Pulmonary Function Testing Quiz
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Questions and Answers

Which of the following calibration measurements would be unacceptable?

  • 3.02 L
  • 3.15 L (correct)
  • 2.83 L (correct)
  • 2.98 L

    • What is the acceptable range for a calibration check, expressed in milliliters?

  • 90 mL
  • 291 - 309 mL (correct)
  • 29.1 - 30.9 mL
  • 2.91 - 3.09 mL

    • What is the primary purpose of a calibration check?

  • To test for leaks in the equipment.
  • To ensure the patient is using the device correctly.
  • To ensure the device is delivering the correct volume of air. (correct)
  • To assess the patient's lung capacity.

    • What should be done if a device fails a calibration check?

    <p>Service the equipment and repeat the calibration check. (C)</p> Signup and view all the answers

    What is the likely cause of a calibration reading of 2.83 L?

    <p>Possible leak in the equipment. (C)</p> Signup and view all the answers

    What does the term "Scoopy" refer to in this context?

    <p>The shape of the flow-volume curve (C)</p> Signup and view all the answers

    Based on the Figure, does the test show a positive bronchodilator response?

    <p>Yes (C)</p> Signup and view all the answers

    What is the formula used to calculate the bronchodilator response?

    <p>((post-bronchodilator FEV1 - pre-bronchodilator FEV1) / pre-bronchodilator FEV1) * 100 (A)</p> Signup and view all the answers

    Based on the calculation in Table 1.9, does the test show a positive bronchodilator response?

    <p>No (D)</p> Signup and view all the answers

    What percentage change is shown in Table 1.10?

    <p>25% (D)</p> Signup and view all the answers

    What does the term "Restriction" refer to in this context?

    <p>A condition where the lungs are stiff and cannot expand fully (C)</p> Signup and view all the answers

    Based on the percentage change shown in Table 1.10, which of the following classifications is most likely?

    <p>Obstruction (C)</p> Signup and view all the answers

    What are some of the possible causes of a bad spirometry test? (Select all that apply)

    <p>Equipment issue (B), Panting too fast (C), Thermal drift (D)</p> Signup and view all the answers

    What is the formula for calculating the percentage change in FEV1 after a bronchodilator?

    <p>$(PostFEV1 - PreFEV1) / PreFEV1 * 100$ (B)</p> Signup and view all the answers

    Which of the following is a sign of a poor start to a spirometry test?

    <p>Early termination of the test (A)</p> Signup and view all the answers

    What is the significance of a 12% change in FEV1 or a 0.2 L increase in FVC after a bronchodilator?

    <p>It indicates a positive bronchodilator response. (A)</p> Signup and view all the answers

    Which spirometry parameter is not used to measure bronchodilator response?

    <p>FEV1/FVC ratio (C)</p> Signup and view all the answers

    What is the primary cause of a scoop-shaped loop in a spirometry test?

    <p>Vocal cord paralysis (D)</p> Signup and view all the answers

    What is the significance of a skinny loop in a spirometry test?

    <p>The patient has aspirated a foreign object. (B)</p> Signup and view all the answers

    What is the best interpretation for a PFT with the following values: FEV1/FVC = 45%, FEV1 = 37%, FVC = 25%, TLC = 298%, FRC = 175%?

    <p>Emphysema (C)</p> Signup and view all the answers

    In the second PFT interpretation, what is the calculated % predicted for the FEV1?

    <p>94% (B)</p> Signup and view all the answers

    What is the best interpretation for a PFT with the following values: FEV1/FVC = 87%, FEV1 = 99%, FVC = 92%, TLC = 90%, FRC = 96%?

    <p>Mild obstruction superimposed on restrictive process (A)</p> Signup and view all the answers

    In a PFT showing a FEV1/FVC ratio of 78% and an FEV1 of 74%, what degree of severity is indicated?

    <p>Mild (D)</p> Signup and view all the answers

    Which of the following is a valid calculation for determining the MVV?

    <p>MVV = FEV1 x 40 (A)</p> Signup and view all the answers

    What is the appropriate action if variability in a PFT is > 20%?

    <p>Obtain additional maneuvers (C)</p> Signup and view all the answers

    In a PFT, which parameter represents the total lung capacity?

    <p>TLC (C)</p> Signup and view all the answers

    What is the main interpretation of a PFT with the following values: FEV1/FVC = 54%, FEV1 = 74%, FVC = 98%?

    <p>Mixed (C)</p> Signup and view all the answers

    What is the best interpretation for the first PFT, where FEV1/FVC is 48%, FEV1 is 1.5, FVC is 2.1, TLC is 6.5, FRC is 3.5?

    <p>Obstructive (C)</p> Signup and view all the answers

    What best describes the second PFT where TLC is 7.12, RV is 3.6, and DLCO is 12.3?

