Spirometry - Test Your Knowledge (Workbook)

Question 1

How many hours prior to spirometry testing should the patient avoid smoking?

A. 1
B. 8
C. 12
D. 24

Answer 1

A. 1 hour

*page B-6

Question 2

The technologist is performing spirometry testing for a patient who is on 2 L/min of oxygen in the home. The procedure is performed with room air and the patient is having difficulty completing the test. The technologist should

A. place the patient on 2L/min for 20 minutes and then attempt the test again

B. inform the physician that the patient cannot perform the test without oxygen

C. place the patient on 2L/min between maneuvers

D. re-schedule the test when the patient is not as short of breath

Answer 2

C. place the patient on 2L/min between maneuvers.

*page B-8

Question 3

Which of the following is considered the best measurement to diagnose restrictive disease?

A. tidal volume
B. inspiratory capacity
C. expiratory reserve volume
D. vital capacity

Answer 3

D. vital capacity

Question 4

The following volumes are reported for a patient:

TLC     5.4
IRV     2.6
ERV     1.0
FRC     2.0
RV     1.0
VC     4.2
Vt     0.6
IC     3.2

Which of the following capacities is erroneous?

A. TLC
B. VC
C. FRC
D. IC

Answer 4

A. TLC

Question 5

The technologist is performing a post bronchodilator spirometry test on a 68 year old man. The patient completed the SVC capacity maneuver without incident, however the patient fainted during the FVC maneuver. The most likely explanation is that

A. the patient is malingering
B. a vaso-vagal response occurred on exhalation
C. the patient had a positive response to the bronchodilator
D. peripheral air trapping occurred.

Answer 5

B. a vaso-vagal response occurred on exhalation

Question 6

Which of the following tests is considered the best application for monitoring patients with asthma to measure gross changes in airway function before and after a bronchodilator?

A. peak expiratory flow monitoring
B. spirometry before and after the bronchodilator
C. airways resistance measurement in the body box
D. FEF 25-75 measurement from spirometry testing

Answer 6

A. peak expiratory flow monitoring

Question 7

The technologist is evaluating the results of a post-bronchodilator study and notes that the FVC and the FEV1 both increase dramatically after bronchodilator administration. However, the FEF 25-75 measurement has actually decreased. These results are most commonly cause by

A. high airways resistance
B. poor patient effort
C. dramatic increase in the FVC measurement
D. incorrect calculation of the FEF 25-75

Answer 7

C. dramatic increase in the FVC measurement

If the FVC increases, the FEF 25-75 will move further down the curve and appear to be worse.

Question 8

The results of a flow-volume loop study indicate that the expiratory flow curve is normal, however the inspiratory flow curve is decreased. Based upon these results, the technologist should interpret these results as

A. variable extrathoracic obstruction
B. fixed airway obstruction
C. variable intrathoracic obstruction
D. small airway obstruction

Answer 8

A. variable extrathoracic obstruction

Question 9

A 48 year old female patient has a measured MVV value of 102 L/min or 60% of predicted. The patient’s measured FEV1 is 4.2L/min. Which of the following best describes the MVV value?

A. high airways resistance
B. poor patient effort.
C. obstructive lung disease
D. results were not temperature corrected.

Answer 9

B. poor patient effort

FEV1 x 35 should be close to the patients MVV if a good effort is given.

*page B-21

Question 10

A 78 year old male patient has the following results from pre and post bronchodilator spirometry testing:

FVC:
Pre: 3.86
Post: 3.91

FEV1:
Pre: 2.65
Post: 3.04

The change in the patient’s FEV1 post bronchodilator is

A. 10%
B. 12%
C. 15%
D. 20%

Answer 10

C. 15%

Question 11

The following spirometry results were obtained from a 32 year old female:

FVC
Predicted 4.5
Measured 3.15
% of predicted 70%

FEV1
Predicted 3.37
Measured 3.03
% of predicted 90%

FEV1/FVC
Predicted 75%
Measured 96%

These results are most indicative of

A. normal pulmonary function
B. obstructive lung disease
C. restrictive lung disease
D. both obstructive and restrictive lung disease

Answer 11

C. restrictive lung disease

Question 12

The following spirometry results were obtained from a 62 year old male

FVC
Predicted 3.94
Measured 3.16
% of predicted 80%

FEV1
Predicted 2.75
Measured 1.78
% of predicted 65%

FEV1/FVC
Predicted 70%
Measured 56%

These results are most indicative of

A. normal pulmonary function
B. obstructive lung disease
C. restrictive lung disease
D. both obstructive and restrictive lung disease

Answer 12

B. obstructive lung disease

Question 13

The following spirometry results were obtained from a 6’2 tall 22 year old male:

FVC
Predicted 5.2
Measured 4.7
% of predicted 90%

FEV1
Predicted 4.16
Measured 3.95
% of predicted 95%

FEV1/FVC
Predicted 80%
Measured 84%

A. normal pulmonary function
B. obstructive lung disease
C. restrictive lung disease
D. both obstructive and restrictive lung disease

Answer 13

A. normal pulmonary function

Question 14

The following spirometry results were obtained from a 5 year old girl with a history of cystic fibrosis:

FVC
Predicted 1.5
LLN 1.2
Measured 1.3

FEV1
Predicted 1.4
LLN 1.0
Measured 0.8

Peak Flow
Predicted 3.5
LLN 2.5
Measured 2.0

LLN = “lower limit of normal”

These results are most indicative of

A. normal pulmonary function
B. obstructive lung disease
C. restrictive lung disease
D. both obstructive and restrictive lung disease

Answer 14

B. obstructive lung disease

You don’t need to caluculate if a lower limit of normal is given. Anything below that limit is abnormal. VC is normal, FEV1 and FEV1/FVC ratio is below normal. This is indicative of obstructive lung disease.

