ch 8-13,18-20

before an ANG is obtained the pt clotting parameter should be evaluated because:

bleeding time may be prolonged if they are abnormal

common site for ABG

radial artery

which test is performed before an ABG to check circulation before puncture

Allen’s test

during the Allen’s test circulation should pink up in how many secs?

10 -15 seconds

how long should you compress after doing an ABG?

3-5 mins

primary methods of blood transpor?

bound to hemoglobin

what is true about hypoxemia?

it occurs when the pt PaO2 is lower than predicted

what is a decrease in tissue oxygenation called?

hypoxia

what is the most common physiologic cause of hypoxemia in pt with lung disease?

V/Q mismatch

which of the following would be the best assess arterial oxygenation?

CaO2

Which of the following would be the best indicator of tissue oxygenation?

PVO2

what is often the first clinical sign that suggest the presence of hypoxemia?

Exertional Dyspnea

The negative log of the hydrogen ion concentration is defined as which of the following?

pH

which of the following parameter is the respiratory component of the acid base?

PaCO2

what is the direct effect of an increased PaCO2 on HCO3-?

cause it to increase

which is the nest indicator of metabolic acid base status?

base excess

which of the following could cause metabolic acidosis?

renal disease

which of the following is true regarding the PaO2

it shows moderate hypoxemia

which of the following is NOT a general purpose of performing PFT?

the specific diagnosis of pulmonary disease

which of the following is not a parameter that has been studied to establish normal values for PFT?

weight

which of the following factors has the greatest effect on the lung size and predicted values?

height

which of the following is the primary instrument used for PFT?

Spirometer

which of the following associations standards should be met before PFT equipment is purchased and used?

The American thoracic society

Which of the following is not a standard equipment in PFT

O2 source

the volume of air inhaled and exhaled during quiet breathing is known as the

tidal volume

what is the normal minute ventilation of an average person at rest

5 to 10 L/min

what may cause the FVC to decrease in a pt with a restrictive lung disorder

a decrease in lung size

what may cause the FVC to decrease in a pt with an obstructive lung disorder

an increase in RV

the presence of an FRV that is significantly smaller than the slow vital capacity (SVC) is consistent with:

air trapping

the TLC is the function of all the following expect:

birth weight

the law related to the body plethysmography

boyle’s law

which disease will the open circuit nitrogen washout method tend to underestimate the TLV

emphysema

the closed system helium dilution method is used to measure

FRC

the ERV is limited in clinical usefulness. it may be reduced in all the following expect

obstructive disorders

a loss of elasticity of the lung tissue will cause the FRC to

increase

how would the inspiratory reserve volume and the inspiratory reserve capacity be described to the pt with mild to moderate restrictive disorder

normal

the FEV1 usually is expressed as a percentage of the observed

FVC

the FEV3 measurement is an indicator of what

small airway

which of the following test is more sensitive than the FEV1 in detecting airway obstruction

FEF 25%-75%

the MVV test is performed over a period of

12-15 secs

the MVV reflect all expect

condition of lung tissue

which test is often used preop to evaluate whether the pt may have post op complication

MVV test

to determine whether there is a positive response to the bronchodilator therapy made improvements you will see it all the values expect

FEF 75%-85%

the DLCO measures what

ability of a gas to move across the alveolar capillary memebrane.

which of the following conditions is not determinate of gas exchange across the membrane

amount of O2 in the blood.

what is not associated with reduced DLCO

chronic bronchitis

the reason why carbon monoxide is used for DLCO

diffusion limited and not perfusion limited

in pt with an exacerbation of asthma airway resistance will be

increased

what happens to the static lung compliance of a postop heart pt with left lower lobe atelectasis

it will be less than normal

Which of the following test would be used to determine whether there is a gross misdistribution of ventilation in the lungs of a patient given a diagnosis of emphysema

Nitrogen washout

The closing volume test is used for early diagnosis of obstruction of airways of which of the following sizes

Small

Which of the following test is not considered for exercise testing?

DLCO

Which of the following test would be used to determine at what point oxygen demands exceeds oxygen consumption during hard exercise

Anaerobic threshold

Which of the following test would be used to determine a what point oxygen conception reach its peak

Maximal oxygen uptake

Which of the following medications is Used commonly during bronchoprovocation testing

Methacholine

When bronchoprovocation testing is used the FEV1 needs to decrease by what percentage before a diagnosis of hyperactive airway is made

20%

Obstructive lung disorders are characterized by a reduction in

Expiratory flow

Which of the following conditions are not common causes of restrictive lung disease?

