11 Spirometry Flashcards

1
Q

Why should spirometry be done sitting down even though FVC standing > FVC seated?

A

Don’t want patient to faint

High intrathoracic pressure- reduced CO and reduced cerebral blood flow

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2
Q

From this graph, how do we work out Inspiratory Capacity and Functional Residual Capacity?

A
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3
Q

What can forced flow measurements show us?

A
  • Response to treatment
  • Change with age/growth
  • Progression of disease
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4
Q

What are each of the following : FVC, FEV1 and PEF?

A

Functional vital capacity

Maximum volume of air that can be inhaled following a maximum exhalation

FEV1 (Forced Expiratory Volume)

Volume exhaled in first second

PEF (Peak Expiratory Flow)

Maximal speed of airflow as patient exhales (can use FLOWMETER)

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5
Q

Why is FEV1 useful?

A

Most reproducible parameter

Useful for diagnosing and managing patients with obstructive pulmonary diseases eg COPD or Asthma

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6
Q

Explain why the volume time graph for an obstructive pulmonary disease would give the following trace? What would be the expected FEV1/FVC ratio for this type of disease?

A
  • FVC not markedly reduced
  • Narrowing of airways
    • So FEV1 reduced

FEV1/FVC ratio <70% compared to expected (from Nomogram)

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7
Q

How would you expect the volume time graph to appear in a restrictive pulmonary disease? What would you expect the FEV1/FVC ratio to be?

A
  • FVC markedly reduced- lungs can’t expand properly
  • Fraction of air expelled in 1 second is normal but total FEV1 is reduced

Low FVC

Low FEV1

But FEV1/FVC ratio >70%

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8
Q

Where on this flow volume loop is there air coming out of the smaller airways? Indicate the Total lung capacity and the vital capacity

A
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9
Q

What does the scalloping of the graph on the right indicate?

A
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10
Q

What pathology may be causing each of these flow volume loops?

A
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11
Q

For reference: Flow volume loops with restrictive and obstructive pulmonary diseases.

A
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12
Q

When carrying out spirometry, how many recording should you aim for?

A

3

More than 3= fatigue will begin to affect results

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13
Q

What lung function test can be used to measure:

  • Residual volume
  • Dead space
  • Diffusion capacity
A
  • Residual volume: helium dilution test
  • Dead space: nitrogen washout method
  • Diffusion capacity: Carbon monoxide transfer factor (TLCO)
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