Pulmonary Flashcards
Obstructive dz (dilated)
COPD, Bronchiectasis
Obstructive (constricted)
Asthma
Intrathoracic Restrictive (constricted)
Fibrosis, Sarcoidosis, pneumoconiosis
Extrathoracic Restrictive
Chest Cage, kyphosis, spondyloitis, obesity, neurousc (M.gravis, GB syndorme, muscular dystrophy
Normal FEV1/FVC
> 80%
Obstructive dz FEV1/FVC
<80%
Restrictive dz FEV1/FVC
> 80%
COPD
dec FEV1, dec FEV1/FVC, inc TLC, dec DLCO, inc RV
Asthma
dec FEV1, dec FEV1/FVC, inc TLC, nl/inc DLCO, inc RV
Restrictive intrathoracic
dec FEV1, nl FEV1/FVC, dec TLC, dec DLCO, dec RV
Restrictive extrathoracic
dec FEV 1, nl FEV1/FVC, dec TLC, N DLCO, inc RV
best test restrictive vs obstructive
TLC
asthma
restrictive low FEV1, normal FEV1/FVC, low TLC
DLCO 140% predicted, normal FEV1/FVC and TLC
alveolar hemorrhage
Inc DLCO
CHF, MS, ASD/VSD, PDA, pvera
Dec DLCO
COPD, restrictive lung dz, PE, pHTN, anemia
Normal DLCO
asthma, CO poisoning
Fixed extrathoracic
tumors/trachela stenosis both inspir (bottom) and exp(top) loops blunted
Dynamic extrathoracic obstruction
epiglottitis, Vocal cord dysfxn (insp - bottom loop blunted)
Dynamic intrathoracic obstruction
intrathoracic tracheomalacia - exhal (upper) loop blunted
Asthma
reactive to dust, viral, cold, exc, - must show reversible bronchospasm
Asthma dx
PFT - obstructive changes with reversible broncospasm - responds to brochodilators (inc FEV1 by 15%) - if no obst - methacholinie challenge test (15%)
Young man h/o asthma acute asthmatic attack treated with albuterol nebs - f/u now PFT will show
Obstructive defect (still has asthma dx)
35yo M paroxysmal non-prod cough >6months - no ohther sx - spirometry normal, no improvement with anti-histamine/cough meds
methacholine challenge test r/o asthma