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Clinical Medicine II > Pulm: PFTs > Flashcards

Pulm: PFTs Flashcards

(54 cards)

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1
Q

What three tests make up the basic PFTs?

A

Airflow Spirometry

Lung Volumes

DLCO

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2
Q

FEF 25-75%

A

Forced Expiratory Flow 25-75%

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3
Q

SVC

A

Slow vital capacity

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4
Q

IC

A

inspiratory capacity

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5
Q

IRV

A

Inspiratory Reserve Volume

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6
Q

FRC

A

Functional Residual Capacity

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7
Q

How many times must spirometry be performed and for what reason

A

3x, it is an operator dependent test

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8
Q

In what position should spirometry be performed?

A

sitting

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9
Q

What is the test procedure for spirometry?

A
  1. relax, breath normally
  2. deep breath in
  3. Forceful exhalation of all air
  4. Deep Breath In
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10
Q

This measurement is most useful for measuring obstruction…

A

FEV1

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11
Q

This measure is the total volume of air with maximal effort

A

FVC

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12
Q

This measure defines the severity of obstruction and assists in differentiating obstructive and restrictive lung disease

A

FEV-1/ FVC Ratio

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13
Q

What measure of FEV-1/FVC is considered an obstructive pattern?

A

< 0.7

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14
Q

This measures the airflow movement during the middle half of forced expiration.

It is nonspecific for small airway obstruction, but may indicate early disease.

A

FEF 25-75%

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15
Q

If this test is positive it:

Aides in Dx
Provides Tx options
Improves Compliance

A

Bronchodilator/Reversibility testing

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16
Q

What indicates reversibility with bronchodilator testing?

A

FEV1 increased by 12% and 200ml

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17
Q

What is the protocol for bronchodilator/reversibility testing?

A
  1. Use neb or inhaler, monitor technique
  2. 2-4 puffs, hold in lungs 5-10 seconds
  3. spirometry after 15 minutes
  4. Repeat 3-8 rounds
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18
Q

What indicates a positive bronchoprovication/methacholine challenge test?

A

FEV-1 decreased by 20%

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19
Q

What is the protocol for the bronchoprovocation/methacholine challenge test?

A
  1. administer dilute methacholine solution via neb.
  2. spirometry at 30 and 90s
  3. increase concentration
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20
Q

Does bronchoprovocation need to be monitored? Methacholine is a part of what drug class that makes this so?

A

Yes

M agonist causes bronchoconstriction

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21
Q

What must be achieved when assessing the quality of the curves in spirometry? (4)

A
  1. volume-time curve plateu
  2. expiration lasting > 6s
  3. two best efforts w/in 0.2:L
  4. flow-volume loop free of artifact
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22
Q

Inspiratory flow > Expiratory flow indicates…

Study These Flashcards
A

obstructive disease

23
Q

Inspiratory flow > Expiratory flow indicates…

Study These Flashcards
A

restrictive lung disease

24
Q

Volume of air within the lung after maximal inhalation…

25
Volume of air we breathe out following maximal inhalation
VC
26
The volume of air remaining in the lungs after maximal exhalation
RV
27
Formula for TLC...
TLC = VC + RV
28
This test: Measures ability of lungs to transfer gas and saturate Hb Uses CO as surrogate for O2 transfer
DLCO
29
What can lead to a false reduction in the DLCO?
anemia
30
How is DLCO measured?
measurement of helium/CO during exhalation
31
DLCO test is administered and the following result achieved: -Little CO collected during exhalation How should these results be interpreted?
``` Healthy lungs (CO exchanged for CO2 in the alveoli, so little CO remains in lungs) ```
32
DLCO test is administered and the following result is achieved: -higher CO levels collected during exhalation How should these results be interpreted?
Diseased lungs | less CO can diffuse, so more remains in the lungs
33
This PFT profile indicates obstructive or restrictive disease? ``` TLC: Increased FVC: Normal RV: Increased FEV-1: Decreased FEV-1/FVC: Decreased ```
Obstructive
34
This PFT profile indicates obstructive or restrictive disease? ``` TLC: Decreased FVC: Decreased RV: Decreased FEV-1: Decreased FEV-1/FVC: Normal/Increased ```
Restrictive
35
Obstructive or restrictive? Airway narrowing --> limited airflow with expiration Reduced airflow with high lung volumes Normal inspiration
Obstructive
36
Obstructive or restrictive? Reduced lung expansion --> Reduced lung volume Inspiration and expiration will appear normal, but flow and volume significantly reduced
Restrictive
37
FEV-1/FVC Decreased...
obstructive
38
FEV-1/FVC increased/normal
Restrictive
39
The following conditions are considered obstructive or restrictive? ``` Asthma Asthmatic bronchitis bronchitis COPD CF Emphysema Upper Airway Obstruction ```
Obstructive
40
The following conditions are considered obstructive or restrictive? ``` Pulm. Fibrosis ILD Thoracic deformity pleural effusion tumor neuromuscular disease obesity ```
Restrictive
41
5 Steps to PFT Interpretation:
1. examine flow-volume curve 2. examine FEV-1 value 3. Examine FEV-1/FVC ratio 4. Examine bronchodilator response 5. Examine DLCO
42
3 things to look for on flow-volume curve...
1. normal appearing? 2. scooped out? (obstructive pattern) 3. increased/peaked slope? (restrictive)
43
On the flow-volume curve, you notice a scooped out appearance. What does this indicate?
Obstructive Lung Disease
44
On the flow-volume curve, you notice the slope is increased with a peak appearance. What does this indicate?
Restrictive lung disease
45
What 3 things should you look for when examining FEV-1 and lung volumes?
1. Normal? r/o obstruction/restriction 2. Decrease by 15-20% from predicted value? Obstruction 3. TLC increased 15-20%? Obstruction
46
What 3 things should be examined when looking at the FEV-1/FVC Ratio
1. Ratio 70% or less? Obstructive 2. Ratio 70%-LLN. 3. Normal/increased? restrictive
47
A normal FEV-1 and lung volumes rules out...
obstruction and restriction
48
A decreased FEV-1 and lung volume by 15-20% of predicted value indicates...
obstruction
49
A TLC increased by 15-20% indicates...
obstruction
50
An FEV-1/FVC ratio 70% or less indicates...
obstruction
51
If FEV-1/FVC ratio is between 70%-LLN, what should you consider?
Mild obstruction Refer to FEV-1 and FEF 25-75% for asthma consideration
52
If FEV-1/FVC is normal to increased, what should you consider?
restrictive disorder
53
When examining bronchodilator response, the FEV-1 increased by 12%. What does this suggest?
hyperreactive, reversible airways
54
What should you look for on DLCO?
normal, increased or decreased?

Clinical Medicine II (31 decks)

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