Asthma and emphysema

Which of the following conditions is associated with a low FVC, low FEV1 but normal FEV1/FVC, small TLC, low DLCO, and no response to a bronchodilator

Pulmonary fibrosis

Electrons coming off of the cathode In an x-ray machine or focused to hit a small area of anode called the

Target

The ability of X-rays to penetrate matter in inversely proportional to which of the following physical properties of matter

Density

Which of the following tissues will look radiolucent on a chest x-ray?

Lungs

Which of the following terms defines high density tissues on the x-ray films

Radiopaque

As a patient who is being positioned for a chest x-ray is moved closer to the source of the x-ray what happens to the shadows of the anatomic structure seen on the chest x-ray?

They get larger

To minimize the Magnification associated with portable films how far should the patient and the film be from the source of the x-ray in a conventional chest x-ray?

6 feet

Which of the following statements is not considered an indication for obtaining a radiograph

Diagnose Specific diseases

What breathing instruction is a patient Given immediately before an AP or pa Chest radiograph

Take a deep breath

Email patient who is standing upright with his back to the x-ray to his interior thoracic pressed against a metal acid containing the film in his arms position out of the way position for x-ray view

Pa view

Which of the following views provide less cardiac magnification And a sharper view of the left lower lobe

Left lateral view

Which of the following views is used to see whether free fluid is present in the chest in the left plural region

Lateral decubitus view

A lateral decubitus view is able to detect as little as what milliliter of the plural fluid

25 to 50

Which of the following views is the most helpful in identifying a pneumothorax?

Expiratory view

AP portable films are obtained to value all of the following except

Lung tumor growth

A portable film is ordered immediately after a patient is intubated in the emergency department, which of the following distances confirm proper placement of the endotracheal tube

3 to 5 cm above the carina

A portable film is ordered immediately after a central venous pressure catheter is placed via The subclavian Vein which of the following is the correct placement site for the catheter?

At the confluence of the super vena cava and the right atrium

The presence of the characteristic signet sign is a CT scan is consistent with which of the following diseases

Bronchiectasis

In which of the following areas MRI demonstrated superiorly over CT

Evaluation of the hila

Which of the following forms of radiologic assessment is most useful for studying the distribution of ventilation and perfusion as the effects the disease may have these two important functions

Lung scanning

Which of the following studies is gradually replacing V/Q scanning for the diagnosis of pulmonary embolism

CT angio

The presence of hotspots in a pet scan indicate

metabolically active tumor or infection

The casting of a white shadow on a film is consistent with which of the following situations

Less exposed films

What is the significance of the silhouette sign?

It helps determine whether an infiltrate is in contact with a heart boarder

Which of the following radiologic terms confirms the presence of intrapulmonary disease

Air bronchogram

Which of the following radiologic finance is not consistent with lobar atelectasis

Shift in hilar structures away from the area of atelectasis

Which of the following clinical or chest x-ray findings is consistent with hyper inflation caused by obstructive lung disorder

large retrosternal space

Which of the following would suggest that a patient has chf

Increase cardiothoracic ratio

All of the following are typical findings of a small plural effusion except

Complete white out of the effective area

Radiographic signs of consolidation include all of the following except

A low shift of the diaphragm

Why is it important for the RT to be able to identify cardiac dysrhythmia?

It is likely that the RT will observe the onset of the initial event

Why is an ECG tracing so useful

It can aid in the diagnosis of cardiac tissue ischemia

Which of the following symptoms is least Suggestive of the need for an ECG

Fever

Which chamber of the heart initially receives deoxygenated blood from the vena cava?

Right atrium

Which chamber is responsible for pumping blood into the pulmonary circulation?

RT ventricle

Which chamber normally has the largest muscle mass?

Left ventricle

Where does the normal electrical impulse originate for each heartbeat

Sa node

What term describes heart cells that have the ability to spontaneously depolarize

Automaticity

Why is the electrical signal delayed slightly at the AV node

To allow better filling of the ventricles, to protect the ventricles against excessively rapid arterial rates

What is the ventricular heart rate at the AV node paces the heart?

40 to 60 bpm

What terms apply to any heartbeat that originates outside the SA node

Ectopic impulse

Which of the following physiological effects is associated with myocardial infraction

Backup of blood into the lungs