pH 7.44, PaCO2 25 mm Hg, HCO3- 17 mEq/L, base excess –6 mEq/L

Compensated respiratory alkalosis

pH 7.50, PaCO2 30 mm Hg, HCO3- 23 mEq/L, base excess +2 mEq/L

Uncompensated respiratory alkalosis

Why do we perform steady state stress testing?

To assesses cardiopulmonary status under constant demand

CVP is a reflection of what?

Right Ventricular filling volume

pH 7.25, PaCO2 32 mm Hg, HCO3- 16 mEq/L, base excess –10 mEq/L

Uncompensated metabolic acidosis

Which of the following radiologic findings is not consistent with lobar atelectasis?

Shift in hilar structures away from the area of atelectasis

Identify the ABG (7.1/95/30/12)

Combined Respiratory Acidosis with Severe Hypoxemia

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Adv CPDx Quiz

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Advanced cardiopulmonary diagnostics final review.

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Questions 120

Answers

1
If a pt has a high FEV1/FVC and a low FVC what does that mean?
Mixed
Normal
Restrictive Disease
Obstructive Disease
2
What test is used to diagnose sleep disorders?
Overnight oximetry
Polysomnography
Leg twitch study
Electroencephalogram (EEG)
3
The preferred site for insertion of an arterial catheter for continuous pressure monitoring.
Ulnar
Radial
Femoral
Brachial
4
PVC's seen on ECG's may be associated with Ischemia?
True
False
5
pH 7.44, PaCO2 25 mm Hg, HCO3- 17 mEq/L, base excess –6 mEq/L
Compensated metabolic acidosis
Uncompensated metabolic acidosis
Uncompensated respiratory acidosis
Compensated respiratory alkalosis
6
pH 7.50, PaCO2 30 mm Hg, HCO3- 23 mEq/L, base excess +2 mEq/L
Uncompensated respiratory alkalosis
Compensated respiratory alkalosis
Uncompensated metabolic acidosis
Uncompensated respiratory acidosis
7
Why do we perform steady state stress testing?
To assesses cardiopulmonary status under constant demand
To assess cardiopulmonary status under varying demand
8
You can measure TLC with bed side spirometry
True
False
9
If a patient has a low FEV1/FVC and a Normal FVC what does that mean?
Normal
Restrictive Disease
Obstructive Disease
Mixed
10
What conditions can sleep apnea contribute to if untreated?
Heart Disease
Hypertension
Stroke
All of these
11
CVP is a reflection of what?
Left Ventricular filling volume
Right Atrial filling volume
Right Ventricular filling volume
Left Atrial filling volume
12
What is the name of the PH electrode?
Clark
Sanz
Boyle
Severinghaus
13
The MVV reflects all of the following except:
airway resistance.
condition of respiratory muscles.
condition of lung tissue.
compliance of the lungs and thorax.
14
A patient has an apnea-hypopnea index (AHI) of 15. What would this be considered?
Mild sleep apnea
Normal
Severe sleep apnea
Moderate sleep apnea
15
On a flow volume loop, what does a “scooped” appearance most likely indicate?
Normal lung function
Obstructive process
Restrictive process
Mixed process
16
All of the following are possible complications of a Swan Ganz except -
Infection
Air embolism
Rash
Pneumothorax
17
Progressive stage stress testing can determine -
Max HR
Max ventilation
Max O2 uptake
All of these
18
What is the normal CVP?
6-12 mmHg
2-6 mmHg
30-40 mmHg
70-105 mmHg
19
Radiographic signs of consolidation include all of the following except:
minimal loss of volume.
homogenous density late in the process.
a low shift of the diaphragm.
lobar distribution.
20
What occurs during REM that results in sleep-disordered breathing (SDB)?
Hypotension
Fall in respiratory rate
Rise in heart rate
Upper airway narrowing
21
What is the name of the PaCO2 electrode?
Boyle
Severinghaus
Clark
Sanz
22
In a healthy adult, your ventilatory reserve should be under 60%?
False
True
23
Obstructive lung disorders are characterized by a reduction in:
Inspiratory flows.
Lung capacities.
Expiratory flows.
Lung volumes.
24
The volume of air inhaled and exhaled during quiet breathing is known as the:
resting volume.
inspiratory capacity.
tidal volume.
inspiratory volume.
25
What is the most common cause of decrease in PCWP?
Pulmonary hypertension
Hypovolemia
Hypervolemia
Right sided heart failure
26
pH 7.25, PaCO2 32 mm Hg, HCO3- 16 mEq/L, base excess –10 mEq/L
Compensated metabolic acidosis
Compensated respiratory acidosis
Uncompensated metabolic acidosis
Uncompensated respiratory acidosis
27
Which of the following would be most suggestive of a patient who is liable to have sleep apnea?
An obese patient
One with a smoking history
A very tall and thin patient
A patient with a history of hypertension
