Deck 9: Bronchoprovocation Testing

Question 1

After 5 minutes of hyperventilation breathing cold air,a subject's FEV₁ falls 16% from the pre-test value.The pulmonary function technologist should conclude that:

A) The subject has hyperreactive airways.
B) The air was not cold enough to provoke a response.
C) An additional 5 minutes of hyperventilation is required.
D) Inadequate CO₂ was added to the inspired gas.

Answer 1

A

Question 2

When developing an exercise bronchoprovocation test protocol,which of the following should be included?

A) The patient should be free from respiratory infections for 1 week before the test.
B) The patient should not do vigorous exercise for 4 hours before testing.
C) The exercise time is planned for 15 to 20 minutes.
D) A cycle ergometer is used to apply the work for the exercise.

Answer 2

B

Question 3

A subject performing a methacholine challenge test has the following reproducible results: The technologist should do which of the following?

A) Administer the first dose of methacholine.
B) Administer 2.50 mg/ml dose of methacholine.
C) Stop-the test is positive.
D) Administer an inhaled bronchodilator.

Answer 3

A

Question 4

What is the highest concentration of methacholine delivered according to the ATS dose-doubling or dose-quadrupling scheme?

A) 25 mg/ml
B) 16 mg/ml
C) 8 mg/ml
D) 4 mg/ml

Question 5

A patient presents with a history of cough after playing ice hockey.Spirometry and lung volume results are normal.Which of the following tests is indicated?

A) Diffusing capacity
B) Mannitol
C) Maximum inspiratory pressure
D) Arterial blood gas

Question 6

When multiple methods of bronchoprovocation are ordered on the same day,how many hours after an exercise test should elapse before another test is performed?

A) 1
B) 2
C) 3
D) 4

Question 7

Which of the following should be withheld for 48 hours before bronchial challenge testing?

A) Theophylline
B) $\beta$ -Adrenergic agents
C) Anticholinergic preparations
D) Beverages containing caffeine

Question 8

What is the typical inspiratory gas mixture when performing a eucapnic voluntary hyperventilation study?

A) 5% CO₂,21% O₂,balance N₂
B) 10% CO₂,balance O₂
C) 5% CO₂,balance O₂
D) 10% CO₂,21% O₂,balance N₂

Question 9

A 15-year-old subject performs an exercise challenge test on a treadmill to a heart rate of 180 beats per minute for 5 minutes and has the following reproducible results: The technologist should do which of the following?

A) The workload was not significant enough to elicit a response.
B) The duration was not significant enough to elicit a response.
C) The results were negative for exercise-induced bronchospasm.
D) The results were positive for exercise-induced bronchospasm.

Question 10

A subject performing a methacholine challenge test has the following repeatable results: The technologist should do which of the following?

A) Repeat methacholine 1.0 mg/ml dose.
B) Administer methacholine 4.0 mg/ml dose.
C) Give 10 breaths of the next dose.
D) Stop-the test is positive.

Question 11

A patient has a eucapnic voluntary hyperventilation (EVH)test to evaluate bronchial hyperreactivity.If the subject's FEV₁ is 3.3 L and her FVC is 4.0 L,which of the following is the appropriate target ventilation for the test?

A) 50 times the FEV₁ for 1 minute
B) 30 times the FEV₁ for 6 minutes
C) 2 times the FVC for 6 minutes
D) Cannot be determined without the MVV

Question 12

What does the acronym PC₂₀ represent?

A) The repeatability has to be 20% when performing a methacholine challenge.
B) The dose that yields a 20% decline in FEV₁
C) A 20% decline in specific conductance
D) A 20% increase in specific resistance

Question 13

Anticholinergic agents should be withheld for 24 hours.

A) 1 and 2
B) 3 and 4
C) 1 and 3
D) 2 and 4

Question 14

A subject performing a methacholine challenge test has the following reproducible results: The technologist should do which of the following?

A) Repeat methacholine 0.25 mg/ml dose.
B) Administer methacholine 1.0 mg/ml.
C) Give 10 breaths of the next dose.
D) Stop-the test is positive.

Question 15

A mannitol challenge is performed with the following results: What should the technologist do next?

A) Proceed to the next level.
B) Deliver a bronchodilator.
C) Terminate the test.
D) Repeat the maneuver.

Question 16

An exercise bronchoprovocation test was completed on a 45-year-old male.The FEV₁ decreased 18% post-exercise.The technologist should explain that this change is related to:

A) Release of mediators from inflammatory cells
B) A direct response of the airway smooth muscle to exercise
C) An exercise-induced increase in the number of inflammatory cells
D) A decrease in water loss from the airways

Question 17

When preparing methacholine dilutions for the doubling protocol from 100 mg of dry powder,which of the following would yield a dilution of 4.0 mg/ml?

A) 3 ml of 16.0 mg/ml
B) 3 ml of 8.0 mg/ml
C) 3 ml of 4.0 mg/ml
D) 3 ml of 2.0 mg/ml

Question 18

Which of the following is a direct bronchoprovocation test?

A) Methacholine
B) Mannitol
C) Adenosine
D) Exercise