Solution
Quiz 2 Review, Pulmonary, Cardiovascular , Gi/Hepatobiliary
Pulmonary
• Acid fast bacilli (AFB) testing-Microscopic test-used to diagnose active TB in
patients with abnormal CXR, positive TB screening test, chronic cough, fever,
night sweats, or unexplained weight loss
• Influenza testing-Obtained via nose or throat swabs. Positive for active
infection by when influenza A and B viral components are identified. They
detect either antigens for rapid results or genetic viral components
(RNA/DNA more accurate)
• Over the counter COVID-19-Antigen tests (rapid tests), detect antigens
from SARS-CoV2, the virus that causes COVID-19. At-home COVID-19
antigen tests are less accurate than molecular tests, such as polymerase
chain reaction (PCR) tests and other nucleic acid amplification tests (NAATs),
which detect genetic material (RNA) from the virus
• Sputum culture-Microscopic test that analyzes phlegm to identify bacteria
or fungi causing lower respiratory infections (pneumonia, tuberculosis, or
bronchitis) to determine the specific pathogen, guide antibiotic selection
and to monitor treatment
• Alpha-1 antitrypsin deficiency-Blood test used to detect genetic
COPD/emphysema
• Complete blood count-Blood test to evaluate for infection
• Lung scan (ventilation/perfusion scan or V/Q scan)-Nuclear medicine study
used to detect pulmonary embolism. It assesses the airflow (ventilation)
and blood flow (perfusion) in the lungs
• CT pulmonary angiography (CTPA)-Used to diagnose pulmonary embolism
, • CT scan of lungs-Used to detect-Nodules, masses, bronchiectasis Interstitial
lung disease, infections, lung cancer screening in smokers
• CXR-X-Ray study to assess heart lungs the lungs and surrounding structures
patients with SOB, cough or other respiratory symptoms to help detect
pneumonia, COPD, lung/thoracic masses, pneumothorax, pleural effusion,
CHF, cardiomegaly, pericardial effusion, aortic aneurysms, rib fractures,
bone tumors, etc
*CXR can reveal structural changes associated with COPD but need spiromerty to
diagnose COPD. CXR can also find possible malignancies but need CT and/or PET
scan and lung bx for confirmation
• Spirometry Test used to monitor decreasing lung function and assess
airflow obstruction test for in patients with COPD (and in patients with
pulmonary fibrosis interstitial lung disease, asbestosis, sarcoidosis)
Spirometry is diagnostic for COPD if post-bronchodilator FEV1 is <0.7
FEV1 (Forced Expiratory Volume in 1 second) The volume of air forcefully exhaled
during the very first second of a breath test. It is a primary indicator of how
quickly airways can empty. FVC (Forced Vital Capacity) The total volume of air
exhaled forcefully after taking the deepest breath possible. It reflects the lungs'
total capacity to release air.
TLC (Total Lung Capacity) The maximum amount of air the lungs can hold at the
peak of a full inhalation. It is the sum of all air volumes in the lung.
RV (Residual Volume) The amount of air that remains in the lungs even after you
exhale as much as possible. You cannot voluntarily breathe this air out; it keeps
the tiny air sacs (alveoli) from collapsing
Measurement Obstructive (e.g., Asthma, COPD) Restrictive (e.g., Fibrosis,
Obesity)
FEV1 Significantly decreased Decreased or normal
FVC Normal or slightly decreased Decreased
FEV1/FVC Ratio Low (Below 70%) Normal or high