28
Which of the following radiologic findings is not consistent with lobar atelectasis?
Shift in hilar structures away from the area of atelectasis
Hemidiaphragm elevation
Shift in hilar structures toward the area of atelectasis
Collapse of lung tissue
29
In the course of one evening the average person will go through how many sleep cycles?
2-3
4-5
1-2
3-4
30
Infection, Hemorrhage, & Ischemia are all complications of an Arterial Line?
True
False
31
Which of the following is the most common cause of erroneous FVC test results?
Suboptimal coaching
Maximal inspiratory effort
Age of the patient
Age of the equipment
32
What kind of pressure monitoring will provide you with "real time" blood pressure monitoring?
None of the above
Pulmonary Capillary Wedge Pressure
Arterial pressure monitoring
Central Venous Pressure
33
What is the most common cause of increase in PCWP?
cardiac tamponade
left ventricular failure
right heart failure
angina
34
Systolic BP may increase ________mmHG to _____mmHg in healthy excercising patients.
10 and 20
100 and 50
120 and 250
50 and 250
35
Identify the ABG (7.35/45/85/24)
Compensated Respiratory Acidosis with Severe Oxygenation
Chronic Respiratory Alkalosis with Normal Oxygenation
Normal ABG
Combined Respiratory Acidosis with Severe Hypoxemia
36
What is the gold standard to test for sleep apnea?
All of these.
Sleep Study
Split night sleep study
Multiple night sleep study
37
What is the number one complaint with CPAP?
The mask is uncomfortable
The airflow is overwhelming
They still snore
Condensation in tubing
38
Which of the following findings on the CXR is considered a secondary sign of emphysema?
Narrowing of the space between the ribs
Blunting of the costophrenic angle
Flattening of the diaphragm
Widening of the cardiac shadow
39
AP portable films are obtained to evaluate all of the following except:
Results of invasive therapeutic procedures.
Line and tubing positions.
Lung tumor growth.
Lung status.
40
On a flow volume loop, what does a narrow loop most likely indicate?
Restrictive process
Obstructive process
Mixed process
Normal lung function
41
All of the following are complications of an arterial line, except -
Hemorrhage
Ischemia
Infection
Hypochondria
42
Identify the ABG (7.1/95/30/12)
Normal ABG
Combined Respiratory Acidosis with Severe Hypoxemia
Chronic Respiratory Alkalosis with Normal Oxygenation
Compensated Respiratory Acidosis with Severe Oxygenation
43
Which of the following is not standard equipment in a pulmonary function laboratory?
Spirometer
Body plethysmograph
Gas analyzer
Oxygen source
44
Which of the following diseases is not associated with a reduced DLCO?
Pulmonary embolus
Pulmonary fibrosis
Chronic bronchitis
Emphysema
45
A loss of elasticity of the lung tissue will cause the FRC to:
None of the above.
stay the same.
decrease.
increase.
46
The body plethysmograph uses which of the following gas laws?
Charles’ law
Gay-Lussac’s law
Boyle’s law
Combined gas law
47
Menopausal women are more likely to have sleep apnea than younger women.
False
True
48
The right heart shadow is not visible on your pts CXR. Which of these pathologies could explain
Right lung pneumothorax
Bilateral emphysema
Bleb in the right lower lobe
Right middle lobe pneumonia
49
How do you determine cardiac output?
CO=HR/SV
CO=HR - SV
CO= HR x SV.
CO=HR+SV
50
What would a score of 25 on the Apnea Hypopnea Index (AHI) indicate?
Moderate Sleep Apnea
Normal Study
Severe Sleep Apnea
Mild Sleep Apnea
51
An arterial waveform will show minimal change in expiration.
False
True
52
What do you need to see in a Pulmonary Function test to see if the bronchodilator is working?
Increase >16%
Increase >20%
Increase >8%
Increase >12%
53
Persantine, Lexiscan & Dobutamine are all used for a chemical stress test?
True
False
54
The Internal Jugular Vein is the more stable insertion site for a Central Venous Pressure Line?
False
True
55
How was sleep apnea treated before CPAP?
Oral Devices
It wasn't
Surgically
Nasal Strips
56
The dicrotic notch on the arterial pressure waveform represents closure of which heart valve?
Mitral
Aortic
Tricuspid
Pulmonary
57
Which of the following radiologic terms confirm the presence of intrapulmonary disease?
Air bronchogram
Compression atelectasis
Sulcus sign
Platelike atelectasis
58
A decrease in HR with exercise may indicate what?
Pulmonary Embolism
Stroke
Pulmonary HTN
Ischemia or Heart Block
59
Where should the CVP transducer be placed?
2nd intercostal space, mid axillary
2nd intercostal space mid clavicular
