Lab Med

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  1. What can PFTs measure?
    • Flow rates
    • Lungs volumes & capacities
    • Alveolar Gas diffusion
    • Lung muscle function
  2. What is "VC"?
    Vital Capacity - volume of air that can be expelled from fully inflated lungs after full inspiration
  3. What is FVC?
    • Forced Vital Capacity
    • Vital capacity with exhalation done at max effort
    • decreased in restrictive & severe obstructive
  4. What is VT?
    Tidal Volume - Volume of air that enters the lungs during normal inspiration and leaves during normal expiration
  5. What is FRC?
    Functional residual capacity - volume of air remaining in the lungs after completion of a normal exhalation
  6. What is ERV?
    Expiratory Reserve volume - volume of air that can be exhaled following a normal expiration
  7. What is RV?
    • Residual Volume - the volume of air remaining in the lung after a forced exhalation
    • decreased in restrictive
    • increased in obstructive
  8. What is TLC?
    • Total Lung Capacity - Total volume of air in the lungs after full inhalation
    • decreased in restrictive
  9. What is IC?
    Inspiratory Capacity - Maximum volume of air that the patient can inhale from a resting level
  10. What is IRV?
    Inspiratory reserve volume - Volume of air that can be inspired above normal inhalation
  11. What is FEV1?
    • Forced expiratory volume in one second
    • decreased in obstructive
  12. What is FEF?
    • Expiratory Flow Rate - Flow rate during the forceful exhalation of the middle half of the FVC maneuver
    • decreased in early obstructive and small airways
  13. What is FEV1%?
    • Percent of FVC exhaled during first second
    • decreased in obstructive
  14. What is Peak Flow?
    • Maximal flow rate that can be achieved during expiration
    • not usually reported on spirometry
  15. What are the indications for a PFT?
    • Evaluate pulmonary sx (cough, dyspnea, wheeze)
    • Screen for pulmonary disease in high risk for early detection
    • Monitor Pulmonary disease (response to therapy, progression)
    • Pre-Op eval
    • Legal & Disability determination
  16. What are some contraindications for PFT?
    • Severely debillitated person
    • Dementia
    • acture respiratory distress
    • Unstable angina
    • recent eye, abdominal, or thoracic surgery
  17. What is the PFT preparation?
    • No taking SABA for 6 hours
    • No taking LABA for 48 hours
  18. What is the FVC maneuver?
    • Breath normally (3 resting breaths)
    • Take full inspiration
    • exhale hard, fast, completely and continuous for 6 seconds or obvious plateu
    • Repeat twice until 3 acceptable tracings
  19. What is a DLco?
    Diffusion capacity - ability of gas to diffuse through alveoli
  20. What is the Gold Standard test for reversible obstructive symptoms?
    Methacholine Challenge Test - makes you spasm
  21. What are the indications for ordering a FULL PFT?
    • Restrictive Pattern on spirometry
    • Severe obstructive pattern on spirometry
    • Mixed pattern on spirometry
    • Inconsistent test or H&P results
  22. What are examples of obstructive diseases?
    • Asthma
    • Emphysema
    • Chronic bronchitis
    • bronchiectasis
    • cystic fibrosis
    • Fixed & variable upper airway disease
  23. What are examples of Restrictive disease?
    • Interstitial lung disease
    • Skeletal and Body
    • Pregnancy
    • Neuromuscular
  24. What are the levels for obstructive disease?
    • Mild - >70%
    • Moderate - 60-69%
    • Moderately severe - 50-59%
    • Severe - 35-49%
    • Very severe - <35%
  25. What are the levels of restrictive disease?
    • Normal - >80%
    • Mild - 70-79%
    • Moderate - 50-69%
    • Severe - <50%
  26. What are some diffusion capacity patterns?
    • Decreased in disease that effect alveoli
    • emphysema w/decrease SA
    • pulmonary fibrosis w/increased thickness
    • can be increased in asthma and pulmonary edema
    • False positve with anemia
  27. What are patterns that can be found in an obese patient?
    • Decreased Total lung capacity
    • Decreased SVC
    • Decreased MVV
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Lab Med
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