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Pulm by Minnie: AH Update > SM 174a, 175a - Pulmonary Function I, II > Flashcards

SM 174a, 175a - Pulmonary Function I, II Flashcards

1
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

FEV1/FVC increases

A

Restrictive

(Even though both FEV1 and FVC decrease, the ratio increases)

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2
Q

What pressures contribute to Palv?

A

Palv = Ppl + Pel

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3
Q

Which number labels Total Lung Capcity (TLC)?

A

8

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4
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Decreased FEV1

A

Both

But more decrease in obstructive than restrictive

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5
Q

Expiratory airflow is decreased most by what combination of pathophysiologic conditions?

a) low Pel and high Raw
b) high Pel and high Raw
c) low Pel and low Raw
d) high Pel and low Raw

A

a) low Pel and high Raw

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6
Q

Which number labels inspiratory capacity?

A

7

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7
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Increased RV

A

Obstructive

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8
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Increased FRC

A

Obstructive

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9
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Decreased DLCO

A

Restrictive

(May also decrease in obstructive, or stay the same)

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10
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Increased isovolume flow compared with a normal curve

A

Restrictive

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11
Q

Flattening of the inspiratory loop suggests:

a) asthma
b) vocal cord paralysis
c) pulmonary fibrosis
d) pulmonary embolism

A

b) vocal cord paralysis

Inspiratory loop can be flattened by anythign that obstructs the upper (extrathoracic) airway, or inadequate strength of inspiration

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12
Q

Which of the following test results suggests asthma?

  1. Low FEV1/FVC that normalizes after albuterol
  2. Low FEV1/FVC with low diffusing capacity
  3. Normal FEV1/FVC after an irritant challenge
  4. Normal FEV1/FVC with low diffusing capacity
A

a. Low FEV1/FVC that normalizes after albuterol

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13
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

TLC decreases

A

Restrictive

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14
Q

What is normal for FEV1/FVC?

A

~75% in healthy people

Decreases with age

<70% indicates obstructive physiology

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15
Q

How do people with obstructive airflow preserve their FVC, depite obstruction to expiratory air flow?

A

Time compensation

Healthy people can exhale their FVC in ~4 seconds, but people with obstructive physiology may take 8-10 seconds

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16
Q

What does DLCO measure?

A

DLCO = diffusing capacity for carbon monoxide

Measures the diffusing capacity across the alveolar membrane

Measures inhaled CO uptake by hemoglobin
(Known [CO] in inhaled air - measured [CO] inexhaled air = uptaken by Hb

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17
Q

Which curve represents an obstructive defect?

18
Q

Why are lung volumes lower in restrictive lung disease

(Ex: pulmonary fibrosis, asbestosis)

A

Restrictive lung diseases are characterized by fibrosis, which increases the elastic recoil pressure of the lung and decreases compliance

If the lungs do not want to expand and they are eager to recoil, lung volumes will not be as high

19
Q

What causes decreased DLCO?

A

Decreased DLCO = Decreased diffusing capacity

  • V/Q mismatch
    • Empysema
  • Blood loss
    • Anemia
  • Loss of functional blood vessels
    • PE
    • Emphysema
    • ILD (Scarring and fibrosis -> loss of blood vessels)
  • R- > L intracardiac shunt
20
Q

Which number labels Tidal Volume (VT)?

21
Q

What are the 3 tests that measure lung volume?

A

Helium dilution

Nitrogen washout

Body plethysmography

22
Q

Why are lung volumes increased in obstructive lung disease?

A

In obstructive lung disease, there is an impediment to expiratory airflow.

  • Emphysema: decreased elastic recoil makes the lungs bad at pushing air out, and loss of teathering leads to airway collapse
  • Chronic bronchitis, asthma: Increased airway resistance obstructs airflow

Air gets trapped in the lung, thus increasing lung volume

23
Q

Which number labels Inspiratory Reseve Voume (IRV)?

24
Q

Which number labels Residual Volume (RV)

25
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

FEV1/FVC decreases

A

Obstructive

FEV1/FVC <0.7 is indicative of an obstructive defect

26
Q

Which number labels Functional Residual Capacity (FRC)?

27
Q

Which curve represents an obstructive defect?

28
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Decreased Peak Expiratory Flow (PEF)

29
Q

Isovolume airflow is high in:

a) asthma
b) vocal cord paralysis
c) pulmonary fibrosis
d) pulmonary embolism

A

c) pulmonary fibrosis

Isovolume air flow is high in restrictive lung disease

30
Q

Which number labels vital capacity (VC)?

31
Q

What is wrong with this flow-volume curve?

What might be causing this?

A

The inspiratory part of the curve (below the x axis) is too flat

Possible causes:

  • Inadequate strength, effort, or technique during forced inspiration
  • Upper airway obstruction
    • Croup
    • Racheal or laryngeal structures
32
Q

Emphysema is best characterized by:

a) high FEV1/FVC
b) hyperinflation with low DLCO
c) high Pel and low Raw
d) fixed inspiratory and expiratory airflow obstruction

A

b) hyperinflation with low DLCO

33
Q

What causes increased DLCO?

A

Increased DLCO = more gas is uptaken by hemoglobin

  • Due to increased hemoglobin in areas of intact ventilation
    • Alveolar hemorrhage
      • Lupus
      • Cocaine
      • Legionella
      • Any condition that causes bleeding in the lung
    • Polycythemia = too many red blood cells
    • L->R intracardiac shunt
34
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Decreased FVC

A

Restrictive

(May see some decrease in obstructive)

35
Q

Which curve represents a restrictive defect?

36
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Decreased RV

A

Restictive

37
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Decreased FRC

A

Restrictive

38
Q

What does spirometry measure?

A

Expiratory air flow rates

FEV1

FVC

FEV1/FVC

PEF

39
Q

Describe the conditions of maximum expiratory flow

A

High Pel and low Raw

Pel = elastic recoil pressure

Raw = airway resistance

40
Q

Which curve represents a restrictive defect?

41
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

TLC increases

A

Obstructive

42
Q

Is the following characteristic of obstructive lung disease or restrictive lung disease?

Decreased isovolume flow compared with a normal curve

A

Obstructive

Pulm by Minnie: AH Update (34 decks)

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