Deck 5: Pulmonary Function Measurements

Question 1

Which of the following is the major feature of pulmonary obstructive disease?

A) Increased RV
B) Reduced maximum expiratory flow rate
C) Decreased VC
D) Increased TLC

Answer 1

Reduced maximum expiratory flow rate

Question 2

A pulmonary function study is performed on a 68-year-old man suspected of having emphysema.The physician requests that the study be performed to measure FRC.
Upon completion of both the helium dilution and body plethysmography it is found that the FRC obtained via body plethysmography is higher than that obtained via helium dilution.What is the probable explanation for the difference in obtained FRC values?

A) Body plethysmography overestimates FRC.
B) Helium dilution measures only the true FRC.
C) Body plethysmography measures only gas that is in communication with unobstructed airways while helium dilution measures all gas in the chest.
D) Body plethysmography measures all gas in the chest while helium dilution measures only gas that is in communication with unobstructed airways.

Answer 2

Body plethysmography measures all gas in the chest while helium dilution measures only gas that is in communication with unobstructed airways.

Question 3

Which of the following methods to measure gas in the lungs is based on Boyle's law?

A) Helium dilution
B) End-tidal CO₂
C) Nitrogen washout
D) Body plethysmography

Answer 3

Body plethysmography

Question 4

Which of the following mechanisms primarily explains the increased WOB in obstructive diseases?

A) Loss of elastance
B) Increased airway resistance
C) Loss of compliance
D) Increased airflow

Question 5

Which of the following is the major feature of pulmonary restrictive disease?

A) Increased RV
B) Reduced maximum expiratory flow rate
C) Decreased lung volumes and capacities
D) Increased TLC

Question 6

Lung function is considered normal when values are within what range of predicted?

A) 80% to 120%
B) 100% to 120%
C) 60% to 80%
D) 80% to 90%

Question 7

Which of the following conditions is associated with increased FRC and RV?

A) Obstructive
B) Restrictive
C) Mixed
D) Idiopathic

Question 8

Which of the following values cannot be directly measured?

A) RV
B) VC
C) IC
D) VT

Question 9

Which of the following methods allow indirect measurement of RV and capacities containing it?
I.Helium dilution
II.End-tidal CO₂
III.Nitrogen washout
IV.Body plethysmography

A) I, III, IV
B) III, IV
C) I, II, III, IV
D) II, IV

Question 10

Which of the following conditions are associated with restrictive pulmonary disease?
I.Fibrotic lung disease
II.ARDS
III.Skeletal deformities
IV.Asthma

A) I, II, III
B) II, III
C) I, II, III, IV
D) II, III, IV

Question 11

Which of the following mechanisms primarily explains the increased WOB in restrictive diseases?

A) Loss of elastance
B) Increased airway resistance
C) Loss of compliance
D) Increased airflow

Question 12

Which of the following conditions is classified as a restrictive pulmonary disease with normal compliance?

A) ARDS
B) Pulmonary fibrosis
C) Neuromuscular disease
D) Pneumonia

Question 13

Which of the following methods allows measurement of gas in the lung of a patient with obstructed airways?
I.Helium dilution
II.End-tidal CO₂
III.Nitrogen washout
IV.Body plethysmography

A) I, III
B) IV
C) III
D) I, IV

Question 14

What is the normal RV/TLC value in healthy adults up to age 49?

A) 5% to 10%
B) 10% to 15%
C) 20% to 25%
D) 30% to 35%

Question 15

Which of the following characteristics influence pulmonary function?
I.Age
II.Gender
III.Height
IV.Diet

A) I, III
B) II, III, IV
C) I, II, III
D) II, IV

Question 16

An abnormally increased FRC is typically associated with which of the following conditions?

A) Hyperinflation
B) Increased elastic recoil
C) Increased compliance
D) Pulmonary fibrosis

Question 17

Which of the following are features of plethysmography?
I.It is quite rapid.
II.Successive FRC measurements can be made.
III.It measures ventilated air space.
IV.It measures nonventilated air space.

A) I, II, III
B) I, II, III, IV
C) II, III
D) I, IV

Question 18

Which of the following explains the lack of response to bronchodilators by some patients with severe emphysema?

A) Airway obstruction is caused by severe bronchospasm.
B) Airway obstruction is caused by passive airway compression and collapse during expiration.
C) Airway obstruction is associated with air trapping.
D) Airway obstruction with hyperinflation is not sensitive to bronchodilators.

