PFT review

True or false

The new ATS/ERS guidelines for PFT interpretation from 2021 will do more emphasis on using PFT’s to classify physiology, in addition to aiding in clinical diagnosis .

• True

• False

Answer explanation

  What is true about the reference equations for PFT interpretation? (check all that apply)

• In USA it is recommended to use National Health and Nutrition Examination Survey 3 (NHANES 3) reference equations.

• The global lung indicative (GLI) reference equations are recommended to be used for spirometry, lung volumes and DLCO.

• There is more emphasis on incomplete understanding of role of race/ethnicity on lung function with the NHANES 3 reference equations.

• There is an option to use race neutral equations with GLI reference equations

• All of the above

Answer explanation

1.       How do the new ATS/ERS guidelines for PFT interpretation from 2021 define a NORMAL range ?

  

• Greater than lower limit of normal LLN ( 5^th percentile)

• Greater than LLN (5^th percentile) but below Upper limit of normal (95^th percentile)

• Use of a fixed ratio FEV₁/FVC

  > 0.70

• Use of percent predicted > 80%

Answer explanation

  What is defined as a bronchodilator response in spirometry according to new ATS/ERS guidelines for PFT interpretation from 2021?(check all that apply)

• >12% and 200 ml in FEV1 or FVC from baseline

• >10% of predicted value in FEV1 or FVC from baseline

•   >12% and 200 ml in FEV1/FVC from baseline

• >10% of predicted value in FEV1/FVC from baseline

• >10% and 200 ml in FEV1 or FVC from baseline

Answer explanation

What is true regarding severity classification in the new ATS/ERS guidelines for PFT interpretation from 2021?

• Use of FEV1 percent predicted for DLCO and Spirometry

• Use of z-scores for all measurements

• Use of FEV1 percent predicted for all measurements

• Use of z-scores for spirometry and DLCO

Answer explanation

14 year old with chronic dry cough and wheezing with exercise and colds undergoes spirometry and lung volumes. The values are as seen on figure 1. What type of physiological impairment does he have?

• A

• B

• C

• D

A 6 year old male with recently diagnosed duchenne’s muscular dystrophy presents to pulmonology clinic for the first time. He has full PFT’s. Which of the following would most accurately represent his physiological impairment?

• A

• B

• C

• D

Answer explanation

A 4 year old presented to the pulmonology clinic for the first time for evaluation of wheezing with colds. Which of the following would most accurately represent suboptimal effort?

• A

• B

• C

• D

Answer explanation

During your PFT reading week you are presented with following spirometry of an 18 year old male. Which of the following would most accurately represent his physiological impairment?

• Non-specific pattern with gas transfer impairment

• Restrictive impairment with gas transfer impairment

• Obstructive impairment

• Gas transfer impairment

Answer explanation

Spirometry has restrictive impairment but TLC > 5th percentile.

Additional testing may be helpful such as a BDR

True or false

A normal FVC usually excludes restriction

• True

• False