Question 15

The following spirometry results were obtained from a 9 year old boy with a history of intermittent asthma:

FVC
Predicted 2.0
LLN 1.6
Measured 1.8

FEV1
Predicted 1.8
LLN 1.5
Measured 1.6

Peak Flow
Predicted 5.0
LLN 4.0
Measured 4.5

These results are most indicative of

A. normal pulmonary function
B. obstructive lung disease
C. restrictive lung disease
D. both obstructive and restrictive lung disease

Answer 15

A. normal pulmonary function

All of the measured values are above the lower limit of normal.

Question 16

The following spirometry results were obtained from a 45 year old patient with a history of dyspnea:

SVC:
Predicted: 4.0
Measured: 2.2

FEV1:
Predicted: 2.8
Measured: 2.0

FEV1/FVC:
Predicted: 70%
Measured: 91%

These results are most indicative of

A. mild obstructive dysfunction
B. moderate obstructive lung disease
C. moderate/severe restrictive lung disease
D. severe restrictive lung disease

Answer 16

C. moderate/severe restrictive lung disease

SVC is 2.2 of a predicted 4.0, which is 55% of predicted. Other values are normal.

<80 is mild
<70 is moderate
<60 is moderate/severe
<50 is severe
<35 is very severe

Question 17

The following spirometry results were obtained from a 59 year old patient:

SVC:
Predicted: 4.5
Measured: 2.92

FEV1:
Predicted: 3.15
Measured: 2.85

FEV1/FVC:
Predicted: 70%
Measured: 97%

These results are most indicative of

A. mild restrictive dysfunction
B. moderate obstructive lung disease
C. moderate restrictive lung disease
D. severe restrictive lung disease

Answer 17

C. moderate restrictive lung disease

SVC is between 60%-70% of predicted. FEV1/FVC ratio is normal. Disregard FEV1 because FEV1/FVC ratio is a better value to assess.

<80 mild
<70 moderate
<60 moderate/severe
<50 severe
<35 very severe

Question 18

The following spirometry results were obtained from a 59 year old patient:

SVC:
Predicted: 4.5
Measured: 4.15

FEV1:
Predicted: 3.15
Measured: 0.95

FEV1/FVC:
Predicted: 70%
Measured: 23%

These results are most indicative of

A. mild obstructive and restrictive dysfunction
B. very severe obstructive lung disease
C. moderate/severe lung disease
D. severe restrictive lung disease

Answer 18

B. very severe obstructive lung disease

FEV1/FVC ratio is below 35% of predicted. Ignore FEV1 because the ratio is a better value to use. SVC is not <80% of predicted so it is normal.

<80 mild
<70 moderate
<60 moderate/severe
<50 severe
<35 very severe

Question 19

The following spirometry results were obtained from a 66 year old patient:

SVC:
Predicted: 3.5
Measured: 2.63

FEV1:
Predicted: 2.45
Measured: 1.74

FEV1/FVC:
Predicted: 70%
Measured: 66%

These results are most indicative of

A. mild obstructive and restrictive dysfunction
B. very severe obstructive lung disease
C. moderate/severe lung disease
D. severe restrictive lung disease

Answer 19

A. mild obstructive and restrictive dysfunction

SVC between 70-80%. mild restrictive

FEV1/FVC under 70% moderate obstructive

*page B-30

<80 mild
<70 moderate
<60 moderate/severe
<50 severe
<35 very severe

Technically, the restriction is mild, but the obstruction should be classified as moderate (66%). Choice A (although not exactly correct) is the most accurate of the 4 answer choices.

This problem is written exactly as found on page B-30 #19 in the workbook.

Question 20

The following spirometry results were obtained from a 74 year old patient:

SVC:
Predicted: 3.2
Measured: 2.6

FVC:
Predicted: 3.2
Measured: 3.0

FEV1:
Predicted: 2.24
Measured: 0.9

FEV1/FVC:
Predicted: 70%
Measured: 30%

These results are most indicative of

A. mild pulmonary dysfunction
B. very severe obstructive lung disease
C. moderate/severe lung disease
D. severe obstructive lung disease

Answer 20

B. very severe obstructive lung disease

SVC above 80% of predicted. (normal)
FVC above 80% of predicted. (normal)

Ignore FEV1, you have FEV1/FVC ratio.

FEV1/FVC ratio is 30% (very severe obstruction)

<80 mild
<70 moderate
<60 moderate/severe
<50 severe
<35 very severe