Pulmonary function test

Question 1

what is the FEV1/FVC ratio to determine Obstructive lung disease?

Answer 1

<0.70

Question 2

what and when to use bronchodilator therapy

Answer 2

Used in obstructive lung disease to determine if the airway obstruction is reversible

Typically give B2 agonist like albuterol

Question 3

what does a positive and negative result mean for bronchodilator therapy

Answer 3

Positive is >12 % increase in FEV1 or FVC and an absolute increase >200 ml

if yes then patient has asthma

if no patient has COPD or other obstructive lung disease

Question 4

What is bronchoprovocation and when to use it?

Answer 4

if PFT is normal but still suspect asthma

use Methacholine (analog of acetylcholine and stimulates muscarinic receptors causing bronchoconstriction)

positive test is >20% reduction of FEV1

Question 5

Characteristic of Flow volume of Obstruction

Answer 5

Concave or scooping pattern

Question 6

Characteristic of flow volume chart of restriction

Answer 6

Peaked, steeple or witch hat pattern

Question 7

what causes a Variable Extrathoracic obstruction on flow volume loop

Answer 7

Vocal Code, paralysis, airway burns

decreased inspiration
normal expiration

Question 8

what causes a variable intrathoracic obstruction on flow volume loop

Answer 8

Airway trauma, airway inflammation, foreign body

decreased expiration
normal inspiration

Question 9

what causes a fixed obstruction on flow volume loop

Answer 9

tracheal stenosis, bronchial stenosis, goiters, upper airway tumors

decreased inspiration
decreased expiration

Question 10

Common causes of restrictive lung disease

Answer 10

abnormalities on chest wall or pleura

Drugs

Instersitial lung disease

Neuromuscular disorder

Question 11

common causes of obstructive lung disease

Answer 11

COPD

• Chronic bronchitis
• Emphysema

Asthma

Bronchiectasis

Bronchiolitis

Question 12

Obstructive lung disease PFT patterns: Lung volume, capacities, DLCO, Bronchodilator response

Answer 12

FEV1/FVC ration 12% increase FEV1 or FVC and >200 ml volume increase patient has asthma

-no means COPD and other obstructive lung disease

Question 13

GOLD obstruction Mild, Moderate, Severe, very severe

Answer 13

Mild = FEV1 >80%

Moderate = FEV1 >50 <80

Severe = FEV1 >30 <50

Very severe = FEV1 <30

Question 14

Restrictive lung disease PFT pattern: FVC, FEV1/FVC, TLC, RV, and DLCO

Answer 14

FEV1 normal or midly reduced

FVC<80%

FEV1/FVC ratio is normal to >.70

TLC: decreased

RV: decreased

DLCO: could be normal or low

Flow volume is peaked, steeple, or witches hat pattern

Question 15

what are the FEV1/FVC and TLC in a mixed PFT pattern

Answer 15

FEV1/FVC ratio is low

TLC: is low