The Diagnostic portion of the Respiratory Therapist Board Examination in the Philippines places a significant emphasis on Pulmonary Function Testing (PFT), which is essential for evaluating respiratory health and diagnosing pulmonary conditions. Mastery of these diagnostic tools is crucial for exam success and effective clinical practice.
Spirometry is a fundamental component of PFT that measures lung volumes and capacities, including Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), and the FEV1/FVC ratio. These parameters are critical in identifying obstructive and restrictive lung diseases, making their interpretation a frequent topic in board exams.
Diffusion Studies assess the efficiency of gas exchange, particularly through the Diffusing Capacity for Carbon Monoxide (DLCO) test. Knowledge of factors affecting DLCO, such as lung membrane thickness and blood flow, is essential for identifying conditions like emphysema and interstitial lung disease.
Plethysmography provides comprehensive lung volume measurements, including Total Lung Capacity (TLC) and Residual Volume (RV). This method is essential for detecting lung hyperinflation and air trapping, which are common in chronic obstructive pulmonary disease (COPD). Exam takers should be familiar with both the procedure and clinical interpretation of results.
The Methacholine Challenge Test evaluates airway hyperreactivity, an essential diagnostic tool for confirming asthma. Understanding the test's indications, contraindications, and interpretation criteria is vital for the exam, as respiratory therapists are often involved in asthma diagnosis and management.
A thorough understanding of these PFT procedures, their clinical significance, and accurate interpretation aligns with the competencies expected from board-certified respiratory therapists in the Philippines. Prospective examinees must develop analytical skills to interpret PFT results effectively and apply this knowledge to both theoretical questions and clinical scenarios presented during the licensure exam.
RESPIRATORY THERAPIST REVIEWER
Welcome to our Respiratory Therapist Reviewer. In this session, you'll have the opportunity to test your understanding of key concepts in Pulmonary Function Testing (PFT). The quiz consists of multiple-choice questions covering various topics. Pay close attention to each question and select the best answer. After completing the exam, check the video below for the answer key and explanations.
SPIROMETRY
1. Which parameter is most commonly used to assess airflow obstruction in spirometry?
A. FVC
B. FEV1
C. TLC
D. DLCO
2. A normal FEV1/FVC ratio is approximately:
A. 40%
B. 50%
C. 70-80%
D. 90-100%
3. What spirometry pattern is typically seen in restrictive lung disease?
A. Decreased FEV1 and decreased FVC with a normal or high FEV1/FVC ratio
B. Decreased FEV1 and normal FVC with a decreased FEV1/FVC ratio
C. Increased FEV1 and FVC
D. Normal FEV1/FVC ratio with an increased TLC
4. A post-bronchodilator increase in FEV1 of at least what percentage suggests reversible airway obstruction?
A. 5%
B. 12%
C. 20%
D. 25%
5. Which of the following values is most indicative of obstructive lung disease?
A. FEV1/FVC ratio of 85%
B. Normal FEV1 with decreased TLC
C. Increased FVC
D. FEV1/FVC ratio of 55%
6. In which condition would you expect a "scooped-out" pattern on a flow-volume loop?
A. Pulmonary fibrosis
B. Asthma
C. Pleural effusion
D. Neuromuscular disease
DIFFUSION STUDIES (DLCO)
7. DLCO is used to evaluate:
A. Airway hyperreactivity
B. Gas exchange efficiency
C. Static lung volumes
D. Pleural pressure
8. Which condition is associated with a decreased DLCO?
A. Pulmonary fibrosis
B. Asthma
C. Acute bronchitis
D. Upper airway obstruction
9. A patient with anemia is expected to have a:
A. Normal DLCO
B. Increased DLCO
C. Decreased DLCO
D. Variable DLCO
10. Which condition is likely to result in an increased DLCO?
A. Emphysema
B. Pulmonary embolism
C. Polycythemia
D. Pulmonary fibrosis
PLETHYSMOGRAPHY (LUNG VOLUMES)
