Pulmonary Function tests
a 55 YR old male with history of interstitial fibrosis undergoes PFT. what parameter would most likely be decreased in this restrictive lung disease patient?
A. FVC
B. Peak expiratory flow rate
C. FEV1
D. FEV1/FVC
E. fraction of expired O2
A. FVC
Presence of air or gas in the pleural space
Pneumothroax
Causes of respiratory mechanics ( extrapulmonary, normal DLCO, normal A-a gradient)
respiratory muscle weakness : polio, MG, Gullian Barre syndrome, ALS
chest wall abnormalities: scoliosis , severe obesity
Name 3 pathology types of emphysema and where in the lungs they effects
2. panacinar: lower lobes. assct with a1-antritrypsin.
3. distal : distal alveoli. assctd with spontaneous pneumothorax.
A 49-year-old man has a pulmonary embolism that completely blocks blood flow to his left lung. As a result, which of the following will occur?
(A) Ventilation/perfusion (V/Q) ratio in the left lung will be zero
(B) Systemic arterial PO2 will be elevated
(C) V/Q ratio in the left lung will be lower than in the right lung
(D) Alveolar PO2 in the left lung will be approximately equal to the PO2 in
inspired air
(E) Alveolar PO2 in the right lung will be approximately equal to the PO2 in
venous blood
D. Alveolar PO2 in the left lung will equal the PO2 in inspired air. Because there is no blood flow to the left lung, there can be no gas exchange between the alveolar air and the pulmonary capillary blood. Consequently, O2 is not added to the capillary blood
Pulmonary vascular resistance should be assessed when the effects of lung volume on pulmonary perfusion are minimal. When is this most likely to occur ?
A. At high intrapleural pressures
B. at high alveolar pressure
C. at residual volume
D. at functional residual capacity
E. at total lung capacity
D. at fxnl residual capacity
Which of the following is the site of highest airway resistance?
(A) Trachea
(B) Largest bronchi
(C) Medium-sized bronchi
(D) Smallest bronchi
(E) Alveoli
The answer is C . The medium-sized bronchi actually constitute the site of highest resistance along the bronchial tree. Although the small radii of the alveoli might predict that they would have the highest resistance, they do not because of their parallel arrangement. In fact, early changes in resistance in the small airways may be “silent” and go undetected because of their small overall contribution to resistance.
Predominantly affects black female population. characterized by widespread noncaseating granulomas
-
Acute severe bronchospasm – bronchospasm that is not reversed by usual treatment measures
Status asthmaticus
Pulmonary emboli typically originate here
Deep veins of lower legs
A hypoxemic 50-year-old man with an increased alveolar–arterial O2 gradient is given 100% O2 via a face- mask, causing arterial PO2 to increase to >500 mm Hg. Results of a lung-diffusing capacity test were normal. what is likely cause of hypoxemia?
Ventilation/Perfusion mismatch
decreased FVC & TLC
Excess water in the lungs
Pulmonary edema
Hypersecretion of mucus and chronic productive cough that lasts for at least 3 months of the year and for at least 2 consecutive years
Chronic bronchitis
Name one risk factor for pulmonary emboli
Venous stasis
Hypercoagulability
Injuries to the endothelial cells that line the vessels
B-Adrenergic receptor agonists cause which of the following effects on pulmonary function?
A. Decreased forced vital capacity
B. Decreased total lung capacity
C. Increased diffusing capacity
D. Bronchiolar constriction
E. Bronchiolar dilation
E. B -adrenergic receptor agonists relax airway smooth muscle, promoting bronchiolar dilation
Alveoli are well ventilated, but lack perfusion. This causes what?
Alveolar dead space
mixed type III/IV hypersensitivity rxn to environmental antigen.
- seen in farmers & bird handlers.
-causes dyspnea, cough, chest tightness, fever, HA
Hypersensitivity pneumonitis
Abnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls
Emphysema
This can be caused by chronic lung disease or chronic hypoxemia
Pulmonary artery hypertension
Which volume remains in the lungs after a tidal volume (VT) is expired? (A) Tidal volume (VT)
(B) Vital capacity (VC)
(C) Expiratory reserve volume (ERV)
(D) Residual volume (RV)
(E) Functional residual capacity (FRC) (F) Inspiratory capacity
(G) Total lung capacity
E. FRC
During normal breathing, the volume inspired and then expired is a tidal volume (VT). The volume remaining in the lungs after expiration of a VT is the functional residual capacity (FRC).
A 58-year-old woman presents with a right-to-left shunt caused by a pulmonary arteriovenous malformation. Which of the following variables would you predict to be increased in this individual?
A. Arterial dissolved O2 content
B. Alveolar–arterial O2 difference
C. Venous PO2
D. Arterial PO2
E. Oxyhemoglobin levels
B. Right-to-left shunts allow blood to pass from the right to the left heart without being oxygenated.
Characterized by acute lung injury and inflammation and alveocapillary membrane injury leading to pulmonary edema
ARDS
A 16-year-old boy presents with shortness of breath after his family adopts a new pet. His pulmonologist suspects an underlying allergy-induced asthma and orders a pulmonary function test. Which of following is most likely to have decreased in this boy?
A. Tidal volume
B. Expiratory reserve volume
C. Forced vital capacity
D. Inspiratory capacity
E. FEV1 (forced expiratory volume in 1 second)
E. Allergy-induced asthma is associated with airway narrowing and obstruction
Right ventricular enlargement secondary to pulmonary artery hypertension
Cor pulmonale