d.
Fixed upper airway obstruction
1. 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
... [Show More] which of the following?
a. Pulmonary fibrosis
b. Chest wall abnormality
c. Emphysema
2. A 47-year-old man with a history of cough has the following spirometry results:
Measured Predicted
FVC (L BTPS) 3.85 4.01
FEV1 (L BTPS) 2.14 3.33
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
3. A 22-year-old patient with dyspnea performs three spirometry trials.
Trial 1 Trial 2 Trial 3
FVC (L BTPS) 4.21 4.49 4.65
FEV1 (L BTPS) 3.88 3.91 3.93
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.
4. 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.
5. Which of the following determines the shape of the “effort-independent” portion of the expiratory F-V curve?
1. Abdominal pressure during forced expiration
2. Elastic recoil of the lung
3. Flow resistance in the small airways
4. Cross-sectional area of the trachea
a. 1 and 2
b. 2 and 3
c. 1, 3, and 4
d. 4 only
6. A patient being evaluated for disability has the following spirometry results:
Measured Predicted
FVC (L) 4.00 4.10
FEV1 (L) 2.00 3.30
MVV (L/min) 105 110
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.
7. Before bronchodilator studies, inhaled -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
8. 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
9. A subject has spirometry repeated before and after inhaled bronchodilators. The following data are obtained:
Predicted Before Drug After Drug
FVC 5.20 4.90 5.30
FEV1 4.10 3.10 3.30
PEF 9.20 7.77 8.92
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.
10. A 50-year-old woman with dyspnea has the following spirometry results:
Measured Predicted
FVC (L BTPS) 3.99 4.10
FEV1 (L BTPS) 3.44 3.33
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
11. A 17-year-old patient with asthma performs three spirometry trials:
Trial 1 Trial 2 Trial 3
FVC (L BTPS) 3.21 3.44 3.49
FEV1 (L BTPS) 2.88 2.91 2.93
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.
12. A subject being tested for possible environmental exposure to asbestos produces the following spirometry results:
Measured Predicted
FVC (L) 4.00 4.07
FEV1 (L) 3.44 3.37
MVV (L/min) 52 135
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.
13. 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
14. 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
15. A subject has an FVC of 1.8 L (39% of predicted). The same individual has a slow VC of 2.7 L. Which of the following might explain these findings?
1. Normal findings in severe restrictive disease
2. Airway compression in obstructive lung disease
3. Poor effort or early termination of the FVC
4. Representative findings in early small airway disease
a. 1, 3, and 4
b. 2 and 3
c. 1 and 4
d. 2 only
Measured Predicted
FVC (L, BTPS) 4.5 4.0
FEV1 (L, BTPS) 3.6 3.2
These findings are consistent with:
a. Combined obstruction and restriction
b. Moderate obstructive disease
c. Normal lung function
d. Incorrectly selected predicted values
16. A subject produces the following simple spirometry results:
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
18. The FEF25%-75% depends on which of the following?
a. FVC
b. PEF
c. FEV1
d. FEV1%
concave appearance because of:
1. Loss of elastic recoil
2. Turbulent gas flow patterns
3. Increased specific conductance
4. Increased airway resistance
a. 1, 2, and 3
b. 2, 3, and 4
c. 2 and 3
d. 1 and 4
19. In diseases that cause obstruction of the small airways, the MEFV curve may assume a
20. A patient produces the following spirometry results:
Actual Predicted
FVC (L) 4.0 4.1
FEV1 ( L) 2.0 3.3
MVV (L/min) 45 110
These findings indicate that:
1. Obstruction is present.
2. Restriction is present.
3. The FEV1 is overestimated.
4. The MVV is underestimated.
a. 1, 2, and 3
b. 2, 3, and 4
c. 1 and 4
d. 2 and 3
21. In addition to the FEV1 and FVC, which of the following is useful in gauging subject effort during spirometry?
a. PEF
b. FEF50%
c. FEF25%-75%
d. max25
22. 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
23. 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
24. Back extrapolation is the method used to determine “time zero” when measuring which of the following parameters?
a. FVC
b. FEV1
c. FEF25%-75%
d. MVV
25. A subject performed four acceptable FVC maneuvers.
Predicted Maneuver 1 Maneuver 2 Maneuver 3 Maneuver 4
FEV1 4.80 4.83 4.60 4.23 4.03
What do the results most likely represent?
a. Variable effort
b. Malingering
c. Inability to understand the test
d. Maneuver-induced bronchospasm
26. A 62-year-old female complaining of shortness of breath has the following spirometry results. Ambient temperature is 26 C (conversion factor = 1.068).
FEV1 FVC
Trial 1 2.10 2.65
Trial 2 1.96 3.11
Trial 3 1.99 2.99
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
27. 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)
28. What is the calculated bronchodilator response in this subject?
Pre-Drug Post-Dilator
FVC 4.5 4.8
FEV 2.8 3.9
a. 39%
b. 6%
c. 1.1 L
d. 71%
29. According to the ATS-ERS recommendations, what are the criteria for measuring an accurate height in a subject before testing?
1. Shoes off
2. Feet apart
3. Heels flat against wall
4. Standing upright
a. 1 and 4
b. 1, 2, and 4
c. 1, 3, and 4
d. All of the above
30. 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)
31. A 48-year-old female complaining of cough has the following spirometry results:
Pre-Drug % Predicted Post-Dilator
FVC 3.32 94 3.58
FEV1 2.34 79 2.75
FEV1/FVC 70.4 76.7
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
32. A 63-year-old male complaining of shortness of breath and muscle weakness has the following pulmonary function results:
Measured % Predicted
FVC 4.27 96
FEV1 3.29 93
FEV1/FVC 77.1
These findings are consistent with:
a. Normal study
b. Borderline obstruction
c. Neuromuscular weakness (e.g., ALS)
d. Mild obstruction
33. A 69-year-old female complaining of cough and shortness of breath has the following pulmonary function results:
Measured % Predicted
FVC 1.54 58
FEV1 1.22 57
FEV1/FVC 79.2
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 [Show Less]