Oxygen Transport
Most oxygen in the blood is transported in what form?
Bound to hemoglobin
A pH above 7.45 with a PaCO2 below 35 mm Hg and a HCO3 level down slightly represents what disorder?
Acute Alveolar Hyperventilation
What is the formula for cardiac output?
CO = SV x HR
What type of dyspnea occurs when the patient reclines?
Orthopnea/positional dyspnea
Where do most pulmonary blood clots originate?
DVT sites
What are the two major categories of pulmonary edema?
Cardiogenic and noncardiogenic
What procedure removes excess fluid from the pleural space using a needle inserted through the chest wall?
Thoracentesis
How much oxygen can 1 gram of hemoglobin carry?
1.34 mL O2
Interpret:
pH 7.56/ PaCO2 44/ HCO3 36
Metabolic alkalosis
What is the average normal cardiac output?
Chapter: 5 L/min
Boards: 4-8 L/min
What are the oxygen-sensitive receptors located in the carotid and aortic bodies called?
Peripheral chemoreceptors
Name the three components of Virchow’s triad
venous stasis, hypercoagulability, and endothelial injury
What is the most common cause of cardiogenic pulmonary edema?
Left-sided heart failure
What procedure intentionally causes the parietal and visceral pleura to stick together to prevent recurrent air or fluid accumulation?
Pleurodesis
A patient has a PaO2 of 100 mm Hg. Approximately how much dissolved oxygen is present per 100 mL of plasma?
0.3 mL/dL
Interpret:
pH 7.36 / PaCO2 79 / HCO 43/ PaO2 61
What invasive line provides continuous systolic, diastolic, and mean arterial blood pressure?
Systemic arterial catheter (A-line)
What percussion note may be heard with pneumothorax, COPD, or asthma
Hyperresonance
What ABG pattern is expected during the mild-to moderate state of the pulmonary embolism?
Acute respiratory alkalosis with hypoxemia:
↑ pH, ↓ PaCO₂, ↓ HCO₃⁻, ↓ PaO₂, ↓ SaO₂/SpO₂
What classic sputum appearance may occur with pulmonary edema?
Frothy, pink sputum
What procedure inserts a thoracoscope through the chest wall and displays the findings on a video monitor?
Video-assisted thoracoscopy (VATS)
What is the normal oxygenation extraction ratio (O2ER)?
Approximately 25%
Starting at pH 7.40 and PaCO2 40, the PaCO2 suddenly increases to 60 mm Hg. What pH and HCO3 would you expect?
pH 7.28 and HCO3 26
A Swan-Ganz catheter indirectly estimates left arterial pressure by measuring what?
Pulmonary capillary wedge pressure (PCWP)
Why can pursed-lip breathing help a patient with advanced obstructive lung disease?
the positive pressure helps stabilize the airways, reduce early airway collapse and air trapping, and slow the ventilatory rate
What happens to the ABG pattern when a pulmonary embolism progresses to the severe stage?
Acute ventilatory failure/acute respiratory acidosis with hypoxemia:
↓ pH, ↑ PaCO₂, ↓ PaO₂ and ↓ saturation
What classic chest x-ray pattern may be seen in severe left heart failure with pulmonary edema?
Bat’s wing/butterfly pattern
A left-sided tension pneumothorax may push the left lung and thoracic structures in which direction?
Rightward
A patient‘s PaO2/FiO2 ratio is below 200. What does this indicate?
Poor lung function
Interpret:
pH 7.28/ PaCO2 99/ HCO3 45 / PaO2 34
Acute ventilatory failure superimposed on chronic ventilatory failure with severe hypoxemia
Name three conditions that may cause an increase CVP
left ventricular heart failure
excessively high positive-pressure mechanical breaths
cor pulmonale
severe flail chest
pneumothorax
pleural effusion
A patient‘s lungs are exposed to a noxious gas. Which pulmonary reflex can increase respiratory rate and also cause coughing and bronchocontriction?
Why is fast-acting heparin administered in pulmonary embolism?
To prevent existing clots from growing and prevent formation of new clots
A CXR shows fluffy densities near the hills, but the cardiac silhouette is NOT ENLARGED and pleural effusion is absent. Which type of pulmonary edema should you suspect?
Noncardiogenic pulmonary edema
MRI has what major radiation advantage compared with imaging techniques that use ionizing radiation?
MRI uses no ionizing radiation