Pulmonary Function Testing
Case 12
A 44 year-old woman with cirrhosis secondary to chronic alcohol abuse and Hepatitis C presents with complaints of increasing dyspnea. She reports that her dyspnea is worse when she is sitting upright or walking but improves when she is lying flat. She is an active cigarette smoker. On exam, she has a room air oxygen saturation of 88% in the sitting position and a room air oxygen saturation of 96% in the supine position.
Her pulmonary function testing is as follows:
| Pre-Bronchodilator (BD) | Post- BD | ||||
|---|---|---|---|---|---|
| Test | Actual | Predicted | % Predicted | Actual | % Change |
| FVC (L) | 3.94 | 3.69 | 107 | 3.86 | -2 |
| FEV1 (L) | 2.76 | 3.03 | 91 | 2.85 | 3 |
| FEV1/FVC (%) | 70 | 82 | |||
| RV (L) | 1.89 | 1.86 | 102 | ||
| TLC (L) | 5.67 | 5.40 | 105 | ||
| RV/TLC (%) | 33 | 33 | |||
| DLCO* corr | 10.22 | 28.22 | 36 | ||
| *DLCO is measured in ml/min/mmHg | |||||
| Check abbreviations>> | |||||
A flow-volume loop is not available for this case.
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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