EXAM #1: PULMONARY FUNCTION TESTING

Question 1

What are the indications to perform Pulmonary Function Testing?

Answer 1

1) Evaluation of suspected respiratory disease
2) Evaluation of the severity of respiratory disease
3) Pre-op eval.
4) Evaluating persons at risk for pulmonary disease
5) Assessment of response to therapy

This is NOT done in the acute setting

Question 2

What are the elements of pulmonary function testing?

Answer 2

1) Flow
2) Volume
3) Gas exchange

Question 3

What is the tidal volume?

Answer 3

Air in/out with normal breath (500 mL)

Question 4

What is the inspiratory capacity?

Answer 4

TV + IRV

Question 5

What is the functional residual capacity?

Answer 5

ERV + RV

Question 6

What is the vital capacity?

Answer 6

TV + ERV + IRV

Question 7

What is the total lung capacity?

Answer 7

TV + ERV + IRV + RV

Question 8

What does spirometry measure?

Answer 8

Air flow

Question 9

What does body plethysmography measure?

Answer 9

Static lung volumes

Question 10

What is the Diffusing capacity of the Lungs for Carbon monoxide (DLCO) measure?

Answer 10

Gas exchange

Question 11

What is FEV1?

Answer 11

Forced Expiratory Volume in the 1st second

Question 12

What is FVC?

Answer 12

Foriced Vital Capacity

Question 13

What is PEF?

Answer 13

Peak Expiratory Flow

Question 14

What are three factors that can negatively effect the accuracy of Spirometry?

Answer 14

1) Inability to follow instructions
2) Muscular weakness
3) Poor oral seal

Question 15

When is most of the air exhaled in spirometry?

Answer 15

FEV1

Question 16

What happens to the FEV1/FVC ratio in obstructive disease?

Answer 16

Decreased

Question 17

What is the marker for severe obstructive disease in terms of FEV1/FVC ratio?

Answer 17

Less than 50%

Question 18

What are the obstructive airway pathologies?

Answer 18

1) Asthma
2) COPD
3) Bronchiectasis
4) CF
5) Upper airway obstruction
6) Extrinsic airway narrowing
7) FB

Question 19

Draw the flow-volume loop for obstructive lung disease.

Answer 19

N/A

Question 20

Draw the volume-time curve for obstructive lung disease.

Answer 20

N/A

Question 21

How does the peak flow differ between obstructive and restrictive lung disease. Draw the difference.

Answer 21

Obstructive= reduced and “scooped out” or steeple

Restrictive= normal peak but reduced volume

Question 22

How does airway obstruction alter the flow-volume loop?

Answer 22

Blunted inspiratory phase

*“Variable extra-thoracic obstruction” is how the graph is read

Question 23

How will variable intrathoracic obstruction appear on flow-volume loop?

Answer 23

Blunted expiratory phase

Question 24

Draw the flow-volume loop for fixed airway obstruction.

Answer 24

N/A

Question 25

What is the indication for a bronchoprovocation test?

Answer 25

To evaluate airway hyperresponsiveness

Question 26

What is the most commonly used drug for a bronchoprovocation test?

Answer 26

Methacholine

Question 27

What is a positive bronchoprovocation test?

Answer 27

FEV1 decreased by 20%

Question 28

What are the techniques to measure lung capacity?

Answer 28

1) Body plethysomography* 2) Nitrogen wash out 3) Helium technique

Question 29

What is the major difference between what can be measure with body plethysmography and spirometry?

Answer 29

Able to measure residual lung capacity and diagnose restrictive lung disease

Question 30

What is the normal TLC?

Answer 30

80-120% of the normal

Question 31

What defines restrictive lung disease?

Answer 31

Less than 80% of reference TLC

Question 32

What defines hyperinflation?

Answer 32

More than 120% of reference TLC

Question 33

What are the restrictive lung disease pathologies?

Answer 33

1) NM 2) Skeletal 3) Diaphragmatic paralysis 4) Pleural disease 5) Parenquimal

Question 34

What is the utility of the DCLO in diagnosing restrictive lung disease?

Answer 34

Normal= extrapulmonary Low= intrapulmonary

Question 35

What is the utility of MIP and MEP (maximal inspiratory and expiratory pressures) in PFT?

Answer 35

Helps diagnose neuromusclar disorders