WVSOM -- Introduction to Pulmonary Function Testing
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| How are lung volumes typically changed in emphysema? | emphysema increases lung volumes
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| How are lung volumes typically changed in pulmonary fibrosis? | fibrosis causes decreased lung volumes
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| How is airway resistance typically affected in emphysema? | Increased resistance due to loss of elastic fibers
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| How is airway resistance typically affected in pulmonary fibrosis? | increased resistance by increased radial traction
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| What are the two main categories of pulmonary function test? | ventilatory capacity and dection of hypoxemia
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| What are the two ways to test ventilatory capacity? | forced expiration and lung volumes
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| What are the 4 tests for detection of hypoxemia? | blood gases, V/Q scan, ventilation inequality and diffusion capacity
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| What are lung volumes like in obstructive lung disease? | large lung volumes
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| What is airway resistance like in obstructive lung disease? | increased airway resistance
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| What are lung volumes like in restrictive lung disease? | small lung volumes
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| What is airway resistance like in restrictive lung disease | normal airway resistance
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| What test differentiates from obstructive vs. restrictive disease? | forced expiration
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| What is measured from a forced expiration? | FEV1 and FVC
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| What is FEV1? | vol exhaled in 1st second
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| What is FVC? | total vol exhaled
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| What happens to FEV in obstructive disease? | decreased
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| What happens to FVC in obstructive disease? | decreased
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| What happens to FEV1 in restrictive disease? | decreased
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| What happens to FVC in restrictive disease? | decreased
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| What happens to the FEV1/FVC ratio in obstructive disease? | decreased
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| What happens to the FEV1/FVC ratio in restrictive disease? | normal or elevated
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| What is normal FEV1/FVC ration? | 0.8
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| What factors determine the FEV1? | lung volume, airway resistance and airway collapse
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| What restricts FEV1 in obstructive disease? | increased airway resistance
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| What restricts FEV1 in restrictive disease? | low lung volume
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| What decreases FVC in obstructive disease? | earlier airway collapse
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| What decreases the FVC in restrictive disease? | low Total Lung Copacity
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| What is normal forced expiratory flow rate? | 3.5L/sec
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| Does Forced expiratory flow rate increase or decrease in obstructive disease? | decrease
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| Does forced expiratory flow rate increase or decrease in restrictive disease? | increase
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| What do you use to measure functional residual capacity? | helium dilution
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| Why is helium used to measure functional residual capacity? | it is nearly insoluble in blood
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| What tests are used to assess the presence or causes of hypoxemia? | blood gas measurement, ventilation-perfusion inequality and diffusion capacity
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| Why do you measure functional residual capacity? | needed for absolute lung volume
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| What is a V/Q scan? | identifies regional reductions in ventilation or perfusion
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| How do you measure the diffusion capacity? | Measure the rate of disappearance of CO from alveolar gas during a 10 sec breath hold
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| Under what situation does DLCO not work? | if there is regional inequality because CO doesn’t’ get to the alveoli
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| How can ventilation inequality be revealed? | by changes in expired N2 concentration following a single breat of pure O2
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| What is expired N2 concentration with equal ventilation? | initially there is no nitrogen but then N2 concentration increases and plateus
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| What is expired N2 concentration with inequality of ventilation? | Initially there is no nitrogen but the concentration rises at the end of expiration
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| What is the DLCO in emphysema? | decreased
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| What is DLCO in astma and chronic bronichitis? | normal
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| What is DLCO in instersitial fibrosis? | decreased
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| What is DLCO in chest wall abnormality and neuromuscular problems? | normal DLCO
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