week 7

Question 1

Whats the purpose of pulmonary function tests?

Answer 1

to look for the presence of lung disease and diagnosis
To grade the severity of a respiratory disorder and show the progress or response to medical treatment
to monitor disease progression over time
to assess risk
to differentiate between different pathologies
to elevate the response to treatment such as bronchodilators/steroids

Question 2

What is the most common PFT?

Answer 2

spirometry

Question 3

What does spirometry show?

Answer 3

abnormalities in lung function, but is not disease specific

Question 4

What is static lung volume?

Answer 4

how much air the lungs can hold

Question 5

What is dynamic lung volumes?

Answer 5

the flow of air through the airways
how fast that volume of air can be moved

Question 6

What are some contraindications for spirometry?

Answer 6

pneumothorax
haemoptysis of unknow origin
aneurysm
recent myocardial infarction or unstable angina
CVS instability
Cerebral instability
recent surgery
recent chest infection
if the patient is too unwell to perform forced expiration

Question 7

What is the spirometry procedure?

Answer 7

sit upright, wearing comfortable loose fitting clothes
after a relaxed breath out, take a maximal breath in
seal your lips around the mouthpiece and blow out as fast and completely as possible

Question 8

What does an acceptable spirogram demonstrate?

Answer 8

quick and forceful exhalation
no coughing
smooth lines on graph
minimum exhalation time of 6 seconds with no change in volume in last second

Question 9

Define total lung capacity

Answer 9

the amount of gas the lungs contain after a maximal inspiratory effort when a person breathes in fully

Question 10

What is the tidal volume?

Answer 10

volume of air normally inhaled or exhaled with each breath during resting, quiet breathing

Question 11

What is the expiratory reserve volume?

Answer 11

Volume of air that can be exhaled with a maximal effort after a normal resisting expiratory breath

Question 12

What is residual volume?

Answer 12

volume of air remaining in the lung after a maximal-effort expiration

Question 13

What inspiratory reserve volume?

Answer 13

The extra volume of air that can be inhaled with maximal effort after a normal resting inspiratory breath

Question 14

What is the equation for inspiratory capacity?

Answer 14

IC = TV + IRV

Question 15

What is inspiratory capacity?

Answer 15

volume of air that can be inhaled with a maximal effort from a resting end expiratory level

Question 16

What is the equation for functional residual capacity?

Answer 16

FRC = RV + ERV

Question 17

What is functional residual capacity?

Answer 17

volume of gas remaining in the lungs at the end of a normal tidal exhalation

Question 18

What is the equation of vital capacity?

Answer 18

VC = IRV + TV + ERV

Question 19

What is vital capacity?

Answer 19

volume from maximal inspiration to maximal expiration

Question 20

Name some factors influencing airway resistance?

Answer 20

types of airflow
lung volume
elastic recoil
bronchial smooth muscle tone
airway obstructions

Question 21

What is forced vital capacity?

Answer 21

the volume expired forcefully (following a maximal inspiration), until residual volume is reached

Question 22

What is forced expiratory volume in one second?

Answer 22

The volume of air a subject can exhale in the first second of a maximal breath out, following a maximal inspiration. This should be approximately 3/4 of the FVC

Question 23

What does the FEV1/FVC ratio look at?

Answer 23

the amount expelled within the first second compared with the overall volume acheived

Question 24

When is FVC considered normal?

Answer 24

the result is considered normal if the score is 80% or more

Question 25

Name some causes of reduced FVC

Answer 25

decreased expansion decreased inspiration muscle strength obesity decreased expiration muscle strength increased airway resistance

Question 26

Name some characteristics of obstructive diseases

Answer 26

limitation of airflow due to partial or complete obstruction

Question 27

Give some examples of obstructive pathologies

Answer 27

emphysema chronic bronchitis bronchiectasis asthma

Question 28

What is the TLC, FVC, FEV1?

Answer 28

TLC = normal FVC = normal or decreased if manoeuvre causes airway collapse FEV1 = decreased

Question 29

What are the characteristics of restrictive diseases?

Answer 29

reduced expansion of lung parenchyma accompanied by decreased total lung capacity

Question 30

Give some examples of restrictive pathologies

Answer 30

interstitial lung disease idiopathic pulmonary fibrosis pneumoconiosis sarcoidosis chest wall neuromuscular disease

Question 31

What is the TLC, FVC and FEV1 of restrictive pathologies?

Answer 31

TLC = decreased FVC = reduced FEV1 = normal or reduced

Question 32

What population group does shortness of breath on exertion effect?

Answer 32

heart failure patients COPD patients Interstitial lung disease

Question 33

What is heart failure?

Answer 33

the pumping ability of the heart has reduced and cant keep up with the workload blood and oxygen may not be circulated around the body as efficiently

Question 34

What can chronic and progressive heart failure be managed by?

Answer 34

medications and lifestyle adapatations

Question 35

How does the heart try to make up for heart failure?

Answer 35

enlarging developing more muscle mass pumping faster

Question 36

How does the body try to compensate for heart failure?

Answer 36

blood vessels narrow The body diverts blood away from less important tissues and organs

Question 37

Name some heart failure symptoms

Answer 37

shortness of breath persistent coughing or wheezing build up of excess fluid in body tissues tiredness and fatigue lack of appetite/nausea confusion and impaired thinking increased HR/palpitations

Question 38

Why do COPD patients become breathless?

Answer 38

COPD is an obstructive condition, bronchioles become inflamed Muscle spasm within the airways, narrowing the area for air to flow excessive mucus production - lining the airways emphysema - break down of the elasticity in the alveoli

Question 39

What type of disease is interstitial lung disease?

Answer 39

restrictive condition

Question 40

What does interstitial lung diseases include?

Answer 40

includes various condition including idiopathic pulmonary fibrosis, sarcoidosis

Question 41

What does interstitial lung disease involve?

Answer 41

fibrosing, scarring and thickening of the lung tissue

Question 42

Why do you exercise?

Answer 42

increase exercise tolerance improves muscle strength reduces breathlessness and fatigue benefits on quality of life other general benefits

Question 43

What is the exclusion criteria for pulmonary rehab?

Answer 43

unstable angina unstable diabetes acute LVF uncontrolled BP uncontrolled arrhythmias history of MI or cardiac surgery in 6 weeks leading up to start of PR mobility limited by musculoskeletal or neurological condition cognitive problems compliance issues (motivation) aortic aneurysm

Question 44

What does exercise in pulmonary rehabilitation involve?

Answer 44

warm up aerobic programme strength training programme cool down

Question 45

Name some health related quality of life tools

Answer 45

chronic respiratory disease questionnaire COPD assessment tool Hospital anxiety and depression scale