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Pulmonary Week 2 > PFTs > Flashcards

PFTs Flashcards

1
Q

When is a PFT indicated?

A

anyone presenting with dyspnea, SOB, cough, pre-operative evaluation, disability

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2
Q

How is spirometry performed?

A

patient is sitting and after tidal volume, max inspiration and max expiration are performed 3 times and then average is taken

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3
Q

What is functional residual capacity?

A

volume of air left after normal expiration (obese decreases this)

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4
Q

Slow expiration is key in spirometry evaluation of which patients?

A

those with obstructive disease

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5
Q

Pulmonary function peaks at what age?

A

25 (secular trend of decline- 25-30cc decline/year)

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6
Q

T or F. The initial part of expiration is EFFORT dependent

A

T. The terminal portion is not and is driven by elastic recoil of the lung

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7
Q

When is a post-bronchodilator response considered positive?

A

An increase of at least 200ml (AND 12%) in FEV1 or 15% from basal FEV1

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8
Q

What is an MVV?

A

Maximal volume ventilation= max inhale and exhale as many times as possible in 12 seconds (needed before lung resection)

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9
Q

What is a normal MVV?

A

40x FEV1

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10
Q

What MVV is needed for pneumonectomy?

A

greater than 55%

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11
Q

What MVV is needed for lobeectomy?

A

greater than 45%

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12
Q

A low MVV suggests what?

A

muscle fatigue

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13
Q

What part of lung function can not be measured with spirometry?

A

residual volume

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14
Q

What lung parameter is very important int he evaluation of hypoxemia in the ICU?

A

FVC

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15
Q

FEV1/FVC is reduced in what type of disease?

A

obstructive ONLY

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16
Q

FVC is reduced in obstructive or restrictive?

A

BOTH

17
Q

FEV1 is reduced in obstructive or restrictive?

A

BOTH

18
Q

What things reduce TLC?

A
  • disease of the thorax or inspiratory muscles
  • pleural diseases
  • loss of alveoli
19
Q

What things reduce VC?

A
  • chest pain

- fatigue or poor effort

20
Q

Why does dynamic hyperinflation occur in obstructive disease?

A

Not being able to get out all the air causes “stacking”

21
Q

In restrictive diseases, compliance is decreased

A

T. Harder to inhale, easier to exhale

22
Q

How does compliance change in asthma patients?

A

it doesn’t even though its obstructive (no destruction of tissue) BUT FEV1/FVC still decreases

23
Q

How does compliance change in emphysema patients?

A

increases

24
Q

Flow velocities during exhalation are higher in which type of lung disease?

A

restrictive

25
Q

Flow volume loops are also used to evaluate what?

A

upper-airway obstruction (carina and up)

26
Q

What is the difference between extra-thoracic and intra-thoracic?

A

extra- suprasternal notch up

intra-carina up to suprasternal notch

27
Q

What part of the flow-volume loop is flattened in extra-thoracic disease?

A

inhalation

28
Q

What part of the flow-volume loop is flattened in intra-thoracic disease?

A

exhalation

29
Q

What is a fixed Upper airway obstruction?

A

where you see flattening of both the inspiratory and expiratory portions of the flow-volume curve

30
Q

What is lung diffusion capacity defined as?

A

rate at which gas enters the blood divided by the driving pressure of the gas (PA-Pa)

31
Q

How is DLCO measured?

A

SINGLE breath (requires inhaled VC of greater than 1 L and 10 of breath holding)

32
Q

Interpreting DLCO

A

Change is DLCO 7% per gram of Hb

33
Q

What is a normal DLCO?

A

81-140%

76-80%- borderline

34
Q

What things can increase DLCO?

A

putting blood/Hb in the lungs (e.g. CHF, pulmonary hemorrhage)

35
Q

What are the uses of DLCO?

A
  • differentiate between asthma and COPD, or interstitial and chest wall disease
  • diagnose pulmonary vascular disease
36
Q

What things would show normal PFT and low DLCO?

A

pulmonary emboli or HTN

37
Q

A negative methacholine challenge rules out ____

A

asthma (more than 20+% decrease with less than 1mg/ml methacholine in FEV1= hypersensitivity)

Pulmonary Week 2 (25 decks)

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