Rogers C-P Exam 1

*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

*All 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 directly describes the measurement of FRC by the closed circuit method I. The system volume of spirometer and circuitry must be calculated II. The test is continued until the He changes by less than 2% in 30 seconds III. A small amount of He is absorbed by the blood and tissues IV. 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

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

1,3,4

*In diseases that cause obstruction of the small airways, the MEFV curve may assume a concave appearance because of: 1.)Loss of elastic patterns 2.)Turbulent gas flow patterns 3.)Increased specific conductance 4.)increased airway resistance

1,4

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

- 90 to 120 breaths/min- 1.5 to 2.0 Hz.

*By performing a combined Raw and VTG maneuver in a plethysmograph, a subject has the following values determined:Raw (cm H2O/L/sec) 2.00VTG (L) 3.00

0.17 L/sec/cm H2O/L

*The Jones method of timing the breath hold for DLCOsb measures the interval from __ of alveolar sampling.

0.3 units of inspiratory time to the middle

*Which of the following is an indication for a cardiopulmonary exercise test?

-pulmonary rehabilitation prescription

*All the following pulmonary function tests may be used to follow the effect of treatment for congestive heart failure except: 1.) Lung Volumes 2.) ABG's 3.) Diffusing Capacity 4.) Maximal respiratory pressures

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.)A He analyzer 3.)A N2 analyzer

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.)temp.

1,2,3

*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 min before test 3.)eating a large meal 2 hours before testing 4.)consuming alcohol within 24 hours of testing

1,2,3,

*According to the ATS/ERS general considerations guidelines, all 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

*Which of the following are considered disadvantages of DLCOrb? 1. Complex calculations2. Rapid responding analyzers required3. Flow must be controlled4. Sensitive to COHb back-pressure

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.)a1-Antitrypsin deficiency 2.)Exposure to environmental pollutants 3.)Radiation therapy 4.)cigarette smoking

1,2,4

*Which of the following disorders would a reduction in DLCO be expected? 1.) Sarcoidosis 2.) Scleroderma 3.)Polycythemia 4.)Interstitial pulm. fibrosis

1,2,4

*Which of the following gases may be used as a tracer gas when performing the DLCO test? 1.) Methane 2.) Neon 3.) Carbon Dioxide 4.) Helium

1,2,4

*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 seconds

*A Pt has following ABGPH 7.41CO2 38PO2 77Hb 10O2Hb 94%What is the CaO2?

12.8 ml/dl

*According to the 2005 ATS/ ERS repeatability standards, of the 3 acceptable tracings, the 2 largest FVC values and 2 largest FEV1 values in a subject with a vital capacity > 1.0 L should be within how many mL

150

*A 62-year-old female complaining of shortness of breath has the following spirometry results. Ambient temperature is 26 degrees C (conversion factor = 1.068).FEV1 FVCTrial 1 2.10 3.05Trial 2 1.96 3.11Trial 3 1.99 2.99What is the subject's reportable FEV1 in BTPS conditions?

2.24 multiply factory by highest FEV1

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 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 parameters has to be corrected to BTPS? 1.) FEV1/FVC ratio 2.)FEF25%-75% 3.) FVC 4.)FEV1

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 subject has an FVC of 1.8 L (39% of predicted). The same individual has a SVC of 2.7 L.Three reasons that might explain these findings: 1.) Normal findings in severe restrictive disease 2.)Airway compression in obstructive lung disease 3.)Poor effort or early termination of FVC 4.) Representative findings in early small airway disease

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 pt with kyphosis 4.)age should be recorded to the nearest decade (10 years)

2,3

*Which of the following correctly describes the measurement of FRC by the open-circiut method? 1.) alveolar N2 is assumed to be 65% at the beggining 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 determines the shape of the "effort-independent" portion of the expiratory F-V curve? 1. Abdominal pressure during forced expiration 2. Elastic recoil of the lung 3. Flow resistance in the small airways 4. Cross-sectional area of the trachea

2,3

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

*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

*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 LTemperature24° C

3.77 L (BTPS)

*A subject has these lung volumes measured using a body plethymograph:Measured PredictedVC 4.4 4.4FRC 3.9 3.7RV 2.2 2.1TLC 6.3 6.5These values are consistent with:

normal lung volume

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

4 - 12 hours for regular or long acting preparations

*The following data are obtained from spirometry and a He dilution FRC test (all values have been corrected to BTPS):VC 3.4 LIC 2.1 LERV 1.3 LFRC 3.9LWhat is the patient's RV/TLC ratio?

43%

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

normal results with a subject with restriction

*A patient produces the following spirometry results:Actual PredictedFVC (L) 4.0 4.1FEV1 ( L) 2.0 3.3MVV (L/min) 45 110

obstruction is present and the MVV is lower than predicted.

