Pulm Diag pft and 2nd exam

One must be especially cautious in interpreting ________ in a patient with leukemia.

PaO2

The effects of excessive liquid sodium heparin on a blood gas sample are:

1. related to the partial pressures of the gases in the liquid.

2. related to the pH of the liquid heparin.

3. related to the buffer systems in the heparin.

1. related to the partial pressures of the gases in the liquid.

2. related to the pH of the liquid heparin.

Which of the following suggest a blood gas sample may be venous?

1. Observation of a flash of blood as the syringe begins filling

2. Bluish coloration of the blood sample

3. Failure of syringe to auto-fill

4. Brownish coloration of blood

2. Bluish coloration of the blood sample

3. Failure of syringe to auto-fill

Temperature correction of blood gases:

1. clearly provides the optimal way to guide clinical decision-making.

2. is only indicated when patient temperature exceeds 40° C.

3. is easily accomplished with most blood gas machines.

3. is easily accomplished with most blood gas machines.

Placing a blood sample in an ice-water solution will interfere with analysis of blood:

Electrolytes

An instrument that measures an unknown voltage by comparing it with a known reference voltage is?

Potentiometer

Dr Bescey and his ARNP M. Armstrong are arguing over what electrode the "SANZ" is. They ask you and you confidently tell them...

pH

A substance through which electrons can flow is called?

Conductor

Of the 3 Electrodes, which is the least accurate?

Clark

The Half-Cell where the actual electrochemical change takes place is called thehalf-Cell

Working

(T/F) Janine has just moved to the Tampa area and has been an RT for 30 years. She is not ready to retire yet but also does not want to be on her feet for 12 hours a day. She finds and is offered a job in Tampa General's blood gas lab. She started to re-educate herself on Blood Gas Errors and she thinks she remembers someone telling her the following "A blood gas lab has to determine the mean and standard deviation for each of its instruments"?

True

The Lab has to perform Linearity and Correlation studies on a_____

6 month basis

(T/F) Co-oximitry is less accurate the pulse oximitry

False

In reference to Cooximetry, Up to how many wave lengths are used to determine the fractional components ofhemoglobin?

23

What amino acid breakdown produces NO (Nitric Oxide).

L-Arginine

Which of the following is NOT a NO Synthase (NOS) enzyme?

Glycine

What year was NO (Nitric Oxide) first detected in exhaled breath

1991

(T/F) iNOS are thought to be the main contributor to elevated exhaled NO in asthmatics?

True

(T/F) An adult with a eNO level of 76 ppb would be considered in a normal range and has no inflammation process happening.

False

Asbestosis

Shipyard worker

Beryllium Disease

Aerospace worker

Silicosis

Sand blasters

Hypersensitivity pneumonitis

mushroom farmer

Fred is a cabinet and countertop fabricator, and has been for 20 years. He is at a higher risk of contracting this disease.

Silicosis

From the list of gases, which one is colorless and used during WWI as a chemical weapon

Phosgene

Brendon worked for NASA until 2001 in the shuttle fleet prep assembly building. Soon after retiring Brendon started having breathing issues, after extensive testing he was diagnosed with this disease ___________________________, which was a direct result of being exposed at his workplace.

Beryllium Disease

(T/F) The safety committee at Hawks Hospital is comprised of Sarah, Kyle, Diane and Jeff After much research and debate the decide that limiting exposure and Ventilation systems are both examples of prevention goals concerning occupational exposures.

True

Lidocaine is often used when performing a bronchoscopy for this reason

Control Gag reflex

(T/F) Its a good idea to do both of these during a bronchoscopy

- Increase all higher end alarm setting

- Continuous monitoring of Sat's, BP, HR, EKG

True

You want to have your FiO2 at this when bronching a vented patient

100%

Kayla is preparing to assist Dr. Cid with a bronchoscopy. Dr. Cid, who likes to hear herself talk says "Flexible bronchoscopes are available in the following sizes for adults"

5.0 and 6.0 mm OD

(T/F) A BAL allows you to take a sample or wash from the lungs, that can then be tested for various bacteria, fungi, etc.

True

Energy Value of Fat

37 KJ per gram

Energy Value of Fiber

13 KJ per gram

Energy Value of Protein

17 KJ per gram

(T/F) The key to indirect calorimetry is that all inspired and expired air must be collected, therefore leaks in the closed circuit would lead to errors in the readings or uninterpretable results.

True

The Metabolic rate is effected by all of the following except

The energy expenditure (EE)

The RMR or BMR are effected by all the following factors EXCEPT:

Blood Pressure

Maureen has come onto her shift and is assigned to the Trauma ICU. Her patient Mr. Williams in on the following settings: SIMV/350/14/50%/+10/ps10. He also has an order for a Metabolic cart study. Maureen decided to contacts the doctor before doing the study. Why?

