 83% Classify this.

Resp acidosis

A patient complaining of SOB has the following with an FIO2 of 21%. pH7.28 CO2 51 PO2 55 HCO3 25.8 BE 2.1 O2HB 82% Interpret Results:

Resp. acidosis

Subject referred for SOB has the following ABG: pH 7.46 CO2 34 PaO2 57 HCO3 22 Interpret Results:

Respiratory alkalosis with moderate hypoxemia

Sarcoidosis is a systemic disorder that usually causes which of the following?

Restrictive disease

Explain these results change 9:10AM pH 7.39, PCO2 41, PO2 92, Hb 14.4 9:20AM pH 7.38, PCO2 26, PO2 109, Hb 11.5

Sample was contaminated with heparin solution

DLCO measurements may be indicated to evaluate pulmonary involvement in which of the following systemic diseases?

Sarcodoisis

Measurement of oxygen saturation by pulse ox may produce an erroneous reading in the presence of?

Shivering, CO

An ECG rhythm strip shows a ventricular rate of 46 beats/min, a regular rhythm, a PR interval of 0.14 second, a QRS duration of 0.06 second, and one upright P wave before each QRS. This rhythm is:

Sinus bradycardia

The rate of a sinus bradycardia is

Slower than 60

Which of the following best describes why significant obstruction can be present in small airways without abnormalities in Raw or sGaw?

Small airways contribute one fifth of total resistance to flow

Subject displays signs and symptoms of severe hypoxemia has the following blood gas: pH 7.44 CO2 36 PO2 83 SaO2 94% COHb 1.7% Hb 7.3 g/dl Which of the following best describes these findings?

Subject has a decreased CaO2

An ECG rhythm strip shows a ventricular rate of 128 beats/min, a regular rhythm, a PR interval of 0.16 second, a QRS duration of 0.08 second, and one upright P wave before each QRS. This rhythm is sinus

Tachycardia

A Valsalva maneuver or a Müller maneuver during the DLCOsb may cause:

The DLCOsb to appear artificially reduced

The following raw data are obtained from spirometry and a He-dilution FRC test (all values have been corrected to BTPS): VC 3.4 IC 2.1 ERV 1.3 FRC 3.9 L What is the patient's RV/TLC ratio?

The patient's RV is 2.6 L (BTPS) TLC = FRC + IC; RV = TLC − VC 2.1 + 3.9 = 6.0; 6.0 − 3.4 = 2.6

The main indication for the measurement of lung volumes is to do which of the following?

To test for the presence of pulmonary disease

The technologist obtains the following airway mechanics results: sGaw Trial 1: 0.140 Trial 2: 0.132 Trial 3: 0.128 What should the technologist do next?

Trial 1 and 2

A 40 yr old female was admitted to the ER with SOB and has the following blood gas on .21 FIO2: pH 7.56 PCO2 25 PO2 112 HCO3 24 Classify this

Uncompensated resp alkalosis with hyperoxemia

Which of the following is true when comparing dilutional lung volumes with body plethysmography in subjects who have severe obstruction?

Underestimate TLC

For which of the following conditions might pulmonary function testing be contraindicated?

Untreated pneumothorax

An adult male subject has the following measurements made: Measured value: DLCOsb (mL CO/min/mm Hg STPD) 10 pH 7.41 PCO2 (mm Hg) 40 PO2 (mm Hg) 89 Hb (g/dL) 9 O2Hb (%) 88 COHb (%) 6 What DLCO value should be reported?

couldn't find

In what units is DLCO/VA reported?

ml CO/min/mmHg per L (BTPS)