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

660 and 940

A patient with a pulm artery cath in place has the follwoing blood gas results while breathing 100% O2 at a barometric pressure of 750 mmHg

8%

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

8-12 seconds

*There are three essential components to an FVC maneuver. Which two are considered the most important?

A deep breath and the initial blast, INSPIRE DEEPLY

*A subject has the following test results from spirometry and N2 washout FRC determination:Measured Predicted % PredictedVC 4.60 4.7 98FRC 8.2 3.8 216TLC 10.2 7.5 136RV/ TLC % 55 37Which best explains these findings?

A leak occurred during the FRC test

*A patient is being evaluated for disability has the following results: Measured FVC 4.00 Predicted 4.10 Measured FEV1 2.00 Predicted 3.30 Measured MVV 105 predicted 110 What do these findings indicate?

A obstructive disease

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

A restrictive ventilatory defect, RESTRICTIVE

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

Clinical Question

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

will cause variable or fixed obstruction, so diminished airflow

*A subject performed four acceptable FVC maneuvers:Predicted Effort #1 Effort #2 Effort #3 Effort #4FEV1 4.80 4.83 4.60 4.23 4.03

bronchospasm.

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

ALS

*Which answer is consistent with the following flow - volume curve?

Airway Obstruction

*Which answer is consistent with the following flow - volume curve? on expiratory side, what disease

Airway Obstruction, emphysema

*A subject has the following lung volumes measured using a body plethysmographMeasured PredictedVC 4.91 5.20FRC 4.66 3.90RV 3.80 2.10TLC 8.71 7.30These values are consistent with which of the following?

An obstructive pattern such as emphysema

*Blood gas analysis is used with pts w/COPD to do which of the following?

Assess need for supplement O2

*All the following disease processes are potential causes of a restrictive pattern except:

Asthma

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

Asthma

*The single-breath diffusing capacity test was first described by?

August and Marie Krogh in 1911

*The reported value for VTG should be:

Averaged from 3 acceptable maneuvers

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

Blunt the inspiratory portion of the curve, effect flow volume loop by blunting insp. portion of cord

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

Closing the shutter at end-expiration

*A 48-year-old female complaining of cough has the following spirometry results:Pre-drug % Predicted PostdilatorFVC 3.32 94 3.58FEV1 2.34 79 2.75FEV1/FVC 70.4 76.7

Obstruction and + bronchodilator response

*Carbon monoxide interferes with O2 transport by?

CO attaches to the Hb better than O2

*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 whichof 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%. Descrice his acid-base status

Compensated resp acidosis w/mild hypoxemia

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

Data are not acceptable; perform another maneuver.

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

DLCO

*The following data are obtained from a subject complaining of shortness of breath:Predicted Measured % PredictedTLC 4.29 5.63 104%RV 1.97 2.22 113%FVC 3.42 3.48 102%FEV1 2.73 2.66 98%FEV1/FVC 79.9 76.5DLCO 22.7 16.0 70%VA 5.16 6.62 128%Which 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

*Which of the following DLCO methods is best suited to measuring diffusing capacity during exercise?

DLCOrb

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

DLCOrb

*In addition to explaining the procedure for each pulmonary function test to the pt, the pulmonary function technologist should do which of the following?

Demonstrate the correct performance of the test maneuver

*The main indication for the measurement of lung volumes is?

Diagnose and assess the severity of restriction

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

Fixed upper airway obstruction

*The following data are obtained from and 80 year old male subject complaining of SOB: (PICTURE) Which of the following interpretations is most consistent with the data?

Emphysema

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

Emphysema, asthma, chronic bronchitis

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

Exhaled alveolar gas concentrations can be visually expected, inspection of the washout gasses of the trace gasses

*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 which of the following parameters?

FEV1

*The following data are obtained from spirometry and an He dilution FRC test (all values have been corrected to BTPS): Find RV VC 3.4 LIC 2.1 LERV 1.3 LFRC 3.9 L

FRC - ERV = RV3.9 − 1.3 = 2.6 L

*A patient with Cystic Fibrosis may present with an increased?

FRC then RV/TLC ratio

*The FEF 25%-75% depends on which of the following?

FVC

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

FVC END OF CP 3

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

Four doses of albuterol (100 μg) or ipratropium bromide (40 μg)

*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 calculation for sGaw is the following:

Gaw = 1 / 2.2 = 0.45,sGaw = 0.45 / 3.7 = 0.12

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

Having the subject inspire and expire rapidly

*who first popularized spirometry for the evaluation of pulmonary function?