Question 19

The ability to generate high flow rates depends on which of the following factors?
I.Muscle strength
II.Airway patency
III.Neurological function
IV.Diaphragmatic function

A) I, II, III
B) II, III, IV
C) I, II, III, IV
D) II, III, IV.

Question 20

Which of the following concepts apply to FVC?
I.It is the most frequently performed pulmonary function test.
II.It provides much information about large and small airway function.
III.It is an effort-dependent test.
IV.A test is assumed valid if the person can repeat three FVC maneuvers with a variation no greater than 10%.

A) III, IV
B) I, II, III
C) I, II, IV
D) I, II, III, IV

Question 21

Which percentage of the total airway resistance depends on small airways less than 2 mm?

A) 10%
B) 20%
C) 30%
D) 40%

Question 22

Which of the following tests is considered more sensitive for detection of small airway obstruction than FEF_25-75% or FEV₁?

A) PEF
B) The volume of isoflow (V_isoV.)
C) FEV₁/FVC
D) Dynamic compliance

Question 23

How long does it take a normal individual to exhale 100% of the FVC?

A) 2 to 4 seconds
B) 4 to 6 seconds
C) 1 to 2 seconds
D) 6 to 8 seconds

Question 24

Which of the following tests is considered the most sensitive for early detection of abnormal small airways resistance?

A) FEF_25-75%
B) Frequency dependence of compliance
C) Closing volume
D) Low-density gas spirometry

Question 25

What is the normal amount of FVC expired during FEV? in a healthy adult?

A) 67%
B) 83%
C) 94%
D) 97%

Question 26

Which of the following are characteristics of PEF?
I.It reflects large airway function.
II.PEF in normal adults may exceed 10 L/sec.
III.It is an effort-dependent test.
IV.PEF is useful in assessing gross changes in airway function and evaluating the response to bronchodilator drugs.

A) III, IV
B) I, II, III
C) I, II, IV
D) I, II, III, IV

Question 27

According to the GOLD guidelines, a patient with COPD is classified as stage III (severe) in the presence of which of the following spirometric values?

A) FEV1 30% to 50% and FEV1/FVC < 70%
B) FEV1 < 50% and FEV1/FVC < 70%
C) FEV1 50% to 80% and FEV1/FVC < 70%
D) FEV1 < 80% and FEV1/FVC < 60%

Question 28

The MMV is relatively unaffected by which of the following respiratory conditions?

A) Obstructive
B) Restrictive
C) Mixed
D) Idiopathic

Question 29

Which of the following statements are true of the FEF_25-75%?
I.It is more sensitive to flow coming from medium to small airways.
II.Normal FEF_25-75% for a healthy young adult is approximately 4 to 5 L/sec.
III.It does not have more variance than other measures of flow.
IV.Because the FEF_25-75% is so variable, its validity is questionable.

A) III, IV
B) I, II, III
C) I, II, IV
D) I, II, III, IV

Question 30

Which of the following values indicates significant airway obstruction?

A) FEV₁/FVC < 85%
B) FEV₁/FVC < 80%
C) FEV₁/FVC < 75%
D) FEV₁/FVC < 65%

Question 31

Which of the following conditions define an obstructive impairment?

A) A low FEV₁ and a low FEV₁/FVC ratio
B) A high FEV₁ and a low FEV₁/FVC ratio
C) A low FEV1 and a high FEV₁/FVC ratio
D) A normal FEV₁ and a low FEV₁/FVC ratio

Question 32

The maximum voluntary ventilation reflects the overall integrated function of which of the following parameters?
I.Ventilatory apparatus
II.Muscle strength
III.Endurance
IV.Airway diameter, lung compliance, and neural control mechanisms

A) III, IV
B) I, II, III
C) I, II, IV
D) I, II, III, IV

Question 33

Which of the following conditions define a restrictive impairment?

A) A low FEV₁ and a low FEV₁/FVC ratio
B) A high FEV₁ and a low FEV₁/FVC ratio
C) A low FEV₁ and a normal FEV₁/FVC ratio
D) A normal FEV₁ and a low FEV₁/FVC ratio

Question 34

A 52-year-old woman who was diagnosed with pulmonary emphysema 7 years ago and who smokes two packs of cigarettes a day is brought to the emergency department.She complains of having the flu 2 weeks earlier and that her breathing has become more difficult since then.Her pulmonary function test reveals the following results:

(A value equal to or greater than 80% of the predicted value is considered normal.)
What condition do these pulmonary function results suggest?

A) Obstructive
B) Restrictive
C) Mixed
D) Neuromuscular disease