4th intercostal space, mid clavicular
4th intercostal space, mid axillary
60
What does a flattened diaphragm (hoover sign) usually indicate?
Atelectasis
Pneumothorax
Hyperinflation
Pneumonia
61
How many times an hour do you show signs of apnea and are still considered normal?
45
15
30
5
62
What vitals may change during REM sleep?
HR
All of these
RR
BP
63
You can have a normal FEV1/FVC and still have an obstructive disease.
False
True
64
A 30 on the Apnea Hypopnea Index would indicate -
Mild Sleep Apnea
Severe Sleep Apnea
Normal
Moderate Sleep Apnea
65
Exercise Tests are divided into 3 categories?
False
True
66
What is the normal minute ventilation of an average person at rest?
<5 L/min
5 to 10 L/min
>15 L/min
5 to 15 L/min
67
What is the significance of the silhouette sign?
Determines if a infiltrate is in contact with a heart border
Differentiation between alveolar and interstitial opacities
It can aid in detection of pleural effusion
Differentiation between alveolar and interstitial infiltrate
68
Which of the following is the primary instrument used in performing PFTs?
Flowmeter
Spirometer
Thermistor
Spirograph
69
Which of the following views is most helpful in identifying a pneumothorax?
Expiratory view
AP view
Lateral decubitus view
Left lateral view
70
What is normal PCWP?
70-105 mmHg
6-12 mmHg
2-6 mmHg
30-40 mmHg
71
All of the following are typical findings of a small pleural effusion except:
a partially obscured diaphragm.
complete whiteout of the affected side.
blunting of the costophrenic angle.
a small meniscus sign.
72
Which of the following behavioral interventions is least useful for the tx of sleep apnea
Avoidance of daytime naps
Weight loss
Avoidance of sedatives
Avoidance of alcohol
73
Which of the following is not a parameter to establish normal values for PFTs?
Race
Height
Gender
Weight
74
The DLCO is a test that is used to measure the:
amount of carbon monoxide in the blood.
ability of a gas to move across the A-C membrane.
thickness of the alveolar-capillary membrane.
diffusion coefficient of carbon monoxide in the lungs.
75
Which of the following medications is used most commonly during bronchoprovocation testing?
Methacholine
Metaproterenol
Isoproterenol
Methylene blue
76
Blunting of the costophrenic angles seen on the PA or lateral chest film typically indicates:
rib fractures.
obesity.
emphysema.
excess pleural fluid.
77
Which of the following statements is false regarding the use of the CXR to detect a pneumo?
An expiratory film may be best for a small pneumothorax.
Standard chest film is of limited use in detecting a pneumo
Film will show a lack of vascular markings
The lung margin is often visible with a pneumothorax.
78
What is normal MAP?
2-6 mmHg
6-12 mmHg
30-40 mmHg
70-105 mmHg
79
Which of the following statements best describe the typical findings on a CXR for a pt with ILD
Diffuse pulmonary hyperinflation
Diffuse pleural inflammation
Diffuse bilateral infiltrates
Unilateral upper lobe infiltrates
80
The closed-system helium dilution method is used to measure:
FRC.
FVC.
TLC.
TV.
81
What is the primary problem in obstructive lung disease?
Low lung volumes
Increased pulmonary capillary pressure
Reduced lung diffusion
Increased airway resistance
82
Which chest x-ray view is best used to identify excess pleural fluid?
Apical lordotic
Anteroposterior
Posteroanterior
Lateral decubitus
83
Before an ABG value is obtained, the patient’s clotting parameters should be evaluated because:
It may slow filling of blood during the draw.
they may affect the patient’s PaO2.
they may affect the accuracy of the sample pH.
bleeding time may be prolonged if they are abnormal.
84
What is normal pulse pressure?
2-6 mmHg
70-105 mmHg
30-40 mmHg
6-12 mmHg
85
More than 10 PVC's per minute indicate mitral valve prolapse?
True
False
86
Which of the following conditions are not common causes of restrictive lung disease?
Chest wall dysfunction and neurologic disease
Atelectasis and obesity
Interstitial lung disease and lung scarring
Asthma and emphysema
87
If patient shows ST elevation or depression during stress test what do you do?
Stop the test and get cardiologist
Apply 1L O2 via nasal cannula and continue testing
Keep going, this is a cardiac stress test
Stop the test, rest for a moment, restart the test
88
pH 7.29, PaCO2 68 mm Hg, HCO3- 29 mEq/L, BE + 1 mEq/L
Uncompensated respiratory alkalosis
Uncompensated metabolic acidosis
Compensated respiratory alkalosis
Uncompensated respiratory acidosis
89
What is the name of the PaO2 electrode?
Clark
Severinghaus
Sanz
Boyle