Hutchinson

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

Hyatt

*Diffusing capacity is reduced in emphysema because of which 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

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

Interstitial lung disease

*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

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

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

*Which of the following methods does the ATS-ERS recommend to calculate breath-hold time?

Jones Method

*What does the abbreviation DM represent?

Membrane Conductance

*47 year old male with history of cough has following spirometry results:Measured PredictedFVC (L BTPS) 3.85 4.01FEV1 (L BTPS) 2.14 3.33, these findings show the presence of which of the following?

Moderate Obstructive Disease

*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: TLC 6.59/4.12/63, RV 2.43/3.01/124, FVC 4.16/1.14/28, FEV1 3.16/1.16/37, FEV1/FVC 76/99, MEP +190/63/33, MIP -101/-56/55, These data are most consistent w/which disease entity?

Myasthenia Gravis, because we see MEP

*A 50 year old woman with dyspnea has following spirometry resultsMeasured PredictedFVC 3.99 4.10FEV1 3.44 3.33

Normal Lung Function

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

Normal Lung Function

*Which of the following diagnoses is consistent with the flow volume curve below?

Normal expiratory / inspiratory flow

*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 LVTG 2.34 LFRC (predicted) 3.67 L

Normal for this disease. FRC is typically decreased in restrictive diseases, as seen in interstitial diseases associated with fibrosis.

*A subject produces the following simple spirometryMeasured PredictedFVC (L BTPS) 4.5 4.0FEV1 (L BTPS) 3.6 3.2

Normal lung function

*In addition to the FEV1 and FVC, which 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, detect inflammatory changes in airway

*To measure accurately the VTG, the patient should be instructed to do which of the following?

Pant about once per second

*How do you calculate the bronchodilator response in this subject?Pre-drug PostdilatorFVC 4.5 4.8FEV1 2.8 3.9

Percent change in FEV1 is calculated.[(post FEV1 - pre FEV1) / pre-FEV1] X 100 = %[(3.9 - 2.8) / 2.8] X 100 = 39%).

*A nonsmoking subject performs two DLCOsb maneuvers, and the following results are obtained:Test 1 24.3 ml CO/min/mm HgTest 2 18.7 ml CO/min/mmHg

Performing an additional maneuver

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

Pneumothorax

*Which of the following statements is correct regarding DLCO adjustments?

Polycythemia will increase the DLCO

*A subject being tested for possible environmental exposure to asbestos produces the following spirometry results:Measured PredictedFVC (L) 4.00 4.07FEV1 (L) 3.44 3.37MVV (L/min) 52 135

Poor pt effort

*A subject has a DLCOsb of 10.2 mL CO/min/mmHg (STPD) which is 51% of her predicted value. Her DL/VA ratio is 4.1.Which of the following diagnosis is most consistent with these values?

Pulmonary Resection

*A subject has a DLCOsb of 8.3 ml CO/min/mmHg STPD, which is 38% of his predicted value. His calculated Dl/Va ratio is 1:1. These values are most consistent with which of the following?

Pulmonary emphysema.

*The following data are obtained from a subject complaining of shortness of breath: TLC 5.76/3.18/55, RV 2.38/1.18/50, FVC 3.38/2.10/62, FEV1 3.38/1.88/71, FEV1/FVC 78/89, DLCO 23.1/6.0/26, These data are most consistent w/which disease entity?

Pulmonary fibrosis

*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

*The following data are obtained from spirometry and an He dilution FRC test (all values have been corrected to BTPS):Find TLC VC 3.4 LIC 2.1 LERV 1.3 LFRC 3.9 L

RV + VC = TLC2.6 + 3.4 = 6.0 L

*DLCO is characteristically decreased by which of the following?

Radiation therapy of the lung and emphysema,

*Alveolar pressure is measured in the body plethysmograph by:

Recording mouth pressure when the shutter is closed

*Which of the following combinations are characteristic of a restrictive pattern?

Redeuced VC. TLC, normaly RV/TLC ratio,

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

Report the mean of the 2nd and 3rd trials

*Subject referred for SOB has the following ABGpH 7.46CO2 34PaO2 57HCO3 22Interpret Results

Respiratory alkalosis with moderate hypoxemia

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

Restrictive Disease

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

Sarcoidosis

*A subject has the following measurements obtained during pulmonary function testingFVC 3.90 LFEV1 1.10 LFRC (He) 3.62 LVTG 4.77 LThese findings are consistant with:

Severe obstruction with air trapping

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

Small airways contribute only approximately one-fifth of the total resistance to flow.

