Deck 2: Spirometry

Question 1

A patient being evaluated for disability has the following spirometry results: What do these findings indicate?

A) The patient has moderate obstructive disease.
B) The patient has restriction.
C) The patient's FEV₁ is larger than measured.
D) The patient did not make a good effort on the MVV.

Answer 1

A

Question 2

A 22-year-old patient with dyspnea performs three spirometry trials. The pulmonary function technologist should do which of the following?

A) Report the values from Trial 3.
B) Report the largest sum of FVC and FEV₁.
C) Average the data from Trials 2 and 3.
D) Perform at least one more maneuver.

Answer 2

D

Question 3

A subject produces the following simple spirometry results: These findings are consistent with:

A) Combined obstruction and restriction
B) Moderate obstructive disease
C) Normal lung function
D) Incorrectly selected predicted values

Answer 3

C

Question 4

Which answer is consistent with the flow-volume curve shown?

A) Normal forced expiratory flow pattern
B) Variable intrathoracic obstruction
C) Airway obstruction
D) Fixed extrathoracic obstruction

Question 5

A subject who complains of shortness of breath has an FVC of 2.57 L,but her VC is 2.99 L.These findings suggest which of the following?

A) Pulmonary fibrosis
B) Chest wall abnormality
C) Emphysema
D) Fixed upper airway obstruction

Question 6

Before bronchodilator studies,inhaled $\beta$ -adrenergic agents should be withheld for how long?

A) 0.5 to 1.5 hours unless corticosteroids are being used
B) 4 to 12 hours for regular or long-acting preparations
C) 24 hours for most inhalers
D) 24 to 48 hours

Question 7

According to the 2005 ATS-ERS repeatability standards,of the three acceptable tracings,the two largest FVC values and the two largest FEV₁ values in a subject with a vital capacity greater or equal to 1.0 L should be within how many milliliters?

A) 50
B) 100
C) 150
D) 200

Question 8

In addition to the FEV₁ and FVC,which of the following is useful in gauging subject effort during spirometry?

A) PEF
B) FEF_50%
C) FEF_25%-75%
D) max₂₅

Question 9

A 17-year-old patient with asthma performs three spirometry trials: The pulmonary function technologist should do which of the following?

A) Report the values from Trial 3.
B) Average the data from Trials 2 and 3.
C) Calibrate the spirometer and repeat all three trials.
D) Perform at least one more maneuver.

Question 10

Which of the following diagnoses is consistent with the following flow-volume curve?

A) Variable intrathoracic obstruction
B) Fixed extrathoracic obstruction
C) Small airway obstruction
D) Normal expiratory and inspiratory flows

Question 11

A 47-year-old man with a history of cough has the following spirometry results: These findings show the presence of which of the following?

A) Reversible airway obstruction
B) Moderate obstructive disease
C) Normal lung function
D) Incorrectly selected predicted values

Question 12

Back extrapolation is the method used to determine "time zero" when measuring which of the following parameters?

A) FVC
B) FEV₁
C) FEF_25%-75%
D) MVV

Question 13

A 50-year-old woman with dyspnea has the following spirometry results: These findings are consistent with which of the following?

A) Reversible airway obstruction
B) Mild obstructive disease
C) Normal lung function
D) Invalid predicted values

Question 14

The FEF_25%-75% depends on which of the following?

A) FVC
B) PEF
C) FEV₁
D) FEV_1%

Question 15

Which answer is consistent with the following flow-volume curve?

A) Normal forced expiratory flow pattern
B) Variable intrathoracic obstruction
C) Airways obstruction
D) Fixed large airway obstruction

Question 16

Why should all values from a series of peak flow measurements be reported?

A) PEF may decrease with repeated efforts.
B) A minimum of three values must be averaged.
C) Peak flowmeters do not need to be precise.
D) Forced exhalation produces a bronchodilator effect.

Question 17

A subject referred for pulmonary function tests because of shortness of breath has an FEV₁ of 98%.This finding is suggestive of:

A) Restrictive lung disease
B) Obstructive lung disease
C) Normal lung function
D) Upper airway abnormality

Question 18

A subject being tested for possible environmental exposure to asbestos produces the following spirometry results: The pulmonary function technologist may conclude that:

A) The patient has restriction.
B) The patient has moderate obstructive disease.
C) The patient's FEV₁ is not valid.
D) The patient did not make a good effort on the MVV.