90
Term is used to describe the shadows seen on CXR when alveoli fill with pus, fluid, or blood
Infiltrates
Consolidates
Alveolar lesions
Densities
91
If HR and SV increases, what happens to CO?
Increases
Stays the Same
Decreases
Slight Decrease
92
What is the first sign of sleep apnea?
Excessive daytime sleepiness (EDS)
Hypercarbia
Snoring
Cyanosis
93
Which of the following tests is not considered for exercise testing?
Ventilatory capacity
Stress ECG
DLCO
Anaerobic threshold
94
Your pt just had an AP chest film taken. When you view the film, what may be a consideration?
The ribs may appear more horizontal than normal.
The heart may appear larger than it really is.
The heart may appear less dense then it really is.
The lungs may appear smaller than they really are
95
Which of the following would suggest that a patient has congestive heart failure (CHF)?
Increased retrosternal air space on a lateral film
Tracheal deviation
Increased cardiothoracic ratio
Low and flat diaphragm
96
Which of these structures will result in the most radiopaque shadow on the chest radiograph?
Aorta
Lungs
Ribs
Heart
97
Which radiographic view of the chest allows the physician to read the best quality film?
Posteroanterior
Lateral
Lordotic
Anteroposterior
98
What do you want to check before a stress test?
Albumin
Troponin
PCWP
CVP
99
Which of the following may decrease the FVC in a patient with an obstructive lung disorder?
An increase in residual volume (RV)
An increase in airway resistance caused by the disease
A decrease in lung size
A decrease in expiratory muscle mass
100
What are some of the modalities used for stress testing?
Yoga
Stationary Bike
Treadmill
Zumba
101
In which of the following conditions is total lung capacity (TLC) always reduced?
Obstructive lung disease
Restrictive lung disease
Acute airways obstruction
Combined restrictive and obstructive disease
102
During an exercise stress test a patient SpO2 drops 5%. What does this mean?
Exercise desaturation.
Normal exercise desaturation
103
How is sleep apnea rated?
Apnea Index (AI)
Hypopnea Index
Apnea Hypopnea Index (AHI)
All of these
104
How do you predict someones max HR?
HR= 220 - height of pt in cm
HR= 200 - age of pt
HR= 220 - weight of pt in kg
HR= 220 - age of pt
105
Which of the following is the most common site for arterial puncture?
Radial artery
Ulnar artery
Jugular artery
Temporal artery
106
Hypopnea is the cessation of airflow during sleep.
True
False
107
What is the most commonly seen arrhythmia during stress testing?
Bradycardia
Atrial Fibrillation
Atrioventricular block
PVCs
108
Which of the following is not a general purpose of performing pulmonary function tests (PFTs)?
The diffusion characteristics of the A-C membrane
The functional status of the lungs
The specific diagnosis of pulmonary disease
Quantity and speed of gas moved into and out of the lungs
109
A restrictive defect is present when volumes are less than what percentage of predicted?
90%
60%
80%
70%
110
What is the calculation for MAP?
Diastolic+Systolic
Diastolic+(Systolicx2)/3
Systolic+(Diastolicx2)/3
Diastolic+Systolic/2
111
You need a X-ray to verify placement of a central line?
False
True
112
Whats another name for exercise testing?
All of the above
Graded exercise test
Cardiac Stress Test
Stress test
113
What would IRV and IRC be in a patient with a mild to restrictive disorder?
Abnormally increased
Not measured
Normal
Abnormally decreased
114
What may cause the FVC to decrease in a patient with a restrictive lung disorder?
An increase in the expiratory reserve volume (ERV)
An increase in airway resistance caused by the disease
A decrease in expiratory muscle mass
A decrease in lung size
115
What is the type of CXR that will most clearly show a pneumothorax or pleural effusion?
AP positioning
Lordotic View
PA positioning
Lateral decubitous
116
How will air appear on a CXR?
Radiopaque
Radiolucent
117
In a patient with an exacerbation of asthma, airway resistance will be:
increased.
decreased.
normal.
impossible to measure.
118
Which of the following diagnostically defines the presence of moderate sleep apnea?
AHI of 3
AHI of 32
AHI of 44
AHI of 12
119
What is the equation for pulse pressure?
diastolic-systolic
systolic-diastolic
diastolic+(systolic x 2)/3
systolic+(diastolic x 2)/3
120
The ERV is limited in clinical usefulness. It may be reduced in all of the following except:
obesity.
restrictive disorders.
patients making a poor effort during testing.
obstructive disorders.

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