RCP 410 - Cardio/Pulmonary Diagnostics

1. Summarize the uses of pulmonary function testing
   1. List the benefits of pulmonary function testing
   2. List indications for pulmonary function testing
   3. Explain the three basic abnormalities which may be identified with pulmonary function testing
   4. Describe how demographic factors will affect performance on pulmonary function tests
   5. Describe methods by which predicted values for pulmonary function tests may be obtained
   6. Explain how the various sets of predicted values were constructed.
   7. Describe how predicted values are used in the inter-pretation of the results of pulmonary function tests
   8. Determine predicted values from nomograms and regression equations
   9. Convert gas volumes to BTPS units
   10. Calculate percent of predicted for pulmonary function tests
   11. Calculate percent of improvement following administration of a bronchodilator
   12. Identify the lung volumes and capacities on a spirographic tracing
   13. Define the four lung volumes and the four lung capacities
   14. Describe the rationale for the information which should be obtained in a patient history prior to pulmonary function testing
   15. Demonstrate proper coaching of a person on whom pulmonary function tests are being performed
2. Identify the equipment needed to perform pulmonary function testing
   1. Describe the construction and function of four types of volume displacement spirometers
   2. Describe how volume displacement spirometers are used to generate pulmonary function test data
   3. Describe the construction and function of four types of flow measuring spirometers
   4. Explain how volume measuring spirometers can generate flow information
   5. Explain how flow measuring spirometers can generate volume information
   6. Describe the construction and function of devices used to measure the concentrations of nitrogen, oxygen, helium and carbon monoxide.
   7. Describe the construction and function of devices used to graphically represent the results of pulmonary function test data
   8. Differentiate between graphic representation of test results which can be generated
3. Perform and interpret results of basic spirometry testing
   1. Describe and demonstrate the performance of the following test
   2. Describe and demonstrate the derivation/calculation of
   3. Describe and demonstrate the derivation/calculation of the following from the volume vs. time tracing for lung subdivisions the following from the tracing of restion ventilation
   4. Describe and demonstrate the derivation/calculation of the following from the timed vital capacity volume vs. time, and flow vs. volume tracings:
   5. Identify which of the tests above may be obtained from each the Volume/Time and Flow/Volume Graphs of the Forced Vital Capacity Test
   6. Describe and demonstrate the derivation/calculation of the following from the tracing produced in a Maximim Voluntary Ventilation Test:
   7. Describe the rationale for performance of spirometry before and after bronchodilator administration
   8. Describe the interpretation of before and after bronchodilator spirometry studies
   9. Perform and interpret tests to determine lung volumes
   10. Describe the indications, equipment and technique of determining RV, FRC, TLC, and RV/TLC using the helium dilution method
   11. Describe the indications, equipment and technique of determining RV, FRC, TLC
   12. Describe the method for determining Thoracic Gas Volume (TGV) using the body plethysmograph
   13. Describe the method for determining TLC from chest x-rays
   14. Describe how and why TGV and TLC may not be equal.
   15. Describe and demonstrate the measurement and calculation of RV, FRC, and
   16. Describe the causes for and interpretation of abnormal lung volumes TLC from the above tests
4. Perform and interpret tests of diffusing capacity
   1. Describe and demonstrate the indications, equipment, techniques and calculations for determining diffusing capacity
   2. Describe the causes for and significance of abnormal diffusing capacities 
5. Perform and interpret tests of closing volume
   1. Describe the indications, equipment, techniques and calculations of closing volume
   2. Describe the causes for and significance of abnormal closing volumes
6. Describe indications for each type of pulmonary function test
7. Describe effective quality control in the pulmonary function laboratory
   1. Summarize the components of an effective quality control program in the pulmonary function laboratory
   2. Define the concepts of accuracy and precision
   3. Explain how test accuracy and patient effort on PFT’s can be evaluated
   4. Explain how computerization of the PFT laboratory affects the quality control program
8. Describe techniques of determining cardiac output.
   1. Explain the technique of thermal dilution to determine cardiac output
   2. Demonstrate how the Fick equation may be used to determine cardiac output
   3. Describe how the dilution of dyes may be used to determine cardiac output
9. Describe techniques of noninvasive cardiovascular diagnostic testing
   1. Explain basic techniques and value of echocardiography.
   2. Explain basic techniques and value of phonocardiography
   3. Explain basic techniques and value of vascular flow studies
10. Demonstrate performance of basic electrocardiography
    1. Demonstrate proper placement of leads for a 12 lead ECG
    2. Describe proper evaluation of quality of tracings obtained from ECG
    3. Identify common arrhythmias on ECG’s. 
11. Evaluate date obtained from “STRESS” testing
    1. Describe the rationale for exercise testing
    2. Explain the types of devices which may be used to increase workload for exercise testing
    3. Describe the monitoring of test subjects which is required during exercise testing
    4. Explain indications for termination of exercise testing
    5. Describe how the results of exercise testing are interpreted
    6. Explain performance and interpretation of methacholine challenge testing
12. Describe techniques of invasive cardiovascular diagnostic testing
    1. Identify the construction and location of the ports of a four lumen Swan Ganz catheter
    2. Describe the physiologic data which may be obtained with a Swan Ganz catheter
    3. State the normal ranges for the following and describe how the catheter would be used in the measurement or determination
    4. Identify the wave forms which would be seen as the catheter is inserted into the patient
    5. Describe two methods by which cardiac output may be determined using the Swan Ganz catheter
    6. Describe the significance of and method for calculating cardiac index
    7. Describe the techniques used in cardiac catheterization
    8. Describe the technique of selective coronary angiography
    9. Define and describe the clinical significance of preload, afterload, isovolumetric contraction, contractility
    10. Describe how the intra-aortic balloon pump impacts the function of the heart
13. Describe techniques and interpretation of polysomnographic testing
14. Describe rationale and techniques of intraaortic balloon pumping