PFTs, D KInder, DSA

Question 1

What is definition of obstructive ventilatory defect

Answer 1

FEV1/FVC less than 70%

Question 2

What is definition of restrictive ventilatory defect

Answer 2

TLC of 80% or less

FEV1/FVC is increased

Question 3

What are msot important mortality predictors in COPD

Answer 3

postbronchodilator FEV1 and age

Question 4

What is predictive of O2 desaturation with exercise

Answer 4

DLCO less than 50%

Question 5

Best test to evaluate obstructive lung disease

Answer 5

spirometry

Question 6

What FEV1 indicates severe obstruction? mild?

Answer 6

mild is greater than 2L

less than 1L is severe

Question 7

Cuases of obstructive lungs

Answer 7

COPD, asthma, CF, bronchiolitis obliterans

Question 8

When is methacholine challenge used

Answer 8

intermittent obstruction from bronchospasm may not be manifested as dec in FEV1/FVC if at time with no bronchospasm

Question 9

What decrease in FEV1 with methacholine means there is bronchial hyperreactivity

Answer 9

20%

Question 10

Is methacholine test specific?

Answer 10

can have false positives. 95% negative predictive value

Question 11

What can differentiate extrathoracic obstructions from intrathoracic

Answer 11

present of truncated inspiratory curves

Question 12

What data is obtained from spirometry

Answer 12

maximal inhalation followed by maximal exhalation, measuring volume of air and time

Question 13

What do you obtain from helium lung volume test

Answer 13

RV, ERv, IRV, TC with calculation of tLC, VC, FRC and IC

Question 14

What is key factor in restrictive lung diseases

Answer 14

TLC

Question 15

what indicates mild vs severe restrictive lung disease

Answer 15

65-80% mild

less than 50% severe

Question 16

A restrictive ventilatory defet with normal FRC should raise suspicion for what

Answer 16

neuromuscular disease

Question 17

A decrease in FRC indicates what

Answer 17

either noncompliant lung or chest wall pathological condition(obesity or kyphoscoliosis)

Question 18

What does CO diffusion depend on

Answer 18

pp of CO in albeolus

Question 19

What can cause low DLCO

Answer 19

interstitial lung disease and emphysema

CHF with pulm edema, pulmonary HTN and PE

Question 20

What can cause increase in DLCO

Answer 20

polycythemia, pulmonary hemorrhage, early CHF, L-R cardiac shunts

Question 21

What values do you obtain from spirometry

Answer 21

FVC, FEV1, FEV1/FVC, FEF 25-75%

maximal voluntary ventilation

Question 22

The primary abnormality detected by spirometry is what

Answer 22

airway obstruction

Question 23

What is necessaroy to accurately Dx restrictive pathology of lungs

Answer 23

measure lung volumes

Question 24

what are techniques to measure RV

Answer 24

nitrogen washout tecnhique
helium dilution technique
body plethysmography

Question 25

What is the only technique for RV that measures the non-ventilated regions

Answer 25

body plethysmography

Question 26

which lung pathologies have decreased VC

Answer 26

restrictive disease and obstructive disease

Question 27

steady state PCO2 is normally what

Answer 27

38-42

Question 28

steady state HCO3

Answer 28

22-28 mM

Question 29

what is a volatile acid

Answer 29

CO2

Question 30

where does 80-90% HCO3 resorption take place

Answer 30

proximal tubule

Question 31

hypokalemia and high PCO2 stimulate what of HCO3

Answer 31

increased reabsorption