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RC Test 2 > B4.37 - Evaluating Pulmonary Function Tests > Flashcards

B4.37 - Evaluating Pulmonary Function Tests Flashcards

1
Q

Indications for PFT

A

Screening

Evaluation of respiratory symptom or sign

Grading severity of respiratory disease

Following progression of respiratory disease

Monitoring response to therapy

Monitoring occupational, drug or radiation toxicity

Predicting prognosis

predicting post op pulmonary risk

assessing disability/impairment

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2
Q

what does spirometry measure

A

how fast and much you air you breath out

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3
Q

what are teh ATS acceptability criteria for FVC

A

Good start of test

Smooth continuous curve

Satisfactory exhalation

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4
Q

what determines if the start of the test was good enough

A

extrapolated voluem <5% of FVC or 150 mL

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5
Q

what is the minimun time an exhalation must be for it to be acceptable

A

6 seconds

10 is prefered

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6
Q

what are ATS reproducability criteria for FVC

A

after 3 acceptable maneuvers, the two largest FVC adn FEV1 are within i150 mL of each other

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7
Q

what is depicted her

A

excellent effort

the goal

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8
Q

what is depicted here

A

hesitating start

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9
Q

what is depicted here

A

submaximal effort

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10
Q

what is depicted here

A

rainbow curve

normal in young, non smoking females

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11
Q
A

early termination

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12
Q
A

coughing

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13
Q
A

subject briefly stopped exhaling

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14
Q
A

the “knee”

normal in young non smokers

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15
Q

what are gas dilution methods

A

nitrogen washout and helium dilution

takes advantage of inert, poorly soluble gas of known concentration

a way to measure lung volume

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16
Q

what is a non gas way of measuring lung volume

A

body box

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17
Q

equation for Vf (unknown lung volume)

A

Vf = (change in V/change in P) (PB)

18
Q

what is TLC

A

total lung capacity

FRC + IC

or

RV + VC

19
Q

what is RV

A

residual volume

FRC - ERV

20
Q

what is the reference equation used for finding reference ranges for spirometry

A

from NHANESIII

FEV1 - 80-120

FVC - 80-120

21
Q

what is an obstructive pulmonary defect

A

a disporportionate reduction of maximal airflow from the lung with respect to the maximal volume (FVC) that can be displaced from the lung. Indicates expiratory airlow limitation

22
Q

what is a normal FEV/FVC

A

>.7 is the cutoff for normal

23
Q

what do these indicate and why

A

Obstructive pulmonary defect

because the FEV1/FVC ration is low and expiratory phase of flow/volume loop is lower than expected indicating an issue with exhalation

24
Q

causes of obstructive pulmonary defect

A

Asthma

COPD

bronchiectasis

Obliterative bronchiolitis

LAM

Diffues panbronchiolitis

25
Q

what is restrictive pulmonary defect

A

characterized physiologically by reduction in TLC below the 5th percentile of normal distribution.

26
Q

what can a restrictive pulmonary defect be inferred

A

when theres FVC that is reduced and FEV1/FVC ration is nromal or increased.

27
Q

what does this demonstrate

A

restrictive pulmonary defect

Note: normal FEV1/FVC ration

Narrower exhalation because of reduced overall volume

28
Q

what are restrictive defects in the lung

A

resection

atelectasis

stiff lung (fibrosis)

CHF

Thickened pleura

tumor

29
Q

what are restrictive defects in the pleual cavity

A

effusion

enlarged heart

tumor

30
Q

what are restrictive defects in the chest wall

A

scleroderma

ascites

pregnancy

obesity

kyphoscoliosis

splinting due to pain

31
Q

what are restrictive defects in muscle

A

neuromuscular disease

old polio

paralyzed diaphragm

32
Q

what is a mixed pulmonary defect

A

coexistence of obstruction and restriction

defined physiologically when both the FEV1/FVC ratio and the TLC are decreased

33
Q

what are the categories of severity of spirometric abnormalities

A
34
Q

what is a bronchodilator response

A

usually four separate doses of albuterol is given by metered dose inhaler using a space. Tests repeated after 15 minute delay

a >12% and 200mL increased in FEV1 or FVC meets critera for bronchodilator response

35
Q

can you differentiate asthma and COPD with a bronchodilator response

A

no bitch

36
Q

differentiate between extrathoracic, intrathoracic, varable and fixed airway obstructions

A

extrathoracic - above suprasternal notch

intrathoracic - between suprasternal notch and carina

Variable - lesion narrows and decreases flow excessively during one phase of respiration

fixed - narrowing causes decreased flow equally during both phases of respiration

37
Q

examples of variable extrathoracic lesions

A

vocal chord paralysis/dysfunction

tracheomalacia

goiter

38
Q

examples of variable intrathoracic lesions

A

traheomalacia

malignant tracheal lesions

tracheal stricture

39
Q

fixed lesions

A

tracheal stenosis

vocal cord paralysis

vocal cord malignancy

40
Q

name the type of obstruction

A

variable extrathoracic

41
Q

name the type of obstruction

A

variable intrathoracic

42
Q

name the obstruction

A

fixed major airway obstruction

RC Test 2 (19 decks)

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