11. Which lung volume cannot be measured by simple spirometry?
A. Tidal Volume (TV)
B. Residual Volume (RV)
C. Vital Capacity (VC)
D. Inspiratory Capacity (IC)
12. Total Lung Capacity (TLC) is the sum of:
A. RV + ERV
B. IRV + TV + ERV
C. IRV + TV + ERV + RV
D. VC + IC
13. Which test is most useful for determining lung hyperinflation in COPD?
A. Spirometry
B. DLCO
C. Body plethysmography
D. Methacholine challenge test
METHACHOLINE CHALLENGE TEST
14. The methacholine challenge test is primarily used to diagnose:
A. COPD
B. Pulmonary fibrosis
C. Asthma
D. Restrictive lung disease
15. A positive methacholine challenge test is indicated by a decrease in FEV1 of at least:
A. 5%
B. 10%
C. 15%
D. 20%
16. Which of the following conditions can lead to a false-positive methacholine challenge test?
A. Chronic bronchitis
B. COPD
C. Allergic rhinitis
D. All of the above
MISCELLANEOUS PFT QUESTIONS
17. Which condition would most likely present with a normal FEV1/FVC ratio but reduced lung volumes?
A. Asthma
B. Pulmonary fibrosis
C. Chronic bronchitis
D. Emphysema
18. What is the primary indication for performing a PFT?
A. Evaluate lung transplant eligibility
B. Measure arterial blood gases
C. Assess cardiac function
D. Diagnose and monitor lung diseases
19. Which parameter is used to differentiate obstructive from restrictive lung disease?
A. DLCO
B. FEV1/FVC ratio
C. TLC
D. RV
20. A patient with emphysema is expected to have which of the following PFT results?
A. Decreased FEV1, decreased FVC, and normal TLC
B. Decreased FEV1, normal FVC, and decreased TLC
C. Decreased FEV1, decreased FEV1/FVC, and increased TLC
D. Normal FEV1, normal FEV1/FVC, and decreased TLC
21. Which lung volume increases the most in patients with air trapping?
A. Inspiratory Reserve Volume (IRV)
B. Tidal Volume (TV)
C. Residual Volume (RV)
D. Expiratory Reserve Volume (ERV)
22. Which of the following conditions would likely present with a normal DLCO?
A. Pulmonary fibrosis
B. Chronic bronchitis
C. Emphysema
D. Pulmonary embolism
23. What is the most important safety precaution when performing a Methacholine Challenge Test?
A. Ensure the patient is fasting for 8 hours
B. Have bronchodilators readily available
C. Keep the patient in a supine position during testing
D. Monitor arterial blood gases every 5 minutes
24. What is the significance of a decreased inspiratory flow in a flow-volume loop?
A. Upper airway obstruction
B. Restrictive lung disease
C. Bronchial asthma
D. Pulmonary embolism
25. Why is helium dilution NOT ideal for measuring lung volumes in patients with severe obstruction?
A. It cannot measure FEV1 accurately
B. It requires a large number of maneuvers
C. It underestimates lung volumes due to air trapping
D. It causes bronchoconstriction
26. What is the main advantage of body plethysmography over gas dilution techniques?
A. It can measure airflow resistance
B. It is less expensive
C. It is easier to perform
D. It does not require patient cooperation
27. A patient with restrictive lung disease is expected to have which of the following spirometry findings?
A. Decreased FVC, decreased FEV1, normal FEV1/FVC
B. Increased FEV1, decreased FEV1/FVC, decreased TLC
C. Decreased FVC, normal FEV1, decreased FEV1/FVC
D. Increased TLC, increased FEV1, decreased DLCO
28. What is the primary indication for performing a bronchodilator reversibility test?
A. Diagnose chronic bronchitis
B. Assess DLCO
C. Measure lung compliance
D. Differentiate asthma from COPD
29. A patient with severe COPD has the following PFT results: low FEV1, low FEV1/FVC, high RV, and high TLC. What does this pattern indicate?
A. Restrictive lung disease
B. Airway hyperresponsiveness
C. Air trapping and lung hyperinflation
D. Pulmonary fibrosis
30. Which of the following is an expected finding in a patient with an acute asthma attack?
A. Increased FEV1/FVC ratio
B. Decreased Peak Expiratory Flow Rate (PEFR)
C. Increased DLCO
D. Increased inspiratory reserve volume
ANSWER KEY HERE