{"id":3942,"date":"2023-08-30T15:06:00","date_gmt":"2023-08-30T15:06:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=3942"},"modified":"2025-10-02T13:52:03","modified_gmt":"2025-10-02T21:52:03","slug":"pance-question-of-the-day-pulmonary-function-test-pft","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft","title":{"rendered":"PANCE\u00ae Question of the Day: Pulmonary function test (PFT)"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#The_correct_answer_to_todays_PANCE%C2%AE_Question_is%E2%80%A6\" >The correct answer to today&#8217;s PANCE\u00ae Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#A_Decrease_in_FEV1_following_methacholine_administration\" >A. Decrease in FEV1&nbsp;following methacholine administration<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#B_Increase_in_FEV1_from_400_mL_to_420_mL_following_albuterol_administration\" >B. Increase in FEV1&nbsp;from 400 mL to 420 mL following albuterol administration<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#C_DLCO_of_110_with_normal_PFTs\" >C. DLCO of 110% with normal PFTs<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#D_DLCO_of_75_with_normal_PFTs\" >D. DLCO of 75% with normal PFTs<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#E_Flattened_flow-volume_loop_in_inspiration_and_expiration\" >E. Flattened flow-volume loop in inspiration and expiration<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Prepare for the PANCE with this comprehensive topic on pulmonary function testing (PFT) in asthma assessment. Follow the case of a 29-year-old man presenting with dyspnea and dry cough, with a history of childhood asthma. Explore the vital signs, lung auscultation, and laboratory findings to determine the most likely PFT results for this patient. Ideal for physician assistant students and professionals seeking a deeper understanding of PFT interpretation and its significance in diagnosing and managing respiratory conditions. Ace your PANCE exam and excel in clinical practice with this valuable resource.<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 29-year-old man presents to the primary care clinic due to two months of mild intermittent dyspnea and dry cough. The patient was diagnosed with mild intermittent asthma as a child based on symptoms and previously used an albuterol inhaler when playing outside or playing sports, but has not used an inhaler during the last ten years. Vital signs are within normal limits. Lung auscultation demonstrates diffuse wheezing and decreased air movement bilaterally. Serum white blood cell count is 7,000\/mm3 (4,500-11,000\/mm3) and hemoglobin is 14.5 g\/dL (13.5-17.5 g\/dL). Which pulmonary function test (PFT) findings would most likely be found in this patient?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Decrease in FEV1&nbsp;following methacholine administration<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Increase in FEV1&nbsp;from 400 mL to 420 mL following albuterol administration<\/strong><strong>C. DLCO of 110% with normal PFTs<br><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. DLCO of 75% with normal PFTs<\/strong><strong>E. Flattened flow-volume loop in inspiration and expiration<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Scroll down to find the answer!<em>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_PANCE%C2%AE_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s PANCE\u00ae Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Decrease_in_FEV1_following_methacholine_administration\"><\/span><strong>A. Decrease in FEV1&nbsp;following methacholine administration<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the Main Explanation, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s PANCE\u00ae Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Increase_in_FEV1_from_400_mL_to_420_mL_following_albuterol_administration\"><\/span>B. Increase in FEV1&nbsp;from 400 mL to 420 mL following albuterol administration<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Asthma is diagnosed if the FEV1&nbsp;improves by \u226512% following bronchodilator therapy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This degree of response of 5% is inadequate to diagnose asthma and would require further testing.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_DLCO_of_110_with_normal_PFTs\"><\/span><strong>C. DLCO of 110% with normal PFTs<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;An isolated increased DLCO may indicate pulmonary hemorrhage, polycythemia, or a left-to-right shunt. This patient likely has asthma, which would lead to a reduced FEV1\/FVC and bronchodilator response in FEV1 of \u226512%. Asthma is not associated with significant changes in DLCO.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_DLCO_of_75_with_normal_PFTs\"><\/span>D. DLCO of 75% with normal PFTs<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>An isolated decreased DLCO may indicate pulmonary hypertension or anemia. This patient likely has asthma, which can be diagnosed with PFTs showing a reduced FEV1\/FVC and bronchodilator response in FEV1&nbsp;of \u226512%. Asthma is not associated with significant changes in DLCO.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Flattened_flow-volume_loop_in_inspiration_and_expiration\"><\/span>E. Flattened flow-volume loop in inspiration and expiration<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;A flattened loop in inspiration and expiration would be seen in fixed upper airway obstruction, such as tracheal stenosis. Asthma demonstrates a fixed lower airway obstruction pattern (normal inspiratory loop and a \u201cscooped out\u201d expiratory loop).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><\/h3>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\/md\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_b69893.png?w=700\" alt=\"\" class=\"wp-image-3443\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_b69893.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_b69893.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This patient with a history of asthma as a young child who is &nbsp;now presenting with a cough, shortness of breath and wheezing, likely has asthma.&nbsp;<strong>Asthma<\/strong>&nbsp;is an obstructive lung disease characterized by episodic inflammation and hyperresponsiveness of bronchial smooth muscles. These episodes lead to the narrowing of airways, causing decreased and turbulent airflow, which manifests in shortness of breath and wheezing. Asthma can be diagnosed with&nbsp;<strong>pulmonary function tests (spirometry)<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A&nbsp;<strong>decreased FEV1\/FVC ratio<\/strong>&nbsp;indicates obstructive disease (generally asthma or COPD). Providers can give patients &nbsp;an inhaled short-acting beta-agonist and then re-measure FEV1. If the&nbsp;<strong>FEV1&nbsp;increases by \u226512%<\/strong>, this positive response is diagnostic of<strong>&nbsp;asthma<\/strong>; however, patients can undergo further spirometric testing if asthma is suspected but the FEV1 increase is &lt;12%. A&nbsp;<strong>dramatic decrease in FEV1 after provocation<\/strong>&nbsp;(e.g., exercise,&nbsp;<strong>methacholine challenge<\/strong>) is also diagnostic of asthma. Flow-volume loops are also used as part of PFTs to evaluate for obstructive lung disease, but these loops cannot differentiate between COPD and asthma.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Asthma is characterized by episodic reversible bronchial inflammation and hyperreactivity. Patients with an obstructive pattern on PFTs (decreased FEV1\/FVC ratio) should be given a short-acting beta-agonist and have their FEV1\u00a0remeasured to assess for reversibility. An increase in FEV1\u00a0by \u226512% is diagnostic of asthma. A severe decrease in FEV1\u00a0with provocation testing (e.g., exercise, methacholine) also indicates asthma.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>_________________________<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Prepare for the PANCE with this comprehensive topic on pulmonary function testing (PFT) in asthma assessment. Follow the case of a 29-year-old man presenting with dyspnea and dry cough, with a history of childhood asthma. Explore the vital signs, lung auscultation, and laboratory findings to determine the most likely PFT results for this patient. Ideal [&hellip;]<\/p>\n","protected":false},"author":204,"featured_media":3943,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[20,38,1371,37],"tags":[],"class_list":["post-3942","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-exam-prep","category-pance","category-pance-questions","category-pa"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>PANCE\u00ae Question of the Day: Pulmonary function test (PFT) - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/pance-question-of-the-day-pulmonary-function-test-pft\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PANCE\u00ae Question of the Day: Pulmonary function test (PFT) - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Prepare for the PANCE with this comprehensive topic on pulmonary function testing (PFT) in asthma assessment. 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