    <p>Restrictive (A)</p> Signup and view all the answers

    What is the best interpretation for the third PFT, where FRC is 1.86, TLC is 3.99, RV is 1.04, SVC is 2.96?

    <p>Restrictive (A)</p> Signup and view all the answers

    Based on the fourth PFT, what is the best interpretation for the patient's lung function? FRC is 4.26, TLC is 7.71, RV is 3.49, SVC is 4.22.

    <p>Mixed (C)</p> Signup and view all the answers

    In the fourth PFT, why is there no definitive conclusion about the lung function?

    <p>Necessary ratios and % predicted are not provided. (D)</p> Signup and view all the answers

    When determining the acceptability of a pulmonary function test using volume-time and flow-time graphs, what criteria must be met for the test to be considered acceptable?

    <p>Three maneuvers must be performed, all within a range of 0.150 L. (B)</p> Signup and view all the answers

    When assessing the quality of multiple pulmonary function test attempts, which attempt should be considered the best effort?

    <p>The attempt with the highest sum of FVC and FEV1 values. (D)</p> Signup and view all the answers

    What can be concluded from the information provided in the table about the three pulmonary function test efforts?

    <p>Effort 1 shows the highest FVC value, and Effort 2 shows the highest FEV1 value, so the highest value from each should be reported. (C)</p> Signup and view all the answers

    Which of the following is NOT a factor in determining the acceptability of a pulmonary function test?

    <p>The duration of each attempt. (B)</p> Signup and view all the answers

    What is the primary factor in determining the acceptability of a pulmonary function test?

    <p>The consistency and repeatability of the results across multiple attempts. (A)</p> Signup and view all the answers

    Flashcards

    Acceptable Maneuvers

    Tests with 3 maneuvers close in values; differences within 0.150 L.

    Unacceptable Maneuvers

    Tests lacking repeatability; maneuvers disagree by more than 0.150 L.

    Determining Best Effort

    The highest sum of FVC and FEV1 is reported as the best effort.

    Flow/Volume Loops

    Graphical representation to assess lung function during inhalation and exhalation.

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    FRC Graphics

    Displays Functional Residual Capacity in pulmonary testing.

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    Post-Bronchodilator

    The measurement of lung function after bronchodilator administration.

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    Positive Bronchodilator Response

    An increase in lung function values after bronchodilator use, indicating reversible airway obstruction.

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    Forced Vital Capacity (FVC)

    The total amount of air that can be forcibly exhaled after taking a deep breath.

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    Restriction

    A condition where lung capacity is decreased, often measured by lower FVC.

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    Obstruction

    A condition where airflow is blocked, measured by comparing FEV1 to FVC ratios.

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    Large Airway Obstruction

    Narrowing or blockage in the larger air passages of the lungs, affecting airflow.

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    Poor Effort

    An unreliable lung function test result due to inadequate effort by the patient.

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    Spirometric Results

    Data recorded from spirometry testing which evaluates lung function.

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    Good Effort in Spirometry

    A successful spirometry test characterized by straight lines that overlap.

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    Poor Effort Indicators

    Factors like significant coughing, variable flow, and early termination showing poor quality of spirometry tests.

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    Bad Test Graphs

    Graphs that are bent and open in the middle, indicating incorrect technique or equipment issues.

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    Causes of Poor Spirometry Results

    Includes equipment calibration issues and bad technique such as panting too fast or too deep.

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    FEV1 Measurement

    A key measurement in spirometry that represents forced expiratory volume in 1 second.

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    Bronchodilator Response

    A positive result indicated by a 12% change in FEV1 or a 0.2 L increase in FVC after medication.

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    Bronchodilator Calculation Formula

    The formula to calculate percentage change: (Post-FEV1 - Pre-FEV1) / Pre-FEV1 x 100.

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    FEV1/FVC Ratio Use

    The FEV1/FVC ratio should not be used to measure bronchodilator response.

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    FEV1

    Forced Expiratory Volume in 1 second; measures how much air can be forcibly blown out in one second.

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    FVC

    Forced Vital Capacity; the total amount of air exhaled forcefully after taking a deep breath.

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    TLC

    Total Lung Capacity; the maximum amount of air the lungs can hold after a deep breath.

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    DLCO

    Diffusing capacity of the lungs for carbon monoxide; indicates how well oxygen passes from lungs to blood.

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    Air Trapping

    Condition where air gets trapped in the lungs, leading to increased Residual Volume (RV).

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    Poor Patient Effort

    Insufficient effort by a patient during a test impacting results.

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    Calibration Check

    A daily assessment ensuring equipment accuracy using a 3-liter syringe.

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    Calibration Limits

    Calibration must be within 2.91 to 3.09 liters to be valid.

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    Acceptable Calibration Example

    Calibration of 2.98 L is valid for use, within limits.

