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PFTs
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Status
Last Update
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Published
09/08/2024
PFT Components include (3) {{c1::spirometry, DLCO, lung volumes}}
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Indications for PFTS: {{c1::symptoms, risk factors, exposure, screening (ie: amiodarone)}}
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contraindications for PFTs: {{c1::High pressure (brain/eye surgery, pneumothorax, glaucoma), sick (acute respiratory distress), hemoptysis}}
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{{c1::Spirometry}} is the best initial test for the evaluation of pulmonary function
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procedure for a spirometry test:The patient breathes forcefully through their mouth into an external device.Four phases of inspiration and expiration …
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{{c1::Forced Vital Capacity (FVC)}}: how much air is moving?
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normal forced vital capacity is {{c1::≥ 80% predicted}}
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if FVC is reduced → {{c1::RVC}}: resrictive disease which is divided into {{c2::intrinsic}} and {{c2::extrinsic}}
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{{c2::intrinsic}} restrictive disease has to do with the lungs, for example could be due to {{c1::pulmonary fibrosis, pulmonary edema}}
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{{c2::extrinsic}} restrictive disease does NOT have to do with the lungs, for example could be due to {{c1::scoliosis, obesity, neuromuscular disease}…
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{{c1::Forced Expiratory Volume in 1 second (FEV₁)}}: how fast is it moving?
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normal FEV1 is {{c1::≥ 80% predicted}}
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a decreased FEV1 (slower speed) indicates {{c1::obstructive}} disease ({{c1::expiration}} problem)
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examples of obstructive diseases are {{c1::COPD: chronic bronchitis, emphysema }}
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{{c1::FEV₁ / FVC Ratio}}: the portion of FVC that is expelled in 1 second
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a normal FEV₁ / FVC Ratio is {{c1::≥ 70%}}
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if FEV1/FVC ratio is ≤ 70% = {{c1::obstruction}} (a “{{c2::straw}}” problem, trouble getting air {{c2::out}})
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The top of a flow volume loop is {{c1::expiration}} and the bottom is {{c1::inspiration }}
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Flow Volume Loops:*{{c1::Flattening}} = narrowing in larger airways or tracheaVariable {{c4::extra}}thoracic obstruction: {{c2::inspiration}} pro…
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the methacholine challenge is indicated for patients with suspected airway {{c1::hyperresponsiveness}}.PFTs are performed before and af…
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methacholine challenge is the Gold standard for {{c1::asthma}} diagnosis: FEV₁ decrease of ≥ 12%
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{{c1::DLCO}}: diffusion capacity of the lungs for carbon monoxide (CO), normal = {{c2::76-140%}}
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{{c1::DLCO}} is measuring how well does air move from alveoli to capillaries
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DLCO: Hb has a high affinity for CO so it is a good indicator of gas movement across the alveoliInspire full breath of measured CO (used as a pro…
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variables assessed in DLCO:{{c1::Alveolar surface area}}: how much area is available to allow for diffusion?{{c2::Pulmonary perfusion}}: how much bloo…
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{{c1::Tidal volume}}: the volume of air moved in and out of the lungs during normal, quiet breathing
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{{c1::residual volume}}: the volume of air remaining in the lungs after a maximal expiration (maintains alveolar patency)
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{{c1::Expiratory reserve volume}}: the volume of air that can be further exhaled at the end of normal expiration
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{{c1::Inspiratory reserve volume}}: the volume of air that can be further inhaled at the end of normal inspiration
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{{c1::Vital capacity}}: maximum amount of air that can be exhaled following maximum inspiration, all the air that can be moved (IRV + TV + ERV)
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{{c1::Total lung capacity}}: the volume of air in the lungs at maximum inspiration (VC + RV)
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{{c1::Functional residual capacity (FRC)}}: volume of gas in the lungs at normal tidal volume end expiration (ERV + RV)↑ FRC = {{c2::hyperinflati…
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