PEEP is a Contraindication

(T/F) Metabolism is not a life long process

False

The respiratory quotient can be defined as this

Ratio of CO2 produced to O2 consumed

For a average, mildly active person what is the percentage attributed to the thermic effect (thermogenesis)?

8%

Like many mammals Dolphins have strange sleep habit. They...

Sleep one brain hemisphere at a time

You are working with Leo, a sleep study expert, on a patient who you suspect of having OSA. you ask Leo how they determine the severity of his OSA, if indeed he has it. Leo states that if its between 5-15 apneas per hour then it would be considered...

Mild

Currently the gold standard for treating sleep disorders such as OSA is CPAP. The next in line and what some people want to try before going to a CPAP Machine is this

Oral appliances

Brain waves were first discovered by Germans in 1929, This eventually lead to sleep studies. In the 1980's this replaced tracheostomy as a first line defense in treating Sleep Apnea

CPAP

The body tries to combat a high V/Q ratio by doing this?

bronchoconstriction

Which Phase in a V/Q lung scan see the use of Xenon

Ventilation Phase

(T/F) You take your patient for a V/Q scan, after having a lobectomy. while you are watching the scan being performed you see the technicians give a IV injection. You ask the doctor what they are injecting into the patient and he say, oh that is Xenon. Is the doctor correct?

False

(T/F) Is the following Statement True or False

Few conditions constitute a true shunt or true dead space because they would be incompatible with life. Therefore the V/Q mismatch term is used for conditions in between these two extremes

True

You are reviewing the chart of a patient, yesterday she had a V/Q scan that revealed her V/Q ratio was 0.70. You review you notes on this and decide you need to chat to the doctor about the results. You tell the doctor that the result is?

Abnormal

(T/F) Lily and David are discussing CT scans. Lily states that A CT scan is a type of x ray. to which David say "However, a CT scan's pictures show less detail than pictures from a standard x-ray" Is David's statement correct?

False

IF a patient needs to have a CT scan you have to make sure that, although rare, they would not have an allergic reaction to which _______________________ is sometimes used in scans. If they are, they can be administered medications that will relieve the symptoms.

Contrast

Dr. Miguel Cervoleon has ordered a CT scan of the lungs on your 58 year old trauma victim. when you get to CT you have to wait a while due to a back up of patients. You Have some time to look up CT scans on your phone. What is the form of energy that CT scans use?

Ionizing Radiation

As seen on a CT scan, a moderate cavity in the lung with a thin surrounding wall creating a nodule is caused by what?

Aspergillus

(T/F) Angioplasty helps restore blood flow to the heart

True

The image intensifier has 3 components to it, which one below is not one of them

Anode Plate

(T/F) Are the images you see on the monitor in the Cath lab during a procedure "live, in real time"?

True

(T/F) Ablation is the procedure where a Stent is placed in the body at the site of a blockage.

False

Cody, is about to perform his first bronchoscopy, His attending, wants to see how much a 1st year medical resident knows about bronchs and anatomy. He asks "Mild epistaxis can occur when a bronchoscope passes through this"?

Nose

You are preparing to do a bronch on a 12 year old girl that accidentally aspirated a thumb tack. Which type of bronchoscope would you use?

Rigid

Kacee, a recent graduate from the HCC respiratory Care program and now a RRT has asthma. During a Status Asthmaticus attack the doctors are considering a bronchoscopy. Kacee, between wheezes says hold up isn't Status Asthmaticus a contra-indication for bronchoscopy.

true

Teddy, The RT is assisting Dr. Rumback with a Bronchoscopy, Suddenly the patients saturations plummet into the 70s. Teddy immediately knows that this patient has a which is possible when taking tissue samples from a patient during the procedure.

phneumothroax

It's good idea to do both of these during Bronchoscopy

- increase all higher end alarm settings

- Continuous monitoring of sat's,bp,hr,ekg

true

You want to have your Fio2 at this when bronching a vented patient?

100%

chiquita has undergo a dignostic bronchoscopy. She is told by her nurse and the PCT in the room that this is a very common procedure and is mainly used for secretion removal and bronchial lavag.

False

"Signs and symptoms poorly predict  disease severity" is one of the best reasons for a patient to have a sleep study to determine if the patient has a sleep disorder and how bad it may be. 

true

Oral appliance therapy eliminates apnea in approximately what percentage of patients?

50%

Circadian Rhythm Sleep Disorders and Sleep-Related Movement Disorders are just two of

the ________recognized sleep disorders there are?