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    Unacceptable Calibration Example

    Calibration of 2.83 L or 3.15 L cannot be used and indicates issues.

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    Maximum Voluntary Ventilation (MVV)

    The maximum amount of air an individual can breathe in one minute, predicted using reference values.

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    FVC (Forced Vital Capacity)

    The total amount of air exhaled forcefully after taking a deep breath.

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    FEV1/FVC Ratio

    The percentage of the FVC that is exhaled in the first second; used to diagnose obstructive and restrictive lung diseases.

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    Pulmonary Function Test (PFT) Interpretation

    Assessment of various lung volumes to classify lung disease type and severity.

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    TLC (Total Lung Capacity)

    The total volume of air in the lungs after maximum inhalation.

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    FRC (Functional Residual Capacity)

    The volume of air remaining in the lungs after normal exhalation.

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    Lung Disease Types

    Includes obstructive (like asthma) and restrictive (like pulmonary fibrosis) lung diseases, interpreted by PFT results.

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    Study Notes

    Pulmonary Function Testing - Graphics Interpretation and Quality Control

    • Pulmonary function testing uses graphs and charts to evaluate test acceptability, determine which results to report, and ensure good effort.
    • Key aspects include interpreting flow-volume loops, pre/post bronchodilator spirometry, and FRC graphics.

    Determining Acceptability

    • Acceptable maneuvers: Three maneuvers are very close in range, with two maneuvers agreeing within 0.150 L.
    • Unacceptable maneuvers: Three maneuvers demonstrate lack of repeatability, with maneuvers not agreeing within 0.150 L.

    Acceptable or Not?

    • Curves are evaluated to ensure the highest sum of FVC and FEV1 values.
    • The highest sum is considered the acceptable effort.

    What Is Reported?

    • The largest FVC and FEV1 values from acceptable maneuvers are reported.
    • Reported values are from the best effort maneuver, regardless of which maneuver produces the highest result.

    Determining Good Effort

    • A good effort is characterized by a smooth flow-volume loop in which the "FEFmax" or "PEFR" shows a rapid fall and all components of the test are completed smoothly without interruptions
    • "Poor effort" shows a poor execution and is incomplete with interruptions.

    Poor Start of Test

    • A poor start is characterized by an incomplete and irregular start to the flow-volume loop.

    Significant Coughing

    • Significant coughing during the test results in an irregular flow-volume loop, with pauses and unusual patterns.

    Variable Flow

    • A variable flow pattern during the test shows a fluctuating pattern of flow, without clear trends.

    Early Termination

    • Early termination is indicated by an abrupt stop to the flow-volume loop, before completion of the test.

    FRC Graphics

    • Proper technique results in straight lines on FRC graphics, overlapping smoothly.
    • Bent or open lines indicate problems such as equipment issues, thermal drift (temperature calibration), or improper technique.

    Calibration Checks

    • Calibration checks should be performed daily.
    • 3-liter calibration syringes are used at varying speeds, but consistent volumes.
    • Documentation of calibration checks and leak testing is essential.
    • Calibration must fall between 2.91-3.09 L to be considered acceptable. Problems outside this range may indicate equipment issues.
    • Syringes with the standardized volumes are used for calibration checks.

    Quality Control (QC)

    • Biologic quality control uses healthy non-smokers for test validation.
    • Establish the mean and standard deviation for FVC and FEV1.
    • Measured values should fall within +/- 2 standard deviations of the mean.
    • Remedial measures are required if values fall outside the acceptable range.
    • Time sweep testing is used for verifying equipment degradation over time.
    • Equipment function is checked over its full range of operation.

    Calculations Required to Report Results

    • Calculations convert exhaled air to body temperature to obtain accurate results.
    • Air outside the body is different from air in the body and correction is required.

    Maximum Voluntary Ventilation (MVV)

    • MVV testing involves deep and rapid breathing for 12-15 seconds to estimate maximal breathing capacity.
    • Techniques are needed to maintain accuracy.
    • At least two efforts are needed, and repeatability of +/-10% is needed.
    • The highest acceptable value is reported.

    Calculating MVV

    • Extrapolate the expired volume to one minute.
    • MVV = FEV1 x 40

    More Interpretation Practice

    • Various examples of measured results and interpretation of pulmonary function tests (PFTs) are examined.

    What is the best interpretation for this PFT?

    • Different tables with predicted and measured values for PFTs and analysis of the possible diagnoses are presented. Obstructive, and restrictive disorders and various causes are listed.

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    Pulmonary Function Testing PDF

    Description

    Test your knowledge on pulmonary function testing with a focus on graphics interpretation and quality control. This quiz covers key aspects such as acceptable maneuvers, evaluating curves, and reporting results from spirometry. Dive in to enhance your understanding of these critical concepts in respiratory health.

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