1. PFT of the Day!

2. Results indicate a mild restrictive lung disorder.
What conclusions can you draw from the following data, obtained on a 32-year-old 53 kg woman admitted for elective surgery?
ACTUAL PRED %PRED | ACTUAL PRED %PRED
TLC % |FVC %
FRC % |FEV1% 84% 75%
RV % |FEF200– %
VC % |FEF 25%–75% %
Results indicate a mild restrictive lung disorder.
Results indicate normal pulmonary function.
Results indicate a combined disease process.
Results indicate generalized airway obstruction.

3. Results indicate generalized airway obstruction.
What conclusions can you draw from the following data, obtained on a 67-year-old 76 kg man admitted for pulmonary complications arising from silicosis?
Results indicate generalized airway obstruction.
Results indicate normal pulmonary function.
Results indicate a combined disease process.
Results indicate a restrictive lung disorder.
Actual
Predicted
% Predicted
TLC
4.34
7.73
56%
FRC
1.73
4.36
40% RV
1.45
2.63
55% VC
2.89
4.74
61%
FVC
2.86
60%
FEV1
96%
75%
FEF
6.89
6.71
103%
FEF 25%-75%
2.78
2.88

4. Results indicate small airway obstruction.
What conclusions can you draw from the following data, obtained from a 41-year-old man who admits to "occasional smoking" but otherwise reveals no past history of pulmonary problems?
Results indicate small airway obstruction.
Results indicate generalized airway obstruction.
Results indicate a restrictive lung disorder.
Results indicate a combined disease process.
Actual
Predicted
% Predicted
TLC
4.75
4.90
97&
FRC
2.31
2.21
105% RV
1.28
1.20
106% VC
3.48
3.63
96%
FVC
2.96
82%
FEV1
80%
75%
FEF
4.33
5.45
FEF 25%-75%
1.95
3.37
58%

5. The following pulmonary function results are obtained for patient:
Predicted   Observed  % Predicted
Which of the following is the most likely conclusion?
A.severe obstructive pattern
B.severe restrictive pattern
C.mild obstructive pattern
D.mild restrictive pattern
EXPLANATIONS:
(c) A. The significantly decreased FEV1, FEV1/FVC%, and FEF25-75% indicate severe obstruction.
(u) B. Although the FVC is reduced, the TLC is actually 1.1 L larger than expected.
(u) C. Mild obstruction is characterized by smaller decreased flows and an FEV1/FVC ratio in the range of 60-70%.
(u) D. Although the FVC is markedly reduced, the TLC is increased by 1.1 L.

6. A.interstitial fibrosis. B.emphysema. C.chronic bronchitis.
The information below was obtained from the pulmonary function report for a 40-year-old male who weighs 73 kg (161 lb) and is 177 cm (5 ft 9 in) tall: There is no significant response to the bronchodilator. These data most strongly suggest
A.interstitial fibrosis.
B.emphysema.
C.chronic bronchitis.
D.cystic fibrosis.
EXPLANATIONS:
(c) A. Reduced vital capacity suggests restrictive defect. Reduced diffusing capacity and lack of obstruction make this the most likely diagnosis.
(u) B. The FEV1/FVC of 90% does not indicate an obstructive component, which may rule out emphysema, even though FVC and DLCO may be reduced with emphysema.
(u) C. Individuals with chronic bronchitis usually have an obstructive defect characterized by a reduced FEV1/FVC and a response to bronchodilator therapy. Chronic bronchitis does not cause a reduction in diffusing capacity.
(u) D. Although individuals with cystic fibrosis may have a reduced vital capacity and DLCO, the FEV1/FVC ratio of 90% is inconsistent with this diagnosis.

7. C. small airway obstruction D. pulmonary fibrosis
Spirometry testing reveals results below: With which of the following are these values the most consistent?
A. acute asthma
B. normal lung function
C. small airway obstruction
D. pulmonary fibrosis
EXPLANATIONS:
(u) A. During an acute asthma episode, pulmonary function results are consistent with an obstructive defect.
(c) B. These results are within normal limits.
(u) C. In small airway obstruction, the FEF 25-75% is typically less than 70% of predicted.
(u) D. With a diagnosis of pulmonary fibrosis, pulmonary function results are consistent with a restrictive defect.

8. B.restrictive disease only C.obstructive disease only
A patient has the pulmonary function results shown below: Which of the following is the most appropriate interpretation of these results?
A.bronchitis
B.restrictive disease only
C.obstructive disease only
D.mixed restrictive and obstructive disease
EXPLANATIONS:
(u) A. Bronchitis is usually associated with an obstructive pulmonary function pattern and does not cause a decrease in total lung capacity.
(c) B. These values are consistent with a restrictive pattern only. Lung volumes are reduced. Peak flow and MVV are normal or better. FEV1/FVC is normal.
(u) C. The decreased VC and TLC indicate restrictive disease. FEV1/FVC is normal, not reduced as in obstructive disease.
(u) D. The flow values are not consistent with an obstructive disease component.

9. Obstruction
The Internet Journal of Pulmonary Medicine ISSN:
Variability In The Interpretation Of Pulmonary Function Tests

10. The Internet Journal of Pulmonary Medicine ISSN: 1531-2984
Variability In The Interpretation Of Pulmonary Function Tests

11. The Internet Journal of Pulmonary Medicine ISSN: 1531-2984
Variability In The Interpretation Of Pulmonary Function Tests

12. The Internet Journal of Pulmonary Medicine ISSN: 1531-2984
Variability In The Interpretation Of Pulmonary Function Tests

13. The Internet Journal of Pulmonary Medicine ISSN: 1531-2984
Variability In The Interpretation Of Pulmonary Function Tests