88

Brain waves were first discovered by Germans in 1929, This eventually lead to sleep studies. In the 1980's this replaced tracheostomy as a first line defense in treating Sleep Apnea.

CPAP

Rechtschaffen's studies in the 1980's of rats that were being sleep deprived. noticed that the rats died from this condition ________________ which suggests that sleep deprivation may impair the ability of the body's immune system to deal with infection.

sepsis

Deadspace is an area in the lung where there is no ventilation but there is perfusion

True

False

false

In which of the following pathological states would the oxygen content of the trachea resemble the oxygen content in the affected alveoli?

Pulmonary embolism

Beatriz in trying to explain the different types of V/Q ratios. She explains that If the Bronchi constrict, which will decrease the amount of ventilation in a certain area it will limit the _______________

Deadspace

The body will have a lower V/Q ratio and use Vasoconstriction to combat it, as seen in this disease state?

Acute (flash) pulmonary Edema

The Area marked "grey" on this ultrasound would be considered this

Consolidation

This CT scan shows what can happen to the lungs from either a chronic disease, fungal infection or trauma. Identify which one this is.

Bronchiectasis

The individual pictures that CT scans combine to make a detailed picture are called what?

Slices

Dr. Smartypants decides that he wants to test the new RT Ivonne. He asks her "In diagnostic sonography, the ultrasound frequency is usually what? Without a moment of hesitation Ivonne states "well obviously it is between ____________________and _____________________ doesn't everyone know that.

2 and 18 MHz

Lily and David are discussing CT Scans that Lily states that A CT Scan is a type of x ray to which david say' however a CT Scans pictures shows less detail then pictures from a standard x ray. Is david statement correct?

False

What are the name of gas filled Bronchi surrounded by alveoli filled with fluid, pus or other material that can be seen on an ultrasound?

Air Bronchogram

Computerized Tomography Scan is an invasive test?

False

Ablation is the procedure where a Stent is placed in the body at the site of a blockage.

false

The image intensifier has 3 components to it, which one below is not one of them

Anode Plate

Are the images you see on the monitor in the Cath lab during a procedure "live, in real time"?

true

Angioplasty helps restore blood flow to the heart

true

what procedure is being performed in this?

Stent Angioplasty

What condition is shown in this picture?

Tonsillar Hypertrophy

Obesity is probably the biggest (no pun intended) risk factor to sleep apnea.  which of the following is NOT an additional risk factor

Female

You are discussing case studies with other healthcare providers. One of the case studies mentions that the patient had a decreased V/Q ratio. You know that this means either decreased ventilation or increased blood flow. Which of the following conditions/diseases describes this and would have a decreased V/Q ratio?

Foreign body aspiration

You are reviewing the chart of a patient, yesterday she had a V/Q scan that revealed her V/Q ratio was 0.70. You review you notes on this and decide you need to chat to the doctor about the results. You tell the doctor that the result is?

Abnormal

Dr. Miguel Cervoleon has ordered a CT scan of the lungs on your 58 year old trauma victim. when you get to CT you have to wait a while due to a back up of patients. You Have some time to look up CT scans on your phone. What is the form of energy that CT scans use?

Ionizing Radiation

Dr. Smartypants decides that he wants to test the new RT Ivonne. He asks her "In diagnostic sonography, the ultrasound frequency is usually what? Without a moment of hesitation Ivonne states "well obviously it is between ____________________and _____________________ doesn't everyone know that.

2 and 18 MHz

Dr. Wissman loves to challenge his RTs on Respiratory theory. He asks you the following "This calculation is the amount of air reaching the alveoli to the amount of blood reaching the alveoli is called what?

V/Q Ratio

Due to a freak accident with a hot tub, you are transported back to 1953. You decide to check out healthcare of that era. In the local ER you encounter a patient with lesions on his hand, arms, feet and lower legs. Your first question to him is "have you been swimming lately" As the doctors look at you, as though you are crazy the patient says YES i have just a few days ago. What did this patient have?

Mycobacterium Marium

AFB’s are typically ordered for this many collections.

3

Accessing efficacy of a drug treatment on a patient who has been previously diagnosed and treated for a time period is one reason for sputum induction and collection.

True

Blind BAL's (Bronchoaveolar Lavage) must only be done during a bronchscope?

False

When treating mycobacterium, the patient will go through a cycle of antibiotics. Which one has treatment which combines 3 antibiotics over 6 months.

Mycobacterium Avium

Nucleic Acid Amplification test (NAAT) can be ordered to diagnose TB. However the following must also be ordered to confirm this
Group of answer choices

AFB