RUPPEL’S MANUAL OF PULMONARY FUNCTION
TESTING 2026 CERTIFICATION EVALUATION
TEST PAPER QUESTIONS SOLUTIONS GRADED
A PLUS
◉ what of the lung diseases are more common?
Answer: obstructive lung diseases
◉ obstructive lung diseases are primarily disorders of what?
Answer: airways(asthma, COPD, bronchiectasis, and bronchiolitis)
◉ restrictive lungs diseases are a result of what?
Answer: restrictive pathophysiology(parenchymal lung diseases,
abnormalities of chest wall and pleura, neuromuscular disease)
◉ what are disorders of the pumonary vasculature?
Answer: pulmonary embolism, pulmonary HTN, and pulmonary
veno-occlusive disease
◉ what do pulmonary function tests(PFTs) include?
,Answer: spirometry, spirometry before and after bronchodilator,
lung volumes, quantitation of diffusing lung capacity for carbon
monoxide(DLCO)
◉ what is the initial PFT to get due to its availability at most clinics?
Answer: spirometry
◉ what does spirometry assess?
Answer: if flow is obstructive
◉ what is spirometry a key diagnostic test in?
Answer: astma, COPD, and chronic cough(to see if its due to asthma)
◉ what all is spirometry useful in monitoring?
Answer: astma, COPD, interstitial lung disease, neuromuscular
diseases affecting respiratory muscles
◉ spirometry is what kind of test?
Answer: an effort-dependent test
◉ what does spirometry measure that is diagnostic of obstruction?
Answer: diminished forced expiratory volume in 1 sec(FEV1)/forced
vital capacity(FVC)
,◉ what is the flow volume loop?
Answer: effort independent
◉ what are some indications for PFTs?
Answer: 1-diagnose pulmonary disease
2-assess change in lung function 3-preoperative evaluation in
reversible airway disease(asthma) or COPD
4-monitor occupational lung exposures
5-evaluate severity of resp disease
6-evaluation of impairment or disability
7-evaluate effects of various drugs
◉ when are flow-volume loops obtained?
Answer: when stridor is heard over neck, and for evaluation of
unexplained dyspnea
◉ airway obstruction located in pharynx, larynx, or trachea(upper
airways) are impossible to detect usually with what maneuvers?
Answer: FVC
◉ what do you use for upper airway obstruction evaluation?
, Answer: Flow-Volume loops
◉ what is Total Lung Capacity(TLC)?
Answer: total volume of air contained in the lungs
◉ what is functional residual capacity(FRC)?
Answer: volume of air left at the end of normal expiration
◉ what is residual volume(RV)?
Answer: volume of air left in the lungs at the end of forced
expiration(amount of air that cannot be breathed out
◉ what is vital capacity?
Answer: difference between the largest TLC and smallest RV
◉ what is TLC determined by?
Answer: ability of the inspiratory pump(brain, nerves, muscle) to
expand chest wall and lungs
◉ any breakdown of ability of the inspiratory pump to function will
result in what?
Answer: smaller TLC(restrictive lung disease)
TESTING 2026 CERTIFICATION EVALUATION
TEST PAPER QUESTIONS SOLUTIONS GRADED
A PLUS
◉ what of the lung diseases are more common?
Answer: obstructive lung diseases
◉ obstructive lung diseases are primarily disorders of what?
Answer: airways(asthma, COPD, bronchiectasis, and bronchiolitis)
◉ restrictive lungs diseases are a result of what?
Answer: restrictive pathophysiology(parenchymal lung diseases,
abnormalities of chest wall and pleura, neuromuscular disease)
◉ what are disorders of the pumonary vasculature?
Answer: pulmonary embolism, pulmonary HTN, and pulmonary
veno-occlusive disease
◉ what do pulmonary function tests(PFTs) include?
,Answer: spirometry, spirometry before and after bronchodilator,
lung volumes, quantitation of diffusing lung capacity for carbon
monoxide(DLCO)
◉ what is the initial PFT to get due to its availability at most clinics?
Answer: spirometry
◉ what does spirometry assess?
Answer: if flow is obstructive
◉ what is spirometry a key diagnostic test in?
Answer: astma, COPD, and chronic cough(to see if its due to asthma)
◉ what all is spirometry useful in monitoring?
Answer: astma, COPD, interstitial lung disease, neuromuscular
diseases affecting respiratory muscles
◉ spirometry is what kind of test?
Answer: an effort-dependent test
◉ what does spirometry measure that is diagnostic of obstruction?
Answer: diminished forced expiratory volume in 1 sec(FEV1)/forced
vital capacity(FVC)
,◉ what is the flow volume loop?
Answer: effort independent
◉ what are some indications for PFTs?
Answer: 1-diagnose pulmonary disease
2-assess change in lung function 3-preoperative evaluation in
reversible airway disease(asthma) or COPD
4-monitor occupational lung exposures
5-evaluate severity of resp disease
6-evaluation of impairment or disability
7-evaluate effects of various drugs
◉ when are flow-volume loops obtained?
Answer: when stridor is heard over neck, and for evaluation of
unexplained dyspnea
◉ airway obstruction located in pharynx, larynx, or trachea(upper
airways) are impossible to detect usually with what maneuvers?
Answer: FVC
◉ what do you use for upper airway obstruction evaluation?
, Answer: Flow-Volume loops
◉ what is Total Lung Capacity(TLC)?
Answer: total volume of air contained in the lungs
◉ what is functional residual capacity(FRC)?
Answer: volume of air left at the end of normal expiration
◉ what is residual volume(RV)?
Answer: volume of air left in the lungs at the end of forced
expiration(amount of air that cannot be breathed out
◉ what is vital capacity?
Answer: difference between the largest TLC and smallest RV
◉ what is TLC determined by?
Answer: ability of the inspiratory pump(brain, nerves, muscle) to
expand chest wall and lungs
◉ any breakdown of ability of the inspiratory pump to function will
result in what?
Answer: smaller TLC(restrictive lung disease)
