CVPR Week 5: Pulmonary function tests Flashcards

Question

Air movement deficits in Obstructive lung diseases

Answer 1

Difficulty getting air "**out**"

Answer 2

Difficulty getting air "**in**"

Answer 3

\<70% of FEV1/FVC

Answer 4

Moderately severe

Answer 5

Very severe

Answer 6

* Asthma * COPD/Chronic bronchitis * Ephysema * Bronchiectasis

Answer 7

It may be variable obstruction improving post-bronchodilator

Answer 8

* PFTs may be normal if patient's asthma is under control * Normal spirometry doesn't rule out the disease for this reason * Spirometry can help define the severity of the disease * Bronchodilatory response - increase in FEV1 of 12% and greater than 0.2 L suggests response * Lack of bronchodilator response does not rule out asthma or mean that bronchodilators are not useful * Lung volumes are usually not needed

Answer 9

spirometry may be normal if the patient's asthma is under control and for this reason the disease cannot be ruled out by normal spirometry

Answer 10

* increase in FEV1 of 12% and greater than 0.2 L suggests a response * Lack of a bronchodilator response does not rule out asthma or mean that bronchodilators are not useful

Answer 11

Lung volumes are not usually needed

Answer 12

* A decrease in FEV1 helps define the severity of the disease along with functional status and exacerbations for prognostication * Lack of bronchodilator response does not mean that bronchodilators are of no use * Lung volumes can show hyperinflation (elevated TLC) and air trapping (elevated RV)

Answer 13

TLC and RV

Answer 14

not needed as a routine test but is useful in defining restrictive lung diseases

Answer 15

means hyperinflation and increased RV air trapping

Answer 16

* Defined as a decrease in lung volume * decreased TLC below the lower limit of normal * FVC and FEV1 are both reduced but the ratio is normal meaning difficulty getting air in and not getting air out

Answer 17

Based on a reduced TLC A decreased VC in the presence of a normal to increased FEV1?FVC ratio is suggestive of restriction but should also have lung volumes to confirm

Answer 18

TLC = \<70 and \>60

Answer 19

TLC = \<60

Answer 20

* Interstital lung disease/pneumoconiosis * scarring and fibrosis of alveolar septae * Loss of lung tissue * Surgical resection * Breathing mechanics * mechanical/neuromuscular disease leads to a restrictive process however the lungs themselves are normal * Obesity * restriction due to the chest wall and abdomen impinging on the thoracic space * lung parenchyma is normal

Answer 21

* restriction due to the chest wall and abdomen impinging on the thoracic space * lung parenchyma is normal

Answer 22

A mechanical/neuromuscular disease leads to a restrictive process however the lungs themselves are normal

Answer 23

Surgical resection

Answer 24

scarring and fibrosis of alveolar septae

Answer 25

Diffusion capacity for Carbon Monoxide

Answer 26

* Assesses the amount of functional alveolar-capillary surface area or how much blood is in the lung available for gas exchange * Used to assess whether lung parenchyma is normal; particularly in restrictive processes * Decrease can be an early sign of pulmonary fibrosis or pulmonary vascular disease

Answer 27

* Obstructive lung disease (emphysema: loss of alveolar surface area) * Restrictive lung disease (interstital lung disease, not usually in obesity or neuromuscular weakness) * Radiation therapy * Amiodarone Bleomycin Nitrofurantoin and other chemotherapies * Pulmonary vascular disease: PE/pHTN

Answer 28

* Interpretation should be made in light of the clinical question * No single test is diagnostic * Results can be affected by patient effort, machine reproducibility, disease state of the patient * Evaluate the quality of the test * Use of prediction equations are based on population studies and may not represent the patient being studied

Answer 29

* The lab should follow ATS recommendations (special training and certification for RTs to perform PFTs * Results should be reproducible * Minimum of 6 seconds exhalation time with a 2-second plateau on a volume-time curve

Answer 30

normal test

Answer 31

* this is obstructed * and looks like they have a bronchodilator response * FEV1/FVC = \<48 so pretty bad and there is a response to bronchodilators

Answer 32

* mildly restrictive and a little DLCO * FEV1 and FVC is reduced but their ratio is normal * DLCO is corrected for anemia

Answer 33

obstructive ↑ Restrictive ↓

Answer 34

Obstructive: ↓↓ Restrictive: ↓

Answer 35

Obstructive: ↓ Restrictive: ↓

Answer 36

Obstructive: ↓ Restrictive: nml/↑

Answer 37

* A disproportionate reduction of maximal airflow with respect to the maximal lung volume * FEV1 decreases more than FVC * Earliest limitation is in small airways (FEF 25-75)