med 610 clinical respiratory diseases & critcare med

Pulmonary Function Testing

Case 8

A 64 year-old woman presents with complaints of dyspnea and orthopnea. She is a life-long non-smoker.

Her pulmonary function testing is as follows:

  Pre-Bronchodilator (BD) Post- BD
Test Actual Predicted % Predicted Actual % Change
FVC (L) 1.00 2.51 40 1.02 3
FEV1 (L) 0.61 2.00 30 0.69 13
FEV1/FVC (%) 61 80   67 10
RV (L) 1.15 1.55 74    
TLC (L) 2.08 4.04 52    
RV/TLC (%) 55 39      
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Her spirometry is repeated with her in the upright and supine positions:

Test Upright Supine
FVC (L) 0.49 0.37
FEV1 (L) 0.82 0.68
FEV1/FVC (%) 0.60 0.54
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Her flow volume loop in the upright position is as follows:

flow volume loop graph

 

Describe the pattern of abnormality, if one is present.

Grade the severity of the abnormality.

Generate a differential diagnosis for the observed abnormality.

 

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