Houston, We Have Results
Formulary
Transportation Station
Barriers
Shunt Happens
100

The ARDS classification of a P/F ratio of 125

What is moderate ARDS?

100

The components of the alveolar air equation

What is FiO2 X (PB - PH20) - (PACO2 / RQ) ?

where RQ may be 0.8

100

Define gas diffusion

What is gas molecules moving across a membrane from high pressure areas to low pressure areas? 

100

True or false: membrane thickness affects molecular ability to diffuse across it

What is true? 

100

COPD, restrictive lung disorders, and conditions resulting in hypoventilation are examples of this type of shunt

What is an alveolar shunt? 

200

The ventilator tubing was dirty and changed out with a longer circuit. The patient now presents acidotic because this has occurred

What is increased dead space and/or the need for increased minute ventilation? 

200

How to calculate the A-a gradient, where 'A' is the partial pressure of oxygen in the alveoli and 'a' is the partial pressure of oxygen in the arteries

What is PAO2 - PaO2?

200

Five factors that affect the loading and offloading of oxygen

What is blood pH, body temperature, erythrocyte concentration, structure/shape of hemoglobin, and adverse hemoglobin chemical combinations? 

200
This causes a barrier in offloading oxygen to tissues because of an increased affinity for oxyhemoglobin

What is alkalosis? May also accept low body temperature. 

200

This shunt sends venous blood from the right heart to the left heart without gas exchange 

What is a physiologic shunt? 

300

The reason(s) a mountain hiker requires deeper breathing and may encounter varying levels of hypoxia in higher altitudes, similar to that of pilots without added oxygen

What is the barometric pressure drops and therefore the arterial oxygen content is decreased and may lead to hypoxemia?

300

What is the P/F ratio of a patient with a PaO2 of 89 mm Hg using an FiO2 of 45%

What is 197.78, or 198? 

300

Acidity affects the uptake of oxygen by...

What is reducing the ability to obtain oxyhemoglobin? 

300

This condition hardens and changes the shape of hemoglobin, and increases the risk of clot development 

What is sickle cell? 

300

This combination with hemoglobin increases the affinity for oxygen but loses oxygen binding capacity due to the presence of ferric ions

What is methemoglobin? 

400

The presence of this is why young infants may have a left shift on the oxyhemoglobin curve with less tissue oxygen unloading

What is fetal hemoglobin? 

400

The formula for arterial oxygen content that is the sum of oxygen that is actually combined to Hb and dissolved in plasma

What is (0.003 X PaO2) + (1.34 X Hb X SaO2) ? 

400
This is the pulmonary capillary pressure that allows blood flow between capillaries and lung tissue
What is hydrostatic pressure? 
400

True or false: tissue hypoxia does not occur when PaO2 is normal

What is false? 

(think of blood loss or variant Hb)

400

The presence of this easily displaces true oxygen carrying capacity by half because it has a greater affinity for hemoglobin binding and will still show good oxygen saturations

What is carboxyhemoglobin? 

500

This may be indicative of a low V/Q and suggest ventilation is less than normal while perfusion may be unaffected or greater than normal

What is atelectasis or alveolar collapse? 

500
A normal value of 5-10 mm Hg represents this

What is a normal A-a gradient? 

500

CO2 is primarily removed from the body through this event

What is hydrolysis in erythrocytes where carbonic anhydrase breaks down CO2 into HCO3 for buffering, equilibrium, and diffusion? 

500

Septic shock may increase lactic acidosis due to...

What is an unmet oxygen demand leading to anaerobic metabolism and the accumulation of lactic acidosis? 

500

Describe the 50/50 rule

What is an estimation of significant shunt presence when the patient is on more than 50% FiO2 but their PaO2 is less than 50 mm Hg?