Mansoor, 67, is height 165 cm and has been a smoker for 50 years.

He has a history of increasing shortness of breath, chest infections, chronic cough, and hospital admissions (2 in the past 2 years) for respiratory failure secondary to pneumonia. His breathlessness is reproducibly related to effort. A recent chest X-ray shows significant hyperinflation.

Mansoor is referred for lung function tests to document ventilatory function and response to bronchodilator.

Question 2

Which of the following statements are true related to this condition? Select as many as you wish

 a. Expiratory flow volume curves usually show a reduced peak flow followed by a sharp drop in expiratory flows to RV.
 b. The inspiratory curve will show poorly maintained flows.
 c. Spirometry will reveal a very low FEV1, reduced FVC and low FEV1/FCV ratio.
 d. The degree of hyperinflation (increased TLC) and large RV become obvious when flow is plotted against absolute lung volume.
 e. There is usually little improvement in the shape of the flow volume loop or spirometry post bronchodilator.

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Answer 2

a. Expiratory flow volume curves usually show a reduced peak flow followed by a sharp drop in expiratory flows to RV.
  b. The inspiratory curve will show poorly maintained flows F.
c. Spirometry will reveal a very low FEV1, reduced FVC and low FEV1/FCV ratio.
d. The degree of hyperinflation (increased TLC) and large RV become obvious when flow is plotted against absolute lung volume.
e. There is usually little improvement in the shape of the flow volume loop or spirometry post bronchodilator.

All correct apart from selection 2.