Pulmonary function testing

Question 1

Define what peak expiratory flow rate (PEFR) is and state what is used to measure it

Answer 1

• The peak expiratory flow, also called peak expiratory flow rate, is a person’s maximum speed of expiration. Expressed in L/min
• It is measured with a peak flow meter

Question 2

What does the Diffusion capacity of carbon monoxide (DLCO) test measure ?

Answer 2

The DLCO measures the ability of the lungs to transfer gas from inhaled air to the red blood cells in pulmonary capillaries

Question 3

List the causes of a decrease DLCO

Answer 3

• Anaemia
• Emphysema
• Interstitial lung disease
• Pulmonary oedema
• Pulmonary emboli

Question 4

What is the use of DLCO testing?

Answer 4

It is used to monitor treatment response in Interstitial lung disease

Question 5

What is the expected FEV1 response to beta-2-agonist administration for asthma, COPD & restrictive lung disease ?

Answer 5

• > 15% improvement in asthma
• < 15% improvement in COPD
• No response in restrictive lung disease

Question 6

List the main causes of obstructive lung disease

Answer 6

• Asthma
• COPD
• Bronchiectasis
• Bronchiolitis obliterans

Question 7

State the expected spirometry results (FVC, FEV1, FEV1/FVC ratio, PEFR), DLCO & beta-2-agnoist response results for obstructive and restrictive lung disease

Answer 7

Question 8

List the main causes of restrictive lung disease

Answer 8

• Pulmonary fibrosis
• Asbestosis
• Sarcoidosis
• Acute respiratory distress syndrome (ARDS)
• Infant respiratory distress syndrome
• Kyphoscoliosis e.g. ankylosing spondylitis
• Neuromuscular disorders
• Severe obesity