Pulmonary Function Testing
Case 5
A 41 year-old woman presents to the General Internal Medicine Clinic at Harborview Medical Center complaining of dyspnea with mild exertion. She has a 10 pack-year history of smoking and a history of using intravenous drugs including heroin and ritalin.
Her pulmonary function testing is as follows:
| Pre-Bronchodilator (BD) | Post- BD | ||||
|---|---|---|---|---|---|
| Test | Actual | Predicted | % Predicted | Actual | % Change |
| FVC (L) | 0.90 | 3.09 | 29 | 0.74 | - 17 |
| FEV1 (L) | 0.49 | 2.57 | 19 | 0.44 | -10 |
| FEV1/FVC (%) | 54 | 83 | 59 | 8 | |
| RV (L) | 3.83 | 1.49 | 257 | ||
| TLC (L) | 4.78 | 4.44 | 108 | ||
| RV/TLC (%) | 80 | 33 | |||
| DLCO* corr | 0.75 | 24.85 | 3 | ||
| *DLCO is measured in ml/min/mmHg | |||||
| Check abbreviations>> | |||||
His flow volume loops is as follows:
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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