*The following data were obtained while performing a spirometry test on a 43-year-old.Trial 1 Trial 2 Trial 3FVC 3.90 L 4.15 L 4.30 LFEV1 3.25 L 3.60 L 3.50 L

Spirometry acceptability and repeatability criteria were achieved. Report the largest FVC and FEV1.

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

Subject has a decreased CaO2

The following data are obtained during a closed-circuit FRC determination He added: 0.5 L% He initial: 9.0%% He final: 7.1%Temperature: 24˚ CCorrection factor for 24 degrees C: 1.080

The FRC equals 1.50 L BTPS

*A subject has the following spirometry results:Trial 1 Trial 2 Trial 3 Trial 4FVC 1.48 1.67 1.42 1.38FEV1 1.18 1.38 1.22 1.18

The above results represent a variable effort.

*A 17 yr old patient with asthma performs three spirometry trials Trial 1 Trial 2 Trial 3FVC (L BTPS) 3.41 3.44 3.49FEV1 (L BTPS) 2.88 2.93 2.91

The pulmonary function technologist should report the largest FVC and FEV1 when spirometry meets the acceptability and repeatability criteria

*A 52-year-old female has a 30-pack-year history of cigarette smoking and has shortness of breath. Room temperature is 26 degrees C (conversion factor = 1.068).FEV1 FVCTrial 1 2.00 2.94Trial 2 1.98 3.01Trial 3 1.95 2.96

The data appear acceptable and repeatable. The largest FEV1, which is 2.00, should be reported. Multiply this value by the BTPS correction factor (2.00 X 1.068 = ? L). 2.14

In which of the following situations would the DLCO be artificially increased

The measurement is performed at 1500 m above sea level

*A subject has spirometry repeated before and after inhaled bronchodilators.The following data were obtained:Predicted Before Drug After DrugFVC 5.20 4.90 5.30FEV1 4.10 3.10 3.30PEF 9.20 7.77 8.92

There is mild obstruction with significant change after bronchodilator

*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 LVTG (FRCpleth)4.6 LFRC (Predicted) 3.6 LWhich of the following best explains these results?

This is a normal pattern for the patient's diagnosis.

*The technologist obtains the following airway mechanics results:Trial 1 Trial 2 Trial 3sGaw 0.140 0.132 0.128The RCP should:

Trial 1 and Trial 2

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

Washout volume 0.75 to 1.0 L and sample volume 0.5 to 1.0 L

*How should an infrared analyzer used for capnography be calibrated?

calibration with air and 5% CO2 in most circumstances

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

*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

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

equal to capillary partial pressure of CO

*In what units is DLCO/Va reported?

ml CO/min/mmHg per L (BTSP)

*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 mod hypoxemia

*Which of the following is the most common application of the DLCO testing methog 1/DM +1/Vc(membrane diffusing capacity?

limited with research clinical

*Which of the following would be considered key components of the FVC maneuver?

maximal inspiration, blast of expiration, and complete exhalation

*A Valsalva maneuver or a Müller maneuver during the DLCO

may cause the DLCO to appear falsely low or increased.

*Which of the following determines the fractional concentration of CO after 10 seconds of breath holding (FACOT)

measurement of CO from the alveolar sample

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

*the following data are obtained from a 19-year-old female subject complaining of shortness of breath:

mixed of pattern of obstrucive

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, O2hg 96%. Describe this acid base sttatus

partially compensated metabolic acidosis

*The following FRCpleth values are obtained with a body plethysmograph:Maneuver 1: 2.35 LManeuver 2: 2.30 LManeuver 3: 2.15 LAccording to the ATS/ERS standards, the technologist should do what?

perform another maneuver

*The following data are obtained from a 40 yr old male with an FVC of 4.70 and an FEV1 of 3.46 L:

perform another maneuver because ivc is to low

*A 22-year old patient with Dyspnea performs three spirometry trials 1.) FVC 4.21, FEV1 3.88 2.) FVC 4.49, FEV1 3.91 3.) FVC 4.65, FEV13.93 what should the pulmonary function technologist do?

perform another maneuver, because VC doesn't have 3 in the 15% range

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

performing the DLCOsb at two different levels of PAO2.

*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 Trial 2DLCO 45.3 41.5IVC 5.62 5.88What should the technologist do next?

report the mean of the 2 trials

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 21Ph 7.28CO2 51PO2 55HCO3 25.8BE 2.1O2HB 82%Interpret Results

resp. acidosis

*A 69-year-old female complaining of cough and shortness of breath has the following pulmonary function results:Measured % PredictedFVC 1.54 58FEV1 1.22 57FEV1/FVC 79.2sRaw 4.7 110

restriction

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

sample was contaminated with heparin solution

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

shivering, CO

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?

underestimates TLC.

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

used to be BMR, now its REE