Flow Volume Studies A

Question 1

PEF is measured with the patient starting at ___.

Answer 1

TLC.

Question 2

PIF is measured with the patient starting at ___.

Answer 2

RV

Question 3

Decreases in the ___ and ___ are indicative of obstructive disease.

Answer 3

FEF 50% and FEF 75%

Question 4

The ___ correlates with the FEF 25%-75% for diagnosing early small airways disease.

Answer 4

FEF 50%

Question 5

What is the definition of an FEFmax?

How is it used?

Answer 5

The highest flow achieved on the expiratory curve. (Basically the same thing as a PEF or PEFR.)
Evaluates pt expiratory effort.

Question 6

The FIF 25%, 50%, and 75% are measured on the (top or bottom) of the flow volume loop.
They are useful when compared to the expiratory values for determining ___, particularly the ___.

Answer 6

Bottom

Site of large obstruction, particularly the 50% value.

Question 7

What is the definition of the FEF 50% / FIF 50% ratio?

Answer 7

The ratio of forced expiratory flow and forced inspiratory flow at 50% of the vital capacity.

Question 8

What is a normal FEF 50% / FIF 50% ratio?

Answer 8

Between 0.8-1.2

Question 9

A variable extrathoracic obstruction would (increase/ decrease/ not change) the FEF 50% / FIF 50% ratio.

Answer 9

Increase the ratio (above 1.2)

Inhalation would be reduced.

Question 10

A variable intrathoracic obstruction would (increase/ decrease/ not change) the FEF 50% / FIF 50% ratio.

Answer 10

Decrease the ratio (Below 0.8)

Exhalation would be reduced.

Question 11

A fixed airway obstruction would cause (increase/ decrease/ not change) the FEF 50% / FIF 50% ratio.

Answer 11

Not change. (Flows would be decreased on inspiration and expiration.

Question 12

In a variable extrathoracic obstruction, (inhalation/ exhalation/ both) would be reduced.

Answer 12

Inhalation

In extrathoracic, exhalation is normal.

Question 13

In a variable intrathoracic obstruction, (inhalation/ exhalation/ both) would be reduced.

Answer 13

Exhalation

In intrathoracic, inhalation is normal

Question 14

In a fixed airway obstruction, (inhalation/ exhalation/ both) would be reduced.

Answer 14

Both

Question 15

What’s the formula for the FEF 50% / FIF 50% ratio?

Answer 15

FIF50%

Question 16

These readings can only be determined directly from a flow volume loop. (x5)

Answer 16

FEF 25%
FEF 50%
FEF 75%
PIFR
PEFR

Question 17

What does it mean if the PEFmax is less than the FEF25%?

Answer 17

The patient gave poor effort.

Question 18

If the obstruction is located at the level of the upper airway, trachea, or mainstem bronchi, the ___ is useful in determining the site of the obstruction.

Answer 18

FEF 50%

Question 19

Fixed airway obstruction appears as a decreased ___ and a decreased ___ with values being approximately equal.

Answer 19

FEF 50% and FIF 50%

Question 20

What is an example of:

1. A fixed airway obstruction?
2. A variable extrathoracic obstruction?
3. A variable intrathoracic obstruction?

Answer 20

1. Tracheal stenosis
2. Vocal cord paralysis
3. Tumor near the carina

Question 21

A flow volume loop of an asthma patient would cause a decrease in (inspiratory/expiratory) flow and a ___ appearance in the expiratory part of the loop.

Answer 21

Expiratory

“scooped out”

Question 22

A flow volume loop of an asthma patient would cause a decrease in (inspiratory/expiratory) flow and a ___ appearance in the expiratory part of the loop.

Answer 22

Expiratory

“scooped out” more pronounced than asthma patients.

Question 23

When should you give someone a bronchodilator? (x4)

Answer 23

If the FEV1 is below 80% on pre-bronchodilator.
Cough of unknown etiology (could be asthma)
Known asthmatic condition
Anytime airway hyperreactiviy is suspected.

Question 24

What is the fastest acting bronchodilator?

What’s the major side effect?

Answer 24

Isoproterenol

Increases heart rate.

Question 25

In a post-bronchodilator test, the FEV1 must improve by __% and __ liters to be considered a reversible condition.

Answer 25

12%

0.2 liters

Question 26

What’s the formula to determine change in FEV1 during a pre/post bronchodilator test?

Answer 26

(Post FEV1 - Pre FEV1) / Pre FEV1 = % change

Question 27

If patient states subjective improvement in breathing after bronchodilator test, he (may/may not) benefit from continued use of a bronchodilator.

Answer 27

The patient may benefit.

Question 28

Name two tests that need not be repeated post-bronchodilator.

Answer 28

FRC and DLCO

Question 29

Large increases in FVC following bronchodilation may cause the ___ to decrease.
May also cause the ___ to decrease.

Answer 29

FEV1/FVC

FEF 25%-75%

Question 30

If FVC increases in the post-bronchodilator study, it is highly suggestive of ___.

Answer 30

Peripheral air trapping.

Question 31

If a patient has a normal VC and decreased FEV1/FCV%, he has a (obstructive/restrictive) disease.

Answer 31

Obstructive

Question 32

If a patient has a decreased VC and normal FEV1/FCV%, he has a (obstructive/restrictive) disease.

Answer 32

Restrictive

Question 33

Children as young as ___ years old can do an spirometry.

Answer 33

5 years old

Question 34

Children doing spirometry: Flow volume curves that meet the criteria for a good start of test and are free of artifact for at least ___ are called “usable.”

Answer 34

the first second

Question 35

While a child is doing a spirometry, once the child feels that lungs are empty, what should they do?

Answer 35

Stop blowing.

Question 36

If a child doing spirometry stops exhaling when the flow is within ___ of the ___, it is considered a premature termination and is unacceptable.

Answer 36

10% of peak flow

Question 37

When children do spirometry, ___ may be better than an FEV1.

Answer 37

FEV0.5

Question 38

When children do spirometry, increased results may be because they ___.

Answer 38

get better at it with practice.

Question 39

When children do spirometry, if post-bronchodilator FVC increases proportionally with the FEV1, the increase is most likely a result of ___.

Answer 39

Increased effort.

Question 40

When children do spirometry, if post-bronchodilator FVC remains the same but the FEV1 increases, the increase is most likely a result of ___.

Answer 40

the bronchodilator.