Resp new (clinical)

Question 1

Name 2 bronchial challenge tests, including substance administered + threshold

Answer 1

1) Bronchoprovocation test (methacholine) –> check for airway hyperresponsiveness (^resistance) - 20% increase in FEV1 = positive
2) Bronchodilator reversibility (SABA) - monitor for improvement, 12% FEV1 %predicted threshold

Question 2

DLCO helps differentiate between…

Answer 2

Intrapulmonary & extrapulmonary causes of RESTRICTIVE lung disease

Question 3

Respiratory muscle dysfunction (e.g. opiate overdose, TBI, GBS) would manifest on spirometry as ___ lung disease

Answer 3

Restrictive

Question 4

Restrictive lung disease = reduced lung ___

Answer 4

Compliance (impaired ability to expand)

Question 5

Obstructive lung disease = increased….

Answer 5

Increase resistance to airflow (narrowing or airways)

Question 6

Bronchiectasis is a ___ (obstructive/restrictive) lung disease

Answer 6

Obstructive!

Large airways are dilated by small/medium airways (most of tree) have thickening of bronchial wall –> obstruction

Question 7

How does FEV1 change in obstructive vs restrictive lung disease?

Answer 7

Obstructive: FEV1 = reduced
Restrictive: FEV1 = increased (recoil!)

Question 8

Pneumonia/pulmonary edema are ___ lung diseases

Answer 8

Restrictive (alveoli filled, can’t expand/comply normally)

Question 9

Restrictive lung disease can be ___ (e.g. ILD) or ____ (e.g. obesity, ALS, pregnancy)

Answer 9

Intrinsic (parenchymal)

Extrinsic (extrapulmonary)

Question 10

What condition may show a “scoop” shape on a flow-volume loop?

Answer 10

Emphysema (peripheral/lower airway obstruction)

Question 11

If DLCO is the only abnormal thing it’s probably an issue with

Answer 11

The blood

Question 12

FEV1/FVC of what = obstruction?

Answer 12

<0.7 (actual value!)

or

Question 13

After FEV1/FVC indicates there’s an obstruction, what value indicates the SEVERITY of obstruction? I.e…

Answer 13

FEV1 (% PREDICTED!)
>70 = mild
60-69 = mod, 50-59 = modsev, 35-49 = sev, <35 = very sev :(((((

Question 14

What 2 lung volumes are essential to look at on PFT and what do they tell you?

Answer 14

TLC (low = restriction, high = hyperinflation)

RV (low =restriction, high = gas-trapping)

Question 15

Fixed airway obstruction shows ____ on flow-volume loop

Answer 15

Flattening

Question 16

If FEV1/FVC is normal, then look at…

Answer 16

FVC to see if there is a restriction (if both FEV1 & FVC are low the ratio may be normal, restrictive disease)