Pulmonary Function Tests (referencing M&M)

Question 1

Post-surgical morbidity and mortality rates are higher in patients with restrictive and/or obstructive ventilatory defects. What disease in these groups is MOST amenable to treatment? Most difficult to reverse with treatment?

Answer 1

1) COPD

2) restrictive disorders are generally difficult to reverse with therapy

Question 2

_______ helps distinguish restrictive ventilatory defects from obstructive ventilatory defects.

Answer 2

spirometry

Question 3

What are 2 advantages of flow volume loops over spirometry?

Answer 3

1) FVL studies are a sensitive means of detecting early COPD

2) FVL studies differentiate the anatomic location of flow obstruction

Question 4

What 3 parameters CANNOT be measured directly with spirometry?

Answer 4

1) FRC
2) RV
3) TLC
* can obtain–> TV, VC, insp capacity, insp reserve vol, exp reserve volume

Question 5

What are 3 ways to measure FRC?

Answer 5

1) helium dilution
2) nitrogen washout
3) body plethysmography (uses Boyle’s law)

Question 6

What is the definition of FEV1?

Answer 6

forced expiratory volume in one second; this is the volume of gas that can be exhaled within one second of beginning a forced expiration

Question 7

What is the definition of FVC?

Answer 7

forced vital capacity; this is the volume of gas that can be exhaled during a forced expiratory maneuver

Question 8

What is FEV1/FVC?

Answer 8

a ratio that is useful in distinguishing between restrictive and obstructive diseases

Question 9

What are the main diseases categorized as obstructive?

Answer 9

1) asthma
2) COPD
- -> chronic bronchitis (blue bloater)
- -> emphysema (pink puffer)
* airways are obstructed

Question 10

What are the main diseases categorized as restrictive?

Answer 10

1) pulmonary fibrosis
2) pneumothorax
3) chest wall disease (scoliosis)
4) neuromuscular diseases (amyotrophic lateral sclerosis, myasthenia gravis)
* expansion of lungs and/or chest wall is restricted

Question 11

What is considered a normal FEV1/FVC ratio?

Answer 11

normally is >0.7

Question 12

How can you determine if FEV1 and FVC results indicate an obstructive disease? restrictive disease?

Answer 12

• if BOTH FEV1 and FVC are low AND FEV1/FVC is OBSTRUCTIVE

* if BOTH FEV1 and FVC are low and FEV1/FVC ratio is > or equal to 0.7—> RESTRICTIVE

Question 13

What is a normal FEV1?

Answer 13

> 2L or 80% of predicted; normal patients can expire 80% of their predicted normal value

Question 14

What disorder is MOST common…. restrictive or obstructive?

Answer 14

Obstructive