PFT test 1 review with complete solutions
(TLC) and (RV) is considered normal when values are between what numbers? -
ANSWER-80%-120%
A 40 year-old woman presents to her primary care provider complaining of increasing
dyspnea on exertion. She has never had syncope but notes occasional chest pain with
exertion. She is a never-smoker and has no concerning occupational or other
environmental exposures. She is sent for pulmonary function testing, which reveals
normal spirometry and lung volumes but a decreased DLCO (45% predicted). Which of
the following would be the most appropriate initial follow-up test for this patient? -
ANSWER-Echocardiography
A 42 year-old woman who recently moved to the United States from South Africa
presents with dyspnea and is found to have a large goiter. If the goiter is compressing
the upper portion of her trachea outside the chest cavity and the tracheal lumen varies
in diameter between inhalation and exhalation, which of the following findings would you
expect to see on her flow-volume loop? - ANSWER-Flattening of the inspiratory limb
A 51 year-old woman with no prior tobacco use presents to his primary care provider for
evaluation of chronic cough and dyspnea over a several month period. She is referred
for pulmonary function testing which reveals FEV1 1.6L (59% predicted), FVC 1.8 L
(60% predicted) and FEV1/FVC 0.89. Her total lung capacity is 3.0 L (60% predicted).
Which of the following statements correctly characterizes the observed abnormality? -
ANSWER-restrictive defect
A 58 year-old man who formerly work as a hard-rock miner presents to his primary care
physician with dyspnea on exertion. She orders pulmonary function tests, which show a
mixed obstructive-restrictive defect. Which of the following patterns on pulmonary
function testing would be consistent with this pattern of test results? - ANSWER-FEV1
FVC FEV1/FVC TLC RV DLCO
Low Low Low Low Normal Low
A 60 year-old man presents for evaluation of decreasing exercise tolerance. Pulmonary
function testing reveals a decreased total lung capacity with a normal diffusion capacity
for carbon monoxide. Which of the following studies would be most appropriate to order
to follow-up these test results? - ANSWER-Maximum inspiratory and expiratory
pressures
A 60 year-old man presents to clinic with a one-year history of dyspnea on exertion. He
has a 50 pack-year history of tobacco use and is noted on exam to have diffuse
expiratory wheezes and a prolonged expiratory phase. His chest x-ray shows large lung
volumes, flattened hemi-diaphragms and decreased lung markings in the bilateral upper
lobes. Which of the following patterns on pulmonary function testing would be consistent
with these findings? - ANSWER-FEV1 FVC FEV1/FVC TLC RV DLCO
Low Low Low Normal High Low
, A 61 year-old man with a 40 pack-year history of smoking presents to his primary care
provider for evaluation of chronic dyspnea. Office spirometry is performed and reveals
FEV1 (1.5L) 45% predicted, FVC (3.2L) 75% predicted and FEV1/FVC 0.47. Which of
the following statements correctly characterizes the observed abnormality? - ANSWER-
obstructive defect
A 72 year-old man with is sent to the pulmonary function testing laboratory for
evaluation for worsening dyspnea on exertion. His testing reveals an FEV1 (1.3L) 32%
predicted, FVC (1.8L) 39% predicted, FEV1/FVC 0.72, TLC 49% predicted and a DLCO
50% predicted. Which of the following would be the most appropriate follow-up test for
this patient? - ANSWER-High resolution chest CT scan
A bronchodilator response is defined as a _____ ______ _____ _____ increase in the
FEV1 or FVC - ANSWER-200 mL and 12%
A CT pulmonary angiogram would be used to rule out pulmonary embolism. When you
see a restrictive pattern with a normal DLCO, upright and supine spirometry can be
used to determine if a patient has diaphragmatic weakness while maximum inspiratory
and expiratory pressures can be used to assess for respiratory muscle weakness. -
ANSWER-
A normal DLCO in a patient with restriction would indicate that restriction is due to
something outside the lungs (e.g - ANSWER-e.g., chest wall or neuromuscular
disorders).