Question 19

Which answer is consistent with the following three superimposed flow-volume loops?

A) Normal airway function
B) Small airway obstruction
C) Variable intrathoracic restriction
D) Fixed extrathoracic obstruction

Question 20

A subject has spirometry repeated before and after inhaled bronchodilators.The following data are obtained: Which of the following statements best describes these findings?

A) There is mild obstruction with significant response to bronchodilators.
B) There is mild obstruction without significant change after bronchodilators.
C) There is a paradoxical response to bronchodilators.
D) Spirometry is within normal limits.

Question 21

A 52-year-old female has a 30-pack-year history of cigarette smoking and has shortness of breath.Room temperature is 26 $\degree$ C (conversion factor = 1.068). What is the subject's reportable FEV₁ in BTPS conditions?

A) 2.00 L
B) 2.11 L
C) 2.14 L
D) 2.67 L

Question 22

A 48-year-old female complaining of cough has the following spirometry results: How would you interpret her spirometry results?

A) Normal spirometry with no significant response to bronchodilator
B) Mild obstruction with a positive response to bronchodilator
C) Mild obstruction with no significant response to bronchodilator
D) Normal spirometry with a positive response to bronchodilator

Question 23

A 62-year-old female complaining of shortness of breath has the following spirometry results.Ambient temperature is 26 $\degree$ C (conversion factor = 1.068). What is the subject's reportable FEV₁ in BTPS conditions?

A) 2.10 L
B) 2.17 L
C) 2.24 L
D) 2.65 L

Question 24

What is the calculated bronchodilator response in this subject?

A) 39%
B) 6%
C) 1.1 L
D) 71%

Question 25

A 63-year-old male complaining of shortness of breath and muscle weakness has the following pulmonary function results: These findings are consistent with:

A) Normal study
B) Borderline obstruction
C) Neuromuscular weakness (e.g. ,ALS)
D) Mild obstruction

Question 26

A subject has the following spirometry results: What do the results most likely represent?

A) Variable effort
B) Maneuver induced bronchospasm
C) Unacceptable maneuvers
D) Repeatable maneuvers

Question 27

Which of the following would be considered key components of the FVC maneuver?

A) Maximal inspiration,blast of expiration,and complete exhalation
B) Maximal inspiration and exhalation for at least 6 seconds
C) Forceful exhalation,exhalation for at least 6 seconds in adults and 3 seconds in children younger than the age of 10
D) No cough in the first second and a fast start (back extrapolation <150 ml)

Question 28

Which of the following parameters does not have to be corrected to BTPS?

A) FEV₁/FVC ratio
B) FEF_25%-75%
C) FVC
D) FEV₁

Question 29

What are the recommended dosages for assessing bronchodilator response,according to the ATS-ERS spirometry guidelines?

A) Four doses of albuterol (100 µg)or ipratropium bromide (40 µg)
B) Two doses of albuterol (100 µg)or ipratropium bromide (80 µg)
C) Four doses of albuterol (80 µg)or ipratropium bromide (80 µg)
D) Two doses of albuterol (80 µg)or ipratropium bromide (40 µg)

Question 30

A subject performed four acceptable FVC maneuvers. What do the results most likely represent?

A) Variable effort
B) Malingering
C) Inability to understand the test
D) Maneuver-induced bronchospasm

Question 31

A 69-year-old female complaining of cough and shortness of breath has the following pulmonary function results: These findings are consistent with:

A) Severe obstruction
B) Moderate restriction with no evidence of obstruction
C) Severe restriction with concomitant obstruction
D) Variable extrathoracic obstruction

Question 32

The following data were obtained while performing a spirometry test on a 43-year-old patient. What should the technologist do next?

A) Perform another trial.
B) Report the FVC and FEV₁ from Trial 3.
C) Report the FVC and FEV₁ from Trial 2.
D) Report the FVC from Trial 3 and the FEV₁ from Trial 2.