PFT Exam 1 (New)

Who invented the water seal?

John Hutchinson

What are the indications for spirometry? (Which ones are NOT on exam)

- Detect the presence or not of lung disease

- History of pulmonary symptoms

- Decreased breath sounds

- Chest wall abnormalities

- Abnormal laboratory findings

[Doesn't measure volume / to determine the size of TLC]

What are the indications for DLCO testing? (Which ones are NOT on exam)

*Sarcoidosis

*Assess vascular disease

*Differentiates types of obstructive diseases

- Tests about surface area (loss with emphysema)

What are the characterizations of obstructive disease? (M)

- Airway obstruction

- Normal or elevated lung volumes

- Decreased expiratory flows

What are the Obstructive Airway Diseases? (Which one is NOT on exam)

COPD

Asthma

Cystic fibrosis

Emphysema

Chronic bronchitis

Bronchiectasis

Upper airway obstruction

How long to abstain from smoking before a PFT?

Refrain from smoking an hour before exam

What is the proper sequence of PFT exam?

Questionnaire

Physical measurements

*ABG

Spirometry

Lung volumes

DLCO

What examples are volume displacing spirometers? (M)

Water Seal

Bellows Factor

Dry Seal

Which volume displacing spirometer is placed vertically?

Water Seal

All flow sensing spirometers are based on the general concept of?

volume = flow x time

Which type of flow sensor is turbine type?

Wrights spirometer

Equations for Lung Capacities

TLC = VT + IRV + ERV + RV

VC = VT + IRV + ERV

IC = VT + IRV

FRC = RV + ERV

What is the color of CO2 scrubber changed when exhausted?

Baralyme: white-purple

Water remover color changes to?

Drierite: blue-pink

What capacity do we start Slow Vital Capacity?

TLC

What is the general predicted data of PFT?

Age, Height, Race, Gender

What is Forced Expiratory Flow (FEF) 25% - 75%?

the average flow during the middle 50% of an FVC maneuver

What do the reduction of FEF 25-75 indicate?

airway obstruction, decreases with obstructive diseases

- most sensitive test to detect the presence of early small airway disease

What is the value of the Flow Volume Loop to clinician? (M)

provides immediate visual feedback about the overall lung pathology

MVV equal to what?

FEV1 x 35

Bronchodilator equation (2)

(Post - Pre) / Pre x 100

- significant improvement is 12% or > in FEV1 or FVC

- 200 mL greater

Obstructive pattern

FVC - 80-120%

FEV1% -

Restrictive pattern

FVC -

Combined pattern

FVC -

What gives us data?

FVC and FEV1%

- indicates if obstructive, restrictive or both

What is a Heated wire flow pneumotach?

based on the concept of cooling effect of gas flow

Know Flow Volume Loops

In addition to FVC/FEV1, which one engages effort?

Peak Expiratory Flow (PEF)

A Pt has COPD and has the following spirometry trials - FVC and FEV1 in each one of them, what do you do?

You want to do best in both categories

FEV % = (FEV1/FVC) x 100

The main indication for the measure of lung volumes is?

- diagnose or asses severity of restrictive lung disease (TLC)

- differentiate between obstructive and restrictive disease

- asses response to therapeutic interventions

- bronchodilators, steroids

- lung transplantation, resection, reduction

- radiation or chemotherapy

Why do we do ABG analysis for COPD patients?

Assess the need for home O2

What activities should be avoided before PFT?

- smoke

- exercise

- eat big meals

What can cause emphysema? (M)

SVC > FVC

What is the number one contraindications for IPPB or pulmonary testing?

Untreated tension pneumothorax

DLCO indications may be indicated to evaluated pulmonary involvement, in which of the following systemic diseases?

Rheumatoid arthritis

Sarcoidosis

Systemic lupus erythematosus (SLE)

Systemic sclerosis

Mixed connective tissue disease

Which of the following PFTs may fall under the Forced Vital Capacity maneuver?

- PEF

- FEF 25-75

- FEV

Why should all Peak Flow Measurement be recorded?

Tells us which one was the Pts best effort

What is a Potentiometer?

- required to record a flow volume loop with volume displacement spirometer

- a device that produces an analog DC voltage signal proportional to its position or displacement

- provides analog outputs for volume and flow

What maneuver do you have to do to get FEV 25-75?

FVC