Pulmonary Function Tests (Selby)

Question 1

What is tidal volume?

Answer 1

Volume of air inspired and expired with each normal breath

Question 2

What is Forced vital capacity (FVC)?

Answer 2

Amount of air that can be forcefully expelled beginning with the lungs completely full and blowing maximally until the lungs are as empty as possible

Question 3

What is Forced expiratory volume in first second (FEV1)?

Answer 3

Amount of air expelled during the first second of the FVC maneuver

Question 4

What is Residual volume (RV)?

Answer 4

Volume of air remaining in lungs after most forceful expiration

Question 5

What is Total lung capacity (TLC)?

Answer 5

Maximum volume to which lungs can be expanded with inspiration

Question 6

Spirometry with flow volume curves or loops is a component of Pulmonary Function Tests (PFTs) that includes measurement of?

What are the specific measurements?

Answer 6

1) Exhaled or inhaled air during forced maneuvers

2) FVC, FEV1, and FEV1/FVC ratio

Question 7

What FEV1/FVC ratio is obstructive lung disease defined as?

Answer 7

FEV1/FVC < 0.70

Question 8

Flow volume curve is a graphic display of?

Flow volume loop is a graphic display of?

Answer 8

1) Expiratory flow only

2) Both expiratory and inspiratory flow

Question 9

Lung volumes and capacities is a component of PFT that is measured by different techniques but most commonly by?

What are the specific measurements?

Answer 9

1) Body plethysmography

2) TLC and RV

Question 10

Diffusing capacity of lung for carbon monoxide (DLCO) is a component of PFT that measures?

Answer 10

Gas exchange through alveolar wall

Question 11

Bronchodilator therapy is a component of PFT that is used only in?

If >12% increase in FEV1 or FVC AND an absolute volume increase of >200 ml

Answer 11

Obstructive lung disease to determine if airway obstruction is reversible

If Yes, patient has Asthma
If No, Patient has COPD or other obstructive disease

Question 12

Bronchoprovocation is a component of PFT that is used when?

What is the most commonly technique used?

Answer 12

1) If PFT results are normal but physician still suspects asthma
2) Methacholine challenge

Question 13

Methacholine is a synthetic analogue to?

It stimulates what receptors on airway smooth muscle cells leading to bronchoconstriction?

Answer 13

1) Acetylcholine

2) Muscarinic receptors

Question 14

What does the expiratory flow look like on a normal flow volume curve and normal flow volume loop?

What does the inspiratory flow look like on a normal flow volume loop?

Answer 14

1) Rapid rise and linear fall

2) Saddle shaped

Question 15

What is the Flow Volume Curve pattern for obstruction?

For restriction?

Answer 15

1) Concave or scooping pattern

2) Peaked, Steeple, or Witch’s hat pattern

Question 16

COPD (chronic bronchitis, emphysema), Asthma, Bronchiectasis, and Bronchiolitis are all characteristic of?

Answer 16

Obstructive lung disease

Question 17

Abnormalities of chest wall or pleura (kyphosis, scoliosis, obesity), drugs, interstitial lung disease and neuromuscular disease are all characteristic of?

Answer 17

Restrictive lung disease

Question 18

What will we find on spirometry for obstructive lung disease PFT?

Answer 18

1) FEV1/FVC ratio < 0.70

2) Flow volume curve with “Concave or scooped pattern”

Question 19

What will we find on Lung Volumes and capacities for obstructive lung disease PFT?

Answer 19

1) Increase in TLC from air trapping

2) Increase in RV from air trapping

Question 20

What will we find on DLCO for obstructive lung disease PFT?

Answer 20

1) Low in emphysema

2) Normal in asthma and bronchitis

Question 21

What is a positive Bronchodilator response determined by?

If they have a positive response what is the diagnosis?

If they have a negative response what is the diagnosis?

Answer 21

1) ≥ 12% increase in FEV1 or FVC and an absolute volume increase of ≥ 200 ml
2) Asthma
3) COPD

Question 22

What will we find on spirometry for restrictive lung disease PFT?

Answer 22

1) FVC < 80% predicted
2) FEV1/FVC ratio is normal to > 0.70
3) Flow volume curve with “Peaked, steeple, or witch’s hat pattern

Question 23

What will we find on Lung Volumes and capacities for restrictive lung disease PFT?

Answer 23

1) Decrease in TLC

2) Decrease in RV

Question 24

What will we find on DLCO for restrictive lung disease PFT?

Answer 24

1) Low in interstitial lung disease

2) Normal in neuromuscular or chest wall abnormalities

Question 25

What is mixed PFT patterns?

A mixed pattern is present if what values are low?

Answer 25

1) Both restrictive and obstructive lung disease

2) FEV1/FVC ratio and TLC