A patient can be described as having "air trapping" on their pulmonary function testing
when which of the following findings is present? - ANSWER-Increased residual volume
A patient has pulmonary function testing performed and is found to have a low FEV1
and FVC with a preserved FEV1/FVC ratio, a reduced total lung capacity and a
decreased DLCO. This pattern would be consistent with which of the following
diagnoses? - ANSWER-Idiopathic Pulmonary Fibrosis
A patient is deemed to have "hyperinflation" on their pulmonary function testing when
which of the following findings is present? - ANSWER-Increased TLC
Differential Emptying From The Two Lungs (Panel D): In some cases, one lung empties
normally on exhalation, while emptying of the other lung is delayed due to some
process occluding the airway. In such cases, the flow volume loop will appear to have
two phases: (1) a rapidly descending portion of the expiratory limb representing
emptying of the normal lung and (2) a flat portion of the expiratory limb represents the
delayed emptying on the obstructed side. Such a pattern might be seen with a tumor
obstructing one of the mainstem bronchi. - ANSWER-
(TLC) and (RV) is considered normal when values are between what numbers? -
ANSWER-80%-120%
A 40 year-old woman presents to her primary care provider complaining of increasing
dyspnea on exertion. She has never had syncope but notes occasional chest pain with
exertion. She is a never-smoker and has no concerning occupational or other
environmental exposures. She is sent for pulmonary function testing, which reveals
normal spirometry and lung volumes but a decreased DLCO (45% predicted). Which of
the following would be the most appropriate initial follow-up test for this patient? -
ANSWER-Echocardiography
A 42 year-old woman who recently moved to the United States from South Africa
presents with dyspnea and is found to have a large goiter. If the goiter is compressing
the upper portion of her trachea outside the chest cavity and the tracheal lumen varies
in diameter between inhalation and exhalation, which of the following findings would you
expect to see on her flow-volume loop? - ANSWER-Flattening of the inspiratory limb
A 51 year-old woman with no prior tobacco use presents to his primary care provider for
evaluation of chronic cough and dyspnea over a several month period. She is referred
for pulmonary function testing which reveals FEV1 1.6L (59% predicted), FVC 1.8 L
(60% predicted) and FEV1/FVC 0.89. Her total lung capacity is 3.0 L (60% predicted).
Which of the following statements correctly characterizes the observed abnormality? -
ANSWER-restrictive defect
A 58 year-old man who formerly work as a hard-rock miner presents to his primary care
physician with dyspnea on exertion. She orders pulmonary function tests, which show a
mixed obstructive-restrictive defect. Which of the following patterns on pulmonary
function testing would be consistent with this pattern of test results? - ANSWER-FEV1
FVC FEV1/FVC TLC RV DLCO
Low Low Low Low Normal Low
A 60 year-old man presents for evaluation of decreasing exercise tolerance. Pulmonary
function testing reveals a decreased total lung capacity with a normal diffusion capacity
for carbon monoxide. Which of the following studies would be most appropriate to order
to follow-up these test results? - ANSWER-Maximum inspiratory and expiratory
pressures
A 60 year-old man presents to clinic with a one-year history of dyspnea on exertion. He
has a 50 pack-year history of tobacco use and is noted on exam to have diffuse
expiratory wheezes and a prolonged expiratory phase. His chest x-ray shows large lung
volumes, flattened hemi-diaphragms and decreased lung markings in the bilateral upper
lobes. Which of the following patterns on pulmonary function testing would be consistent
with these findings? - ANSWER-FEV1 FVC FEV1/FVC TLC RV DLCO
Low Low Low Normal High Low
, A 61 year-old man with a 40 pack-year history of smoking presents to his primary care
provider for evaluation of chronic dyspnea. Office spirometry is performed and reveals
FEV1 (1.5L) 45% predicted, FVC (3.2L) 75% predicted and FEV1/FVC 0.47. Which of
the following statements correctly characterizes the observed abnormality? - ANSWER-
obstructive defect
A 72 year-old man with is sent to the pulmonary function testing laboratory for
evaluation for worsening dyspnea on exertion. His testing reveals an FEV1 (1.3L) 32%
predicted, FVC (1.8L) 39% predicted, FEV1/FVC 0.72, TLC 49% predicted and a DLCO
50% predicted. Which of the following would be the most appropriate follow-up test for
this patient? - ANSWER-High resolution chest CT scan
A bronchodilator response is defined as a _____ ______ _____ _____ increase in the
FEV1 or FVC - ANSWER-200 mL and 12%
A CT pulmonary angiogram would be used to rule out pulmonary embolism. When you
see a restrictive pattern with a normal DLCO, upright and supine spirometry can be
used to determine if a patient has diaphragmatic weakness while maximum inspiratory
and expiratory pressures can be used to assess for respiratory muscle weakness. -
ANSWER-
A normal DLCO in a patient with restriction would indicate that restriction is due to
something outside the lungs (e.g - ANSWER-e.g., chest wall or neuromuscular
disorders).
A patient can be described as having "air trapping" on their pulmonary function testing
when which of the following findings is present? - ANSWER-Increased residual volume
A patient has pulmonary function testing performed and is found to have a low FEV1
and FVC with a preserved FEV1/FVC ratio, a reduced total lung capacity and a
decreased DLCO. This pattern would be consistent with which of the following
diagnoses? - ANSWER-Idiopathic Pulmonary Fibrosis
A patient is deemed to have "hyperinflation" on their pulmonary function testing when
which of the following findings is present? - ANSWER-Increased TLC
Differential Emptying From The Two Lungs (Panel D): In some cases, one lung empties
normally on exhalation, while emptying of the other lung is delayed due to some
process occluding the airway. In such cases, the flow volume loop will appear to have
two phases: (1) a rapidly descending portion of the expiratory limb representing
emptying of the normal lung and (2) a flat portion of the expiratory limb represents the
delayed emptying on the obstructed side. Such a pattern might be seen with a tumor
obstructing one of the mainstem bronchi. - ANSWER-
