Intro to Pulmonary Medicine

Question 1

Restrictive or obstructive lung disease?

FEV1 and FVC decreased proportionally

Answer 1

Restrictive

Question 2

Restrictive or obstructive lung disease?

FEV1 decreased by an amount reflective of severity of disease, FVC slightly reduced but not as much → change in ratio

Answer 2

Obstructive

Question 3

FEV1/FVC in healthy non smokers decreases w/ age in males, females → (under/over)diagnosis of ____

Answer 3

under-diagnosis

asthma in young people

Question 4

Loss of elastic recoil w/ age → (FEV1/FVC) drops by 25-30 ml/yr more than (FEV1/FVC ) → (under/over)diagnosis of ____

Answer 4

FEV1
FVC
Over-diagnosis
COPD in elderly

Question 5

Restrictive or obstructive lung disease?

Expiratory difficulty

Answer 5

Obstructive

Question 6

Restrictive or obstructive lung disease?

Inspiratory difficulty

Answer 6

Restrictive

Question 7

Restrictive or obstructive lung disease?

Reduction in lung volume&raquo_space; reduction in air-flow

Answer 7

Restrictive

Question 8

Restrictive or obstructive lung disease?

Reduced FEV1: out of proportion reduction in FVC

Answer 8

Obstructive

Question 9

Restrictive or obstructive lung disease?

Reduced FEV1/FVC ration (

Answer 9

Obstructive

Question 10

Restrictive or obstructive lung disease?

Reduction of air flow&raquo_space; reduction in lung volume

Answer 10

Obstructive

Question 11

Restrictive or obstructive lung disease?

Decreased FVC: out of proportion reduction in FEV1

Answer 11

Restrictive

Question 12

Restrictive or obstructive lung disease?

Normal or elevated FEV1/FVC ratio

Answer 12

Restrictive

Question 13

Restrictive or obstructive lung disease?

Increased lung compliance: floppy airways

Answer 13

Obstructive

Question 14

Restrictive or obstructive lung disease?

Decreased lung compliance: stiff airways

Answer 14

Restrictive

Question 15

Restrictive or obstructive lung disease?

Decreased RV, FRC, TLC

Answer 15

Restrictive

FRC = functional residual capacity 
RV = reserve volume

Question 16

T/F: RV and FRC can NOT be measured w/ spirometry

Answer 16

True

FRC = functional residual capacity 
RV = reserve volume

Question 17

Functional residual capacity = ___ +____

Answer 17

Reserve volume + Expiratory Reserve volume

Question 18

Inspiratory capacity = ___ + ___

Answer 18

Tidal volume + Inspiratory Reserve volume

Question 19

Vital capacity = ___ + ____

Answer 19

Expiratory reserve volume + inspiratory capacity

Question 20

T/F: Spirometry can diagnosis restrictive physiology but not obstructive physiology.

Answer 20

False. Can diagnose obstructive physiology

FEV1/FVC ratio

Question 21

Which of the following is NOT cause a decrease in surface area in alveolar oxygen diffusion?
A. Emphysema
B. Asthma
C. Pulmonary embolism
D. Pulmonary HTN
E. Fluid, pus, blood

Answer 21

B. Asthma is a decrease in pressure

A. Alveolar destruction: emphysema
C, D. Loss of capillaries: embolism, pulmonary hypertension
E. Alveolar filling defect: fluid, pus, blood

Question 22

Which of the following causes a decrease in pressure in alveolar oxygen diffusion?
A. Pneumonia
B. Fibrosis
C. Edema
D. Asthma

Answer 22

A, D
Bronchiole obstruction: asthma
Alveolar filling defect: pneumonia

B,C: Increase diffusion distance by widening alveolar capillary space

Question 23

PAO2 =

Answer 23

150- (PaCO2/0.8)

PAO2 = Partial pressure of alveolar oxygen

Question 24

P[A-a]O2 =

Answer 24

Alveolar-arterial oxygen difference
PAO2 - PaO2

PaO2 = partial pressure of arterial oxygen
Normal PaO2 = 104-(0.3 x age)

Question 25

A-a gradient (increases/decreases) with lung diseases.

Answer 25

Increases

The larger the difference, the more